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Astigmatism is a common treatable condition that involves an imperfect curvature of the eye that causes blurry vision both near and far away. This problem is a type of refractive error that affects the eyes and is very common.
Astigmatism develops when either the cornea, which is the front surface of the eye, or the intraocular lens have inconsistent curvatures. Rather than featuring a singular curve akin to a round ball, the surface exhibits the form of an egg. Vision becomes blurry at different distances as a result of this condition.
In many cases, astigmatism develops from birth and may coexist with other vision problems like nearsightedness or farsightedness. In many cases, its intensity doesn’t call for corrective action. However, in situations where correction is required, viable treatment options include the use of corrective eyewear or surgical procedures.
Symptoms
Astigmatism signs and symptoms may include the following:
- Distorted or blurred vision
- Seeing a glare or halos surrounding lights
- Squinting to see clearly
- Sensation of eyestrain or discomfort
- Headaches
- Challenges related to night vision.
If an individual experience eye problems that interfere with their ability to enjoy activities or do daily duties, they should see an eye specialist. A skilled ophthalmologist can determine whether astigmatism is present and how severe it is. They can then advise them on various corrective actions that they might take to improve their visual acuity.
Conducting eye condition screenings and measuring children’s visual acuity are essential for ensuring the health of their vision. This can be accomplished by having assessments carried out by experts like pediatricians, ophthalmologists, optometrists, or skilled screeners.
Screening should occur at the following ages and time intervals:
- In the newborn period
- At well-child visits until school age is attained
- Throughout the school years, with screenings taking place every 1 to 2 years at well-child appointments, optometrist visits, or via screenings organized by schools or public health programs.
Causes
Primarily, astigmatism is often inherited, indicating that it’s a condition passed down from parents to their offspring. It could emerge subsequent to an eye injury, illness, or surgical procedure.
There are two structures in the eye with curved surfaces that are in charge of reflecting light onto the retina. The cornea, the clear front surface of the eye filled with tear fluid, and the lens, clear component inside the eye, are two examples of these structures. The lens has the capacity to change its shape, which helps the eye focus on objects that are close by.
In instances where either the cornea or the lens assumes an oblong shape, characterized by two incongruous curves, the refraction of light rays becomes uneven. This leads to the formation of two distinct images. These images overlap or merge, ultimately leading to the manifestation of blurred vision. Astigmatism is classified as a form of refractive error within this context.
Astigmatism develops when the cornea or lens exhibits a steeper curvature in one direction than another. Astigmatism in the cornea results from the cornea’s uneven curvatures, whereas astigmatism in the lens is caused by the lens’s irregular curvatures. Vision blurriness could start to appear as a result of either type of astigmatism. Certain angles, such as horizontal, vertical, or diagonal, may cause this blurriness to stand out more.
Astigmatism has the potential to manifest alongside additional refractive errors, encompassing:
- Nearsightedness (myopia): The cornea has excessive curvature or the eye is longer than average both lead to this problem. Light converges anterior to the retina instead of achieving precise focus on it, resulting in a blurred vision of distant objects.
- Farsightedness (hyperopia): When the cornea has too little curvature or the eye is shorter than average, this disorder develops. In a state of relaxation, the eye fails to bring light to a focal point at the rear, causing nearby objects to appear unfocused and blurry.
Diagnosis
Astigmatism diagnosis is performed by an eye care specialist through a comprehensive eye examination. This examination involves a complete evaluation of the eyes on the inside as well as the outside.
- Visual acuity test: A visual acuity test is conducted to assess your vision. You’ve undergone a visual acuity test if you’ve ever examined a chart of letters or symbols on a wall as part of an eye examination.
- Refraction test: Your eye care expert will quantify the degree to which light focuses and refracts upon entering your eye.
- Keratometry: The test will measure the curvature of the cornea.
- Slit lamp exam: The eye specialist illuminates the patient’s eye using a slit lamp, a particular microscope fitted with a radiant light source. They will modify the brightness and thickness of the light beam to observe the distinct layers and components within your eye.
Treatment
The main goals of astigmatism treatment are to promote eye comfort and improve visual clarity. The use of corrective lenses or having refractive surgery are two of the treatment options that are available.
- Corrective lenses: Astigmatism is treated by wearing corrective lenses, which balance out the irregular curvatures of your cornea or lens. Some treatment may include:
- Eyeglasses: Lenses within eyeglasses are crafted to counterbalance the uneven shape of the eye. This corrective measure ensures appropriate bending of light within the eye. Eyeglasses have the capability to rectify additional refractive errors, including nearsightedness or farsightedness.
- Contact lenses: Contact lenses possess the ability to effectively address the majority of cases of astigmatism. These lenses come in diverse types and styles, offering a versatile range of options for correction.
Contact lenses are also used in the orthokeratology method. To gradually restore the eye’s curvature, hard contact lenses are worn overnight while an individual sleep. In order to maintain the newly attained shape, lens usage frequency is afterwards decreased. It’s crucial to know that stopping treatment causes the eye to return to its original shape and refractive error. Long-term contact lens use increases the risk of developing eye infections. It is advisable to speak with an eye care professional about the benefits, drawbacks, and possible risks of wearing contact lenses. The best option for the unique situation will be determined by this discussion.
- Refractive surgery: Refractive surgery improves eyesight while reducing the need for glasses or contact lenses. A laser beam is used in this treatment by an eye specialist to alter the cornea’s curvature and correct the refractive error. Eye specialist will evaluate the eligibility and determine whether they are a candidate for refractive surgery before they have surgery.
Types of refractive surgery for astigmatism include:- Laser-assisted in-situ keratomileusis (LASIK): In this technique, an eye surgeon creates a thin, pivotable flap within the cornea. The surgeon employs an excimer laser to sculpt the cornea’s shape before repositioning the flap.
- Laser-assisted subepithelial keratectomy (LASEK): The thin protective layer (epithelium) of the cornea is carefully loosened with a special alcohol by the physician. The surgeon next reshapes the cornea’s curvature using an excimer laser before repositioning the loose epithelium.
- Photorefractive keratectomy (PRK): This technique bears resemblance to laser-assisted subepithelial keratectomy (LASEK), with the exception that the surgeon removes the epithelium. The epithelium grows back naturally, adopting the newly shaped cornea. Following the surgery, it might be necessary to wear a bandage contact lens for several days to aid in the healing process.
- Epi-laser-assisted in situ keratomileusis (LASIK): An alternative method involves the surgeon utilizing a specialized mechanized blunt blade, instead of alcohol, to delicately separate a thin layer of epithelium. Afterward, the surgeon employs an excimer laser to reshape the cornea before reattaching the separated epithelial sheet.
- Small-incision lenticule extraction (SMILE): A more recent type of refractive surgery uses a laser to create a lens-shaped piece of tissue (lenticule) beneath the cornea’s outer layer in order to reshape the cornea. Then, a tiny incision is made to remove this lenticule. Currently, only minor cases of nearsightedness can be treated using the SMILE method.
Clear lens removal and the use of implanted contact lenses are further methods of refractive surgery. It’s crucial to understand that there isn’t a single “best” option for refractive surgery, and the choice should only be made after a thorough evaluation and in-depth discussion with the specialist.
Under- or over-correction of the original problem, visual side effects including halos or starbursts around lights, dry eye, infection, corneal scarring, and, in rare cases, vision loss are all potential consequences after refractive surgery. To fully evaluate the potential benefits and risks of these treatments, it is imperative to have a thorough discussion with the eye specialist.
