Astigmatism

Diagnosis

Astigmatism is diagnosed during a comprehensive eye exam. The evaluation includes tests for overall eye health and refraction tests, which measure how your eyes bend light.

Your eye doctor may:

• Use specialized instruments to examine your eyes

• Shine bright lights directly into your eyes

• Ask you to look through multiple lenses to test vision clarity

These tests help the doctor determine how light is focused in your eyes and the prescription needed to correct your vision with eyeglasses or contact lenses.

Treatment

The main goal of treating astigmatism is to improve vision clarity and reduce eye strain or discomfort. Treatments usually involve corrective lenses or refractive surgery.

Corrective lenses

Corrective lenses adjust for the uneven curvature of the cornea or lens, helping light focus properly on the retina.

• Eyeglasses. Lenses are designed to counteract irregular eye shape, improving vision. Eyeglasses can also correct other vision issues such as nearsightedness or farsightedness.

• Contact lenses. Contacts can correct most cases of astigmatism. They come in different types and styles, including toric lenses specifically designed for astigmatism.

Wearing contact lenses for long periods can increase the risk of eye infections. Discuss the best option for your lifestyle and eye health with your doctor.

Refractive surgery

Refractive surgery reshapes the cornea to reduce dependence on glasses or contact lenses. Your doctor will evaluate whether you are a suitable candidate before the procedure.

Types of refractive surgery for astigmatism include:

• LASIK (Laser-Assisted In-Situ Keratomileusis). A thin corneal flap is created and reshaped using a laser, then repositioned.

• LASEK (Laser-Assisted Subepithelial Keratectomy). The outer layer of the cornea is loosened with alcohol, reshaped with a laser, and replaced.

• PRK (Photorefractive Keratectomy). The cornea’s outer layer is removed and allowed to grow back after laser reshaping. A bandage contact lens is worn for a few days.

• Epi-LASIK. Similar to LASEK, but a mechanized blade separates the outer corneal layer instead of alcohol.

• SMILE (Small-Incision Lenticule Extraction). A laser removes a small tissue lens (lenticule) inside the cornea through a tiny incision, reshaping it. SMILE is currently approved mainly for mild nearsightedness.

Other surgical options include clear lens extraction and implantable contact lenses. The choice of procedure depends on your eye health, prescription, and lifestyle.

Potential complications after refractive surgery may include:

• Undercorrection or overcorrection of vision

• Visual disturbances such as halos or starbursts around lights

• Dry eyes

• Infection

• Corneal scarring

• Rarely, vision loss

Discuss the benefits, risks, and expectations of surgery thoroughly with your eye doctor before making a decision.