What is Astigmatism?

Astigmatism is a common eye condition that causes blurry vision. It results from an imperfect curvature of the cornea, the clear dome that sits over the iris and pupil. The cornea ideally should have the same curvature both horizontally and vertically. This allows light rays to be focused at a single point, which allows us to see a clear image.

Astigmatism is a refractive error, meaning that it affects how your eye bends light. When the horizontal curvature is greater than the vertical curvature of the cornea, or vice versa, light is unable to be focused on a single point, resulting in blurred vision at both near and distance.

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What Causes Astigmatism?

The direct cause of an astigmatism is unknown; however, it is thought to be closely related to genetics. Some are born with astigmatism but there is also the possibility that it could develop later on in life. Astigmatism can also develop due to an injury to the eye or develop after eye surgery and can affect your vision up close or far away. You may be at risk for developing astigmatism if you have:

  • Thinning or scarring of the cornea
  • A family history of astigmatism or other eye disorders such as keratoconus
  • Undergone eye surgery
  • Excessive farsightedness or nearsightedness
  • Experienced direct injury to the eye or surrounding eye area

What are the Symptoms of Astigmatism?

The symptoms of astigmatism can vary person to person. Common symptoms may include but are not limited to:

  • difficulty seeing or driving at night
  • blurry or distorted vision at all distances (up close and far away)
  • constant eye strain or squinting
  • headaches

Treatment Options for Astigmatism

While many patients have very mild cases of astigmatism, some instances may be more severe and can create significant visual distortion. Mild to moderate astigmatism is easily treated with corrective eyeglasses or contact lenses, while more severe instances of the condition can be corrected through a variety of refractive surgeries.

LASIK for Astigmatism

LASIK is a procedure performed by a surgeon with a laser that can reshape the cornea and thus correct the patient’s astigmatism to create clearer vision. Because your eyes and your vision are as unique to you as your fingerprints and DNA, it’s very difficult for us to know whether LASIK eye surgery can benefit you without an eye examination.

While anyone interested in LASIK will need to schedule a consultation, these are the basic qualifications to be a candidate:

  • 18 years or older
  • Stable vision for at least one year (same prescription)
  • Healthy cornea based on pre-operative screening

LASIK has been a huge success in helping those who have experienced astigmatism and is more affordable than continuing to spend money on glasses and contact lenses every year.  The average national cost of LASIK was $2,135 per eye in the first half of 2017 but can range of $1000 to $4000 per eye. The cost usually includes the initial consultation, the procedure, and post-operative follow-up care.

Flexible spending accounts (FSA’s) and Health savings accounts (HSA’s) are employer-sponsored programs allowing pre-tax dollars to be set aside for medical costs giving you the opportunity to get LASIK virtually tax-free!

Learn More about Interest-Free Financing and Tax-Free Savings for LASIK

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Treating Astigmatism through Cataract Surgery

There is also an opportunity to correct astigmatism permanently by way of cataract surgery. The two main methods to correct astigmatism are:

These are both performed at the same time as cataract surgery and result in reduced astigmatism and, often, reduced dependence on glasses. Neither LRIs nor toris lenses are covered by insurance and require an out of pocket fee.

Limbal Relaxing Incisions (LRI)

For small amounts of astigmatism, a technique call Limbal Relaxing Incisions works well. It is a procedure that can be performed either at the beginning or end of cataract surgery. It involves making arc-shaped incisions in the cornea at the areas of steeper curvature. The goal of the incisions is to flatten these areas, correcting astigmatism and resulting in good distance vision without glasses.

Toric IOLs

For higher amounts of astigmatism, where limbal relaxing incisions do not work very well, Toric (astigmatism-correcting) intraocular lenses are very effective. These lenses have greater focusing power in certain parts of the lens in order to cancel out astigmatism of the cornea. The lenses are rotated during surgery to be oriented at the axis of astigmatism. The lenses are more predictable than LRIs as their effectiveness is not variable depending on the healing response of the cornea as is the case with LRIs.

Common Questions About Astigmatism

Can astigmatism get worse?

Unfortunately, astigmatism can change and worsen throughout your lifetime. It can slowly progress with age and is partially influenced by heredity and environment; however, it is very common and easily corrected with glasses, contact lenses, or refractive surgery.

Can astigmatism go away?

Unfortunately, there is no cure for astigmatism or preventative measures that can prevent it from worsening over time. Having astigmatism is not a disease and it typically does not lead to any other problems. You can discuss with your doctor the best ways to correct the condition and see what would be the best approach given your lifestyle and vision goals.

Can astigmatism be corrected?

Yes, there are ways to help correct astigmatism! You can easily correct astigmatism using glasses and contact lenses or by having refractive surgery such as LASIK, PRK, ICL or a refractive lens exchange.

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