Preemies often have an uphill battle to meet developmental milestones, but most catch up by the age of two with little or no long-term effects.1 Optometrists already know to be on the lookout for retinopathy of prematurity in these infants, but new research suggests they should keep an eye on the cornea, too. 

Investigators in Germany studied 11,294 eyes of 7,120 participants in the Gutenberg Health Study, all of which self-reported a low birth weight (commonly below five pounds, 8 ounces in the United States).2,3 Participant ages ranged from 40 to 80, with a mean of 56.2 years. Assessing their anterior segment anatomy and axial length, as well as anterior chamber depth and lens thickness in those with phakia, revealed an association between low birth weight and corneal changes. Patients who were smaller at birth had steeper corneal curvature, smaller white-to-white distance, thinner central corneal thickness and shorter axial length. 

The researches noticed patients with phakia showed no association between their birth weight and anterior chamber depth and lens thickness.

The data suggests that “birth weight and associated factors are crucial in anatomical ocular morphologic development,” the researchers wrote in their paper. They also noted retinopathy of prematurity and its treatment may affect the ocular anatomy, but was beyond the scope of the study.  


1. Supporting You and Your Preemie: Milestone Guidelines for Premature Babies. American Academy of Pediatrics. 2008.
2. Fieß A, Schuster AK, Nickels S, et al. Association of low birth weight with altered corneal geometry and axial length in adulthood in the German Gutenberg Health Study. JAMA Ophthalmol. February 21, 2019. [Epub ahead of print]. 
3. Low birthweight. Children’s Hospital of Philadelphia. Accessed march 1, 2019.