Medically Reviewed by Jack Abrams, MD
Astigmatism is a common vision problem that affects millions of people worldwide. If you’ve been diagnosed with astigmatism or suspect you might have it, you’re likely wondering about your treatment options. This article explores the various ways to correct astigmatism, from traditional eyewear to advanced surgical procedures. Read on to discover which solution might be best for you and how each option works to improve your vision.
Treating Astigmatism with Eyewear, Contacts, and Surgery
The American Optometric Association says that most people have some degree of astigmatism. This condition may be present from birth or develop later in life, and it can increase or decrease over time.
Astigmatism is defined as unequal curvatures in the shape of the cornea or lens. The cornea and lens focus light on the retina, the area of the eye that sends light signals to the brain, allowing us to see. This imperfection results in blurred vision.
If you think you might have astigmatism, or if you’ve recently been diagnosed with astigmatism, read on to learn more about some of the available astigmatism treatment options.
Types of Astigmatism
Astigmatism often occurs with myopia (nearsightedness) or hyperopia (farsightedness):
Myopic astigmatism
In the myopic eye, light rays focus in front of the retina, blurring objects in the distance. Individuals with myopia with astigmatism experience even worse blurring due to the refractive error caused by mismatched curvatures of the cornea or lens.
Hyperopic astigmatism
In people who are farsighted, the light focuses beyond the retina. Individuals with hyperopia and astigmatism experience blur the closer items become.
Mixed astigmatism
In people with mixed astigmatism, one curvature of the cornea or lens focuses light in front of the retina and the other focuses light behind the retina.
Signs and Symptoms of Astigmatism
To be diagnosed with astigmatism, you must be examined by your eye doctor. You’ll take visual acuity tests to determine if you are able to see clearly at various distances, and various instruments will be used to measure how your eyes focus.
Instruments used to diagnose astigmatism
The American Academy of Ophthalmology identifies three instruments that an eye doctor uses to measure astigmatism:
- Auto refractor – This tool measures how light shined into your eyes changes as it refracts off the back of your eye.
- Topography machine/Keratometer – Measures the refraction of light from your cornea to determine the amounts of corneal curvature.
- Phoropter – This instrument contains a series of lenses that you look through to determine the amount of prescription needed to correct your vision.
Symptoms of astigmatism
Because the curvature of your cornea and lens differs from others who share the condition, the symptoms of astigmatism can differ from one sufferer to the next. Generally, the symptoms of astigmatism include:
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- Starbursts at night
- Eye strain and/or squinting
- Blurry or fuzzy vision close up
- Difficulty seeing far away
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- Headaches
Astigmatism Treatment Options: Corrective Lenses
Lenses (temporary) or refractive surgery (permanent) are used to correct astigmatism. If myopia or hyperopia are present in addition to astigmatism, these conditions must also be corrected.
Eyeglasses
If you choose eyeglasses to correct your astigmatism, your prescription will include two measurements that are specific to astigmatism: cylinder and axis.
- Cylinder (CYL) is a measurement that indicates the lens power for astigmatism.
- Axis is measured in degrees from zero to 180 and refers to the position of astigmatism on the cornea.
If you are nearsighted or farsighted, you will also notice “sphere power” on your eyeglass prescription. The higher the number in your prescription, the more severe the condition. A plus sign indicates farsightedness, and a minus sign indicates nearsightedness.
Contact Lenses
Astigmatism was previously corrected with rigid contact lenses. Today, soft toric contact lenses also correct astigmatism.
Toric contact lenses provide more comfort for patients with astigmatism and, according to the American Optometric Association, a “high degree of accuracy and producibility.” Toric lenses are made to bend light in a direction to correct astigmatism.
In more severe cases of astigmatism, an eye doctor may recommend a gas-permeable, rigid contact lens instead of soft toric lenses. Rigid lenses correct astigmatism by creating a spherical service on the surface of the eye.
A third option is Orthokeratology (Ortho-K) treatment. Patients wear Ortho-K rigid lenses for a period of time to reshape the cornea curvature. The correction will occur as long as treatment is ongoing. If treatment ceases, astigmatism will return.
Can LASIK Fix Astigmatism?
Yes, laser surgery can fully correct astigmatism and reduce or even eliminate the need for prescription lenses in most cases. For patients with higher degrees of astigmatism, LASIK often achieves excellent results, and in some cases, a follow-up procedure can further enhance vision clarity and precision.
New LASIK options are available for individuals with higher levels of astigmatism and myopia. Wavefront-guided LASIK (WFG) uses an excimer laser to normalize complex curvatures and irregularities on the cornea. The American Academy of Ophthalmology states that laser ablation results in improved outcomes, including better night vision and fewer visual symptoms of astigmatism.
Femtosecond LASIK uses a femtosecond (FS) laser to create incisions at a specific, pre-programmed depth in the cornea to correct refractive errors. The procedure’s predictability can provide outstanding results.
Is LASIK the Right Option to Correct Astigmatism?
If you are a good fit for this LASIK, you can reap many benefits. The main reason so many people turn to LASIK with astigmatism is that it may improve their vision to the point where they no longer need glasses or contacts.
If you are looking for an eye doctor to discuss surgical or corrective options for astigmatism, connect with our eye care professionals to learn if you may be a good candidate for LASIK.