Astigmatism is a treatable and common imperfection in the eye curvature that causes blurred near and distance vision. It happens when either the cornea or the lens inside the eye has mismatched curves. Typically the eye has one curve, just like a round ball, but with an astigmatism the surface of your eye is instead egg-shaped. This can cause blurred vision. It usually shows up at birth, but it can also happen in combination with farsightedness or nearsightedness.
Symptoms of an Astigmatism
Symptoms of astigmatism can include difficulty with night vision, headaches, discomfort or eyestrain, squinting, or distorted or blurred vision.
Causes of an Astigmatism
The eye is made up of the lens and the cornea. The lens is the clear part inside the eye that changes shape in order to help you focus on near objects. The cornea is the front surface of the eye along with your tear frame. If you don’t have an astigmatism then these elements are round, just like a ball.
If the lens or cornea are instead curved then you have an astigmatism. Lenticular astigmatism occurs if the lens is curved, and corneal astigmatism is when the cornea has curves. Either type can cause blurred vision.
There are a few risk factors for astigmatism. It can be hereditary and present at birth or develop after surgery or injury. It can increase or decrease over time. It can also happen because of a rare eye condition called keratoconus. With keratoconus, the cornea becomes cone-shaped and thinner over time.
When to See Your Eye Doctor
If your eye symptoms are distracting from your enjoyment of your everyday tasks and activities then it’s important to see an eye doctor.
Diagnosis
Symptoms from astigmatism can come on slowly, which is why it’s important to see an eye doctor when you notice changes in your vision. In order to diagnose astigmatism, you will need a full eye exam. The eye doctor will test your eyesight by having you read an eye chart. There are other tools used as well. A keratometer can be used to measure the cornea curve, and an autorefractor will be used to shine a light into your eye to see how it bounces off the back. With this tool, the eye doctor can learn more about which lenses you may need.
Astigmatism in Children
Many people can be born with astigmatism and it can go away by the time the child is one. Since children aren’t able to tell you if there are issues with their vision, it’s important to get regular eye exams at certain intervals beginning at six months of age.
Astigmatism in the Elderly
Astigmatism will typically get worse with age. The cornea becomes irregular with age because of lessening pressure from the eyelids losing muscle tone as you get older. It can remain stable until about 59 years old, but after age 60, the curvature gets worse with each decade. However, your eye doctor can help you manage your astigmatism as you grow older and treatment options are still available even as you age.
Treatment Options for Astigmatism
There are two different types of treatment for astigmatism.
Corrective Lenses: Corrective lenses include both contacts or glasses. Your eye doctor will typically prescribe a type of contact lens called a toric lens. Toric lenses can bend light in more than one direction. If your astigmatism is more severe then there are other types of lenses that may be right. You may get gas-permeable lenses and a procedure called orthokeratology. You will wear lenses when you sleep in order to reshape the cornea. After the cornea is reshaped, you will still need to wear the lenses in order to keep the new shape, but you don’t have to wear them as long.
Refractive Surgery: Laser surgery can also change the shape of the cornea. These surgeries include LASIK and PRK. In order to have refractive surgery, you will need to have healthy eyes with no corneal scars or retina problems.
Astigmatism and Cataract Surgery
There are three choices to eliminate or reduce astigmatism in cataract surgery to leave you with better vision without cataract lenses or glasses.
Limbal Relaxing Incisions: During cataract surgery, cataract experts can do limbal relaxing incisions in order to correct astigmatism. Experts use computer programs to get precise corrections of small amounts of astigmatism. Eye doctors will make relaxing incisions in the cornea. For patients who have larger degrees of astigmatism, this treatment option may not be strong enough.
TORIC Intraocular Implant: For those who do have a larger degree of astigmatism, a TORIC intraocular lens can reduce it. This is a premium implant that corrects the astigmatism. While the incisions correct astigmatism in the corneal plane, the lens implants fix the astigmatism at the lens plane. Patients are typically very satisfied with the results from this treatment option, even if they do have to pay more for this implant.
LASIK: After cataract surgery, eye surgeons can then perform LASIK to eliminate or reduce astigmatism. Both the TORIC implant and limbal relaxing incision can leave small amounts of astigmatism left over. In order to get rid of any residual astigmatism, laser vision correction or LASIK can be used. Patients tend to feel less comfortable that there is a bit of astigmatism leftover from other treatment options so LAISK is an effective, precise, and safe way to finish the job. A patient may elect to have a standard intraocular lens during cataract surgery and then decide that astigmatism reduction is something they want and LASIK can be used to eliminate astigmatism.
Benefits of Toric Contact Lenses
The best choice for those who want to wear contacts with astigmatism is toric contact lenses. These lenses are specifically designed to fix the problem. The shape of the lens creates different refractive solutions and focuses to help fix both lenticular and corneal astigmatisms. The lenses have a thicker zone to prevent them from rotating when in your eyes. This means that they help you orient the lens the same way so you can always be able to see. Toric contact lenses do need to be put in your eye in a specific way so making sure you have the exact fit is important. If the lenses don’t fit right then they won’t do much to help your vision.
Contact Florida Eye Specialists and Cataract Institute
If you have astigmatism and are suffering from issues in your vision, there are treatment options. The eye doctors and specialists at Florida Eye Specialists and Cataract Institute are here to help. With experienced and highly trained doctors in seven locations to serve you, you are only a phone call away from treatment. Contact us for an appointment!
