If you wear glasses or other corrective lenses, you’re probably at least familiar with astigmatism even if you don’t understand it. A lot of people will call it “stigmatism” but the right name is astigmatism. It refers to a specific eye condition that affects how light is focused in your eye.
When someone has astigmatism, it means that light doesn’t focus on the retina and then the vision isn’t clear. What ends up happening is that there are multiple points of focus that cause vision to be out of focus.
Get to Know All About Astigmatism
When you have astigmatism, your vision gets blurry and can cause you headaches or eye strain. You’re likely to experience these issues if you’ve been staring at a screen or a book for a length of time. You might even find yourself squinting.
The most common cause of this vision problem is a cornea that isn’t shaped normally, also known as corneal astigmatism. It tends to look more like a football instead of a basketball. As a result, one of the meridians curves more than it is supposed to.
In other cases, astigmatism is a result of having an irregularly shaped lens inside your eye. This version of this eye condition is also known as lenticular astigmatism.
You’re going to see words like refraction, too, and it will help to know what words like that mean. Refraction is the way light bends as it goes through a lens to the next surface. Some telescopes, as an example, use refractive lenses.
Your eyes function the same way and interpret light differently depending on the curvature of your eye. That’s why someone with astigmatism can have mild or severe vision problems while someone with a normal cornea does not.
Types of Corneal Astigmatism
There are three primary types of corneal astigmatism. They are myopic, hyperopic, and mixed astigmatism.
Mixed astigmatism occurs when one meridian is farsighted while the other is nearsighted. Hyperopic astigmatism is a result of two meridians being farsighted. Myopic astigmatism occurs when meridians are nearsighted.
Corneal astigmatism is also categorized into either regular or irregular classifications. Regular astigmatism happens naturally, while irregular astigmatism tends to be a result of injury, eye surgery, or another eye disease.
Testing for Astigmatism
Eye issues tend to rear their heads when people are young. That is why, you often hear that you need to get your children’s vision checked. By doing so, you can correct astigmatism and steer clear of potential vision problems.
During a routine eye exam, your eye doctor will be able to identify whether or not you have astigmatism as he or she checks for any nearsighted or farsighted issues. At some point, your eye doctor may also shine a light in your eye.
By shining the light into your eye, your eye doctor can assess just how much astigmatism you’re dealing with. In some cases, it might be more of a slight case, and in others, it may be more severe. The actual test that is conducted with the light is called a retinoscopy.
There are other ways of also testing for this eye condition with more sophisticated eye exam instruments as well. These pieces of automated refractive machinery test for astigmatism quickly and efficiently. This is in addition to assessing any other potential eye issues in the process.
You may also undergo what is called manual refraction. This is when your eye doctor uses a phoropter, or a multi-lens unit, to have you compare lenses. If you’ve been to an eye doctor before, you’ll recognize this as the time when the doctor asks you, “which one is better? 1 or 2?”
As the eye doctor goes through the lenses with you to determine which one is going to best correct your vision, he or she will be able to provide a prescription depending on your answers.
There are a few different ways that you can correct astigmatism. You’re not limited to glasses or contacts, although those tend to be the most popular options. Alternatively, you can also choose to undergo refractive surgery.
If you were to choose corrective lenses, then you’re going to be looking at correcting the eye issue by providing a way to correct the meridians. That’s where the prescription comes in. As an example, if your prescription were to be -3.75 -2.0 x 90, there is a specific meaning behind each number.
The -3.75 is the sphere power to correct myopia, or nearsightedness, in the flattest meridian inside your eye. The next number, -2.0, is the power for myopia correction for the meridian that is more curved than the flat one. The final number, the 90, is the axis of astigmatism. This is where the flatter meridian is located on a 180-degree scale.
Once the prescription has been designated, your options include what are called toric lenses, gas-permeable lenses, or refractive surgery like LASIK in addition to traditional eyeglasses. Toric lenses are designed to include all three of the above.
Gas-permeable lenses are hard lenses and virtually replace the cornea. As it stands, your cornea has a refracting surface that allows you to see thanks to the light that gets into your eye. A gas permeable lens becomes that surface when you put it into your eye, and your vision is corrected.
LASIK surgery is a popular option for those who have astigmatism as well. The procedure is capable of correcting most cases of this eye problem. But to be sure, you’ll have to go in for an assessment or evaluation to see if you’re a candidate.
Deciding on Astigmatism Surgery
Corrective lenses are pretty self-explanatory. You get a prescription, and you wear them. Simple, right? But what about surgery?
The truth is that surgery is a permanent fix for astigmatism. But in choosing surgery, you’re going to have a lot of questions from how much it costs, what the expected recovery time will be, and whether or not you would even be a viable candidate.
You may also be surprised to know that one type of corrective surgery does not fit all cases of astigmatism. To give you a general overview, myopic and hyperopic surgeries tend to overlap. Your best options for these types of astigmatism are going to be LASEK, LASIK, and PRK, as they all reshape the cornea.
PRK or photorefractive keratectomy is a laser surgery that will correct moderate astigmatism by reshaping the cornea via a UV laser beam. LASEK treats similar cases of astigmatism, but a surgeon cuts into your cornea and uses a pulsating cool laser to reshape as needed.
LASIK is appropriate for mild astigmatism while LASEK or PRK are better options for more moderate cases. Don’t worry, though, because if you have a high level of astigmatism, all is not lost.
Should you be dealing with severe corneal astigmatism, then you’re going to end up choosing AK or astigmatic keratotomy. This surgery is more invasive compared to the others because it is a manual change as opposed to laser surgery like the others.
Someone will literally shape your cornea to reshape it into a properly occurring cornea. Depending on the severity, your eye doctor may recommend combining AK with LASEK, LASIK, or PRK.
If your lenticular astigmatism is more severe, then you’re going to consider something like RLE or refractive lens exchange. This is a much more invasive surgery than the others because your cornea is cut open and your lens is entirely removed. A new lens is then implanted permanently.
It is also possible that you may need more than one procedure to achieve an optimal vision, especially if your case is more severe.
Due to the range of surgical options, the level of astigmatism that you’re currently dealing with doesn’t matter. Technology today allows for surgery for every level of astigmatism. The only difference is the type of surgery and how invasive it really is to get your eyes working without any other corrective steps.
What is the Cost of Astigmatism Surgery?
This is usually one of the most common questions, but it is a difficult one to answer with a one-size-fits-all kind of response. Truthfully, the cost of such a surgery varies quite a bit because it depends on the type of astigmatism you have as well as your location.
Something else to consider is how many procedures is it going to take to correct your eye issues. If you have more severe astigmatism, you
may end up going through multiple procedures which are naturally going to cost more than someone who needs a single visit to correct mild problems.
But Is It Safe?
Generally speaking, yes, all of these surgeries are safe, but that doesn’t mean they aren’t without risk. If your surgeon doesn’t remove enough corneal tissue, then you won’t get a complete correction. If this happens, then you’ll need to either go through a second round, or you’ll need to wear corrective lenses.
On the other hand, you may have a surgeon who is laser-happy and ends up cutting off too much of your cornea. If that happens, you’ll still end up with lenses, and you may not be able to fix this kind of mistake.
Although rare, some patients will also lose some of their vision or their vision will change so much that they don’t like what happens after surgery. It’s not comfortable anymore, and some people can’t handle it as well as they thought they could. You’ll need to be aware going in that these things are possible even if there aren’t many reports about it.
There may also be side effects to undergoing surgery like eye infections, glares, double vision, lack of night vision, dry eyes, and other things. Eye infections are a real possibility because your eyes are being reshaped and don’t always heal properly.
Depending on how the surgeon cuts your eye, you may also experience double vision or glares at night when you’re driving. It is a real possibility that your vision may end up worse during low-light situations such as at dawn or at twilight.
Your eyes may also feel extremely dry for a long while after surgery. If that happens, you’re probably going to need to depend on eye drops to make your eyes feel normal for a while. There is also no guarantee that dry eyes will ever go away.
A Quick Rundown
To summarize, we’ve put together this list of bullet points that we think will help you understand everything you’ve read so far.
Astigmatism is common, and for some with mild astigmatism, it may even go completely unnoticed.
You can also suffer from significant vision problems as children or adults when you have astigmatism.
There are two types – corneal and lenticular.
Corneal astigmatism is the most common.
There are three types of corneal astigmatism – hyperopic, myopic, and mixed.
Astigmatism results in blurry or possible distortion regardless of the distance.
If you have astigmatism, you may have regular headaches, you may feel generally tired, and your eyes can feel strained.
Astigmatism doesn’t usually have a cause when it happens naturally. You can, however, develop this vision problem after eye surgery or injury.
You are born with it, and as children grow, sometimes it gets better, and other times it gets worse.
The only way to definitively diagnose astigmatism is to have a full eye exam by a licensed eye doctor.
Typical ways to treat astigmatism include corrective lenses like eyeglasses or contacts, in addition to refractive surgery.
Before you make that final decision, though, find out which type of surgery you’ll need if you want to go that route. Ask questions, get answers, and don’t decide until you’re ready for whatever may come.