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Astigmatism occurs when your eyeball has a slightly irregular curvature. This makes it so that your eye cannot focus light properly on the retina, resulting in blurry vision far away and up close. This condition is common and typically corrected with glasses, contacts, or surgery.
Other vision conditions (refractive errors) include myopia (nearsightedness), hyperopia (farsightedness), and presbyopia (age-related farsightedness). You can have a combination of different refractive errors, for example, myopia and astigmatism in one eye, and hyperopia plus astigmatism in the other eye.
Research shows that there is likely a genetic component involved in astigmatism and other eye health issues. Astigmatism may develop in infancy or later on in life.
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People with very mild astigmatism may not have any symptoms. If astigmatism worsens, you may notice vision problems such as:
Astigmatism develops when the curvature of your eye is abnormal. This may happen for a few reasons:
Most people have regular astigmatism. This means the two different curvatures of your eye are 90 degrees apart. Irregular astigmatism occurs when the cornea has more than two curvatures that are not 90 degrees apart.
Irregular astigmatism is not very common and may develop from an eye disease called keratoconus, which causes abnormal steepening and thinning of the cornea. Other causes include eye injury and complications from laser eye surgery.
The eye doctor can diagnose astigmatism by performing a few tests:
If you find yourself struggling with daily activities such as driving, reading, or computer work, consult your eye doctor. Some of the main symptoms that indicate you need correction for astigmatism include blurry vision, headaches, squinting, eye strain, and reduced night vision.
Other signs you may need glasses include:
The eye doctor can examine your eyes to ensure you do not have serious eye conditions that may cause similar symptoms.
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There are different types of materials used for your corrective lenses. They include, in order from thickest to thinnest:
Choosing the right type of lens for vision correction depends on the degree of astigmatism, along with any myopia or hyperopia correction. Generally, the higher your prescription, the thinner the lens you should choose. Thinner lenses also tend to be lighter, although Trivex material is lighter than high-index plastic.
When the eye doctor writes your eyeglass prescription, you should notice a number under the “cylinder” (CYL) section if you have astigmatism. This number indicates how much astigmatism you have, which is measured in diopters (D):
Other tips for choosing eyewear for astigmatism:
If you prefer not to wear glasses, there are other ways to treat astigmatism.
Contacts that correct astigmatism are available as:
LASIK is a form of laser eye surgery that corrects astigmatism, along with myopia or hyperopia. Typically, LASIK can treat up to 6.00 D of astigmatism. However, if your corneas are thin or you have a corneal disease (such as keratoconus), the surgeon may not be able to perform the procedure.
An alternative laser eye surgery is PRK (photorefractive keratectomy). Some people with thinner corneas or higher prescriptions are better candidates for PRK than LASIK.
Other refractive surgeries that correct astigmatism involve placing a lens implant inside the eye. A refractive lens exchange removes the natural lens inside your eye and replaces it with an intraocular lens implant (IOL). These steps are the same as cataract surgery.
The other type of surgery is called a phakic intraocular lens implant surgery. Instead of removing the natural lens, the surgeon leaves it in place and inserts an IOL in front of your natural lens. This IOL can be removed or replaced later.
If you experience any of these symptoms from astigmatism, you may require glasses to correct your vision: blurry vision, headaches, squinting, eye strain, reduced night vision, double vision, difficulty reading, distortion in your vision, halos when driving at night.
Corrective eyeglasses help bend the light passing through your eye to focus on the retina correctly to produce a sharper image.
It depends on the severity of your astigmatism. If your astigmatism is severe, high-index, Trivex, or polycarbonate lenses are best. See an eye care professional for the most personalized recommendation.
For many people, astigmatism stays the same, or barely changes over time. Sometimes it does cause your vision to get worse with time. This depends on your corneal health and whether you have other eye conditions such as keratoconus.
Chuck, Roy S., et al. “Refractive Errors & Refractive Surgery Preferred Practice Pattern.” Ophthalmology, vol. 125, no. 1, 2017, doi:10.1016/j.ophtha.2017.10.003
Kaiser, Peter K., and Neil J. Friedman. The Massachusetts Eye and Ear Infirmary Illustrated Manual of Ophthalmology. Saunders, Elsevier, 2009
Lopes, Margarida C., et al. “Identification of a candidate gene for astigmatism.” Investigative ophthalmology & visual science vol. 54,2 1260-7. 1 Feb. 2013, doi:10.1167/iovs.12-10463
Nanavaty, Mayank A., and Sheraz M. Daya. “Refractive Lens Exchange versus Phakic Intraocular Lenses.” Current Opinion in Ophthalmology, vol. 23, no. 1, Jan. 2012, pp. 54–61., doi:10.1097/icu.0b013e32834cd5d1