Astigmatism Treatment
Recognizing the Signs You Need Astigmatism Treatment
One of the most common signs of astigmatism is vision that appears blurry or distorted whether you are looking at something near or far away. Astigmatism can blur vision at multiple distances, while nearsightedness and farsightedness have different patterns of blur that vary depending on the degree of refractive error and your ability to focus.
You might notice that straight lines appear wavy or that letters and numbers seem to blur together when you read. This happens because light entering your eye does not focus evenly on the retina.
When your eyes work harder to focus through the irregular curvature of astigmatism, you may develop headaches or feel tired after reading or using a computer. This eye strain often gets worse as the day goes on.
- Headaches that start around your forehead or temples
- Tired or achy eyes after screen time or reading
- Difficulty concentrating on visual tasks
- A feeling of pressure behind your eyes
Many people with astigmatism notice that their vision problems become more noticeable in dim lighting or at night. You might see halos or starbursts around lights when driving after dark.
This happens because your pupils dilate in low light, allowing more light to pass through the irregular parts of your cornea or lens. Correcting your astigmatism can make nighttime activities safer and more comfortable.
If you find yourself squinting often to see signs, read text, or watch television, you may have uncorrected astigmatism. Squinting reduces incoming light and increases depth of focus through a pinhole effect, which can temporarily make vision seem sharper, but it is not a long-term solution.
Constant squinting can lead to more eye strain and headaches. Our eye doctor can prescribe corrective lenses that eliminate the need to squint throughout your day.
Not everyone with astigmatism needs treatment right away. Some people have very mild astigmatism that does not interfere with daily activities.
- Your symptoms affect work, school, or hobbies
- You experience frequent headaches or eye strain
- You have difficulty driving, especially at night
- Your vision has worsened over time
How We Test and Measure Your Astigmatism
During your eye exam, we start with a visual acuity test where you read letters on a chart at different sizes. This helps us understand how well you can see at various distances.
Next, we perform a refraction test using a special instrument called a phoropter. We will ask you to look through different lenses and tell us which ones make your vision clearer. This process helps us determine the exact prescription you need to correct your astigmatism.
A keratometer is a device that measures the curvature of your cornea, the clear front surface of your eye. Since most astigmatism comes from an irregularly shaped cornea, this measurement is very important.
The test is quick and painless. You simply rest your chin on a support and look at a target while the device takes measurements. These numbers help us understand the type and degree of astigmatism you have.
For a more detailed picture of your cornea, we may use corneal topography. This advanced technology creates a color-coded map showing the precise shape and curvature of your entire corneal surface.
- Identifies irregular astigmatism that standard tests might miss
- Helps plan for contact lens fittings or laser surgery
- Detects early signs of corneal conditions like keratoconus
- Provides measurements we can track over time
Your astigmatism prescription includes three main numbers. The first number shows the sphere power for nearsightedness or farsightedness. The second number, called the cylinder, indicates the amount of astigmatism. The third number, the axis, shows the orientation of the astigmatism on a scale from 0 to 180 degrees.
We will explain what your prescription means and how it translates into the right corrective lenses for you. Understanding these numbers can help you make informed decisions about your treatment options.
Correcting Astigmatism with Eyeglasses
Eyeglasses for astigmatism use special lenses called toric lenses. Unlike regular spherical lenses, toric lenses have different powers in different meridians to match the irregular shape of your eye.
These lenses bend light more in one direction than the other, compensating for the uneven curvature of your cornea or lens. This correction can provide clear, focused vision at the distances affected by your astigmatism.
When selecting glasses for astigmatism, the frame you choose can affect your visual comfort. Frames that position the lenses close to your eyes and hold them securely in place work best for higher amounts of astigmatism.
- Consider lens materials like polycarbonate for durability and lighter weight
- Anti-reflective coatings reduce glare, especially helpful at night
- Thinner lens designs improve appearance and comfort
- Proper frame fit keeps the axis alignment correct
If this is your first pair of glasses for astigmatism, or if your prescription has changed significantly, you may need a few days to adjust. Your brain needs time to adapt to the new way your eyes are focusing.
You might notice some distortion at the edges of your vision or mild dizziness at first. These sensations usually go away within a week. If discomfort persists, contact our office so we can check your prescription and frame fit.
Your eyes can change over time, so we recommend annual eye exams to keep your prescription current. Come in sooner if you notice your vision becoming blurry again or if your headaches return.
Children and teenagers may need more frequent updates as their eyes grow and develop. Adults over 40 might also need adjustments as presbyopia begins to affect near vision alongside astigmatism.
Contact Lens Options for Astigmatism
Just like toric eyeglass lenses, toric contact lenses have different powers in different meridians to correct astigmatism. These lenses must stay in a specific position on your eye to work properly.
Manufacturers design toric contacts with special features like weighted bottoms or thin zones that interact with your eyelids to keep the lens from rotating. Modern toric lenses are designed to provide stable, clear vision throughout the day for most wearers.
Soft toric contact lenses are the most popular choice because they are comfortable and easy to adapt to. They come in daily, biweekly, and monthly replacement options to fit different lifestyles.
Rigid gas permeable lenses, sometimes called RGP lenses, may provide sharper vision for people with higher amounts of astigmatism or irregular corneas. They take longer to get used to but can last a year or more with proper care.
Fitting contact lenses for astigmatism requires more precision than fitting regular contacts. We measure not only the shape of your eye but also how the lens rotates and settles on your cornea.
- We evaluate the fit while you wear trial lenses
- Multiple follow-up visits ensure optimal comfort and vision
- We check that the lens axis aligns correctly with your prescription
- Fine-tuning the fit prevents blurry vision or discomfort
Proper care keeps your contact lenses comfortable and your eyes healthy. We will recommend a cleaning solution and schedule based on the type of lenses you choose.
Daily disposable lenses require no cleaning, making them convenient and reducing infection risk. Biweekly and monthly lenses need cleaning and disinfecting every night. Follow these essential safety practices to protect your eye health:
- Wash your hands thoroughly before handling lenses
- Never expose lenses to water, including while swimming, showering, or in hot tubs
- Do not top off old solution in your case; empty it, rinse with fresh solution, and let it air dry
- Replace your contact lens case every three months
- Replace lenses on the recommended schedule and never wear them longer than prescribed
- Remove lenses immediately and contact us urgently if you have significant pain, light sensitivity, or sudden decreased vision
When astigmatism is irregular due to conditions like keratoconus, corneal scarring, or complications after surgery, standard soft or rigid lenses may not provide clear vision. Specialty contact lenses such as scleral lenses or hybrid lenses can vault over the irregular cornea and create a smooth optical surface.
- Scleral lenses rest on the white of the eye and bridge over the cornea, offering excellent comfort and vision for advanced irregularities
- Hybrid lenses combine a rigid center for crisp optics with a soft outer skirt for comfort
- Custom rigid gas permeable designs can be tailored to complex corneal shapes
- These lenses require specialized fitting, detailed measurements, and close monitoring
- Many patients with previously uncorrectable vision achieve functional sight with these options
Laser Eye Surgery for Astigmatism
LASIK is a popular laser surgery that can provide long-term reduction of astigmatism by reshaping the cornea. During the procedure, we create a thin flap in the cornea, use a laser to remove precise amounts of tissue, and then replace the flap.
The laser reshapes the cornea to a more regular curve, allowing light to focus properly on the retina. Results are intended to be long-lasting, though vision can change over time due to natural aging or other factors. Many people who have LASIK for astigmatism can reduce or eliminate their dependence on glasses or contacts, though some may still need them for certain tasks or may benefit from enhancement procedures.
PRK, or photorefractive keratectomy, is another laser procedure that corrects astigmatism without creating a corneal flap. Instead, we gently remove the outer layer of the cornea, reshape the underlying tissue with a laser, and allow the surface to heal naturally.
PRK may be a better option if you have thinner corneas or certain corneal irregularities. Other procedures like SMILE or advanced surface ablation may be considered in specific cases depending on your eye anatomy and prescription.
If your astigmatism is caused by keratoconus or another form of corneal ectasia, laser vision correction is typically not appropriate and may worsen the condition. Our eye doctor will use corneal topography and other tests to detect these conditions before recommending any surgery.
Treatment focuses on stabilizing the cornea and optimizing vision with specialty contact lenses. Corneal cross-linking is a procedure that strengthens corneal tissue and can halt progression of ectasia in many cases. In advanced situations, intracorneal ring segments may be considered, and in selected severe cases, corneal transplantation may be necessary. We will coordinate your care with corneal specialists if these conditions are identified.
Some people are not good candidates for laser vision correction due to very high prescriptions, thin corneas, or other factors. In selected cases, our eye doctor may discuss alternative surgical options such as phakic intraocular lenses, also called implantable collamer lenses or ICL, or refractive lens exchange.
Phakic IOLs are implanted in front of your natural lens and can correct higher degrees of nearsightedness, farsightedness, and astigmatism. Refractive lens exchange replaces your natural lens with an artificial lens, similar to cataract surgery. These procedures carry different risks and benefits and are determined on an individual basis in consultation with a refractive surgeon.
Preparing for and Recovering from Laser Surgery
Not everyone with astigmatism is a candidate for laser surgery. We look at several factors to determine if surgery is right for you.
- You are typically at least 18 years old, often older, with a stable prescription demonstrated over one to two years
- Your corneas are thick enough, with no signs of ectasia or irregular topography patterns
- You are not pregnant or nursing, as hormonal changes can temporarily alter your prescription and tear film
- You do not have uncontrolled dry eye, blepharitis, or active eye infections
- You do not have certain autoimmune conditions or factors that impair wound healing
- Your astigmatism and overall prescription fall within the treatable range
- You have realistic expectations about the results and understand the risks
Laser eye surgery is typically quick, with the actual laser time lasting seconds to a couple of minutes per eye, though total time in the surgical suite may be longer. We numb your eyes with drops, so you should not feel pain during the procedure. You may feel pressure and see some lights or blurring.
Recovery differs by procedure type. LASIK patients often notice vision improvement within a day, with mild discomfort for the first few hours. PRK involves more discomfort for several days, a bandage contact lens during early healing, and gradual vision improvement over days to weeks. Complete healing can take several weeks to months for either procedure.
Aftercare is essential for the best outcome and safety:
- Do not rub your eyes, which can displace a LASIK flap or disrupt healing
- Wear protective eye shields as directed, especially while sleeping
- Avoid swimming, hot tubs, and contaminated water for the period specified by our office
- Avoid eye makeup during the early healing phase
- Use all prescribed eye drops exactly as directed to prevent infection and control inflammation
- Attend all follow-up appointments, including the next-day visit
- Contact us immediately if you have worsening pain, rapidly decreasing vision, or increasing light sensitivity
Like any surgery, laser vision correction carries some risks. Possible complications include dry eyes that may be persistent, glare or halos around lights, undercorrection or overcorrection, regression requiring enhancement, irregular astigmatism or higher-order aberrations, flap-related complications with LASIK, corneal ectasia or progressive weakening, inflammation or infection, and in rare cases significant vision loss or chronic neuropathic eye pain.
Many people achieve improved vision after surgery, with outcomes depending on your baseline prescription, corneal health, healing response, age, and other individual factors. Some people may still need glasses for certain activities like reading or night driving. We will discuss your individual risks and expected outcomes during your consultation to help you make an informed decision.
Astigmatism Correction During Cataract Surgery
If you have both cataracts and astigmatism, we can address both conditions during cataract surgery. Toric intraocular lenses are artificial lenses with built-in astigmatism correction that replace your natural lens during cataract removal.
These specialized lenses have different powers in different meridians, similar to toric contact lenses or eyeglasses. The surgeon positions the lens at a precise angle inside your eye to match the axis of your astigmatism. For many patients, toric IOLs reduce or eliminate astigmatism while also restoring clear vision after cataract removal.
Another option for managing astigmatism during cataract surgery is limbal relaxing incisions or arcuate keratotomy. The surgeon makes small, precise incisions at the edge of the cornea to reshape its curvature and reduce astigmatism.
These techniques can be used alone or in combination with toric IOLs depending on the amount and type of astigmatism you have. We will evaluate your corneal measurements and discuss which approach offers the best outcome for your individual situation.
What to Expect After Astigmatism Correction
When you start wearing glasses or contacts for astigmatism, your vision typically improves quickly. However, your eyes and brain may need a brief adjustment period, especially if your correction is strong or this is your first time wearing corrective lenses.
Wear your new correction as much as possible during the first week to help your eyes adapt faster. If you switch between your old and new prescription or go without correction, the adjustment period may take longer.
Proper care extends the life of your corrective lenses and protects your eye health. Clean your eyeglasses daily with a microfiber cloth and lens cleaner, and store them in a protective case when not in use.
- Wash your hands before handling contact lenses
- Use only recommended cleaning solutions for your lens type
- Replace contact lens cases every three months
- Never sleep in lenses unless they are approved for overnight wear
- Keep glasses away from extreme heat or pressure that could warp the frames
We typically schedule a follow-up visit a few weeks after you receive new glasses or contacts to make sure everything is working well. These appointments let us check your vision and address any comfort issues.
After that, annual eye exams help us monitor your eye health and update your prescription as needed. Children, people with progressive astigmatism, and those who have had eye surgery may need more frequent visits.
Even with the right correction, your vision can change over time. Watch for signs that your prescription may no longer be accurate.
- Blurry or unclear vision even with your glasses or contacts
- Headaches that return or worsen
- Increased eye strain or fatigue
- Difficulty seeing at night or reading small print
Most issues with astigmatism correction are minor and can wait for a regular appointment. However, certain symptoms require immediate attention from our eye doctor.
Contact us right away if you experience sudden vision loss, severe eye pain, flashes of light, a curtain or shadow blocking your vision, or signs of infection like redness, discharge, or swelling. These could indicate serious problems unrelated to your astigmatism that need prompt treatment.
Frequently Asked Questions
Astigmatism usually does not go away without treatment, as it results from the physical shape of your cornea or lens. In some cases, astigmatism can change gradually over the years, either improving slightly or worsening. Regular eye exams help us track these changes and adjust your treatment accordingly.
Many people need ongoing correction for astigmatism throughout their lives, though the degree may change. Laser surgery can provide long-term or permanent correction for some people, reducing or eliminating the need for glasses or contacts. Your individual needs depend on how stable your prescription remains and which treatment you choose.
Some people with very mild astigmatism may achieve acceptable vision with regular spherical contact lenses. However, toric lenses designed specifically for astigmatism typically provide clearer, more comfortable vision. We will evaluate your prescription and visual needs to recommend the best lens type for you.
Vision insurance often covers part of the cost of eyeglasses or contact lenses for astigmatism, though coverage varies by plan. Medical insurance may cover eye exams and treatment when they are medically necessary, such as for symptoms, eye disease, or monitoring conditions like diabetes, while routine vision correction typically falls under vision benefits. Laser surgery is usually considered elective and not covered, but some plans offer discounts. We recommend checking with your insurance provider to understand your specific benefits.
Each correction method has advantages depending on your lifestyle, prescription, and preferences. Eyeglasses are convenient and low maintenance, contact lenses offer wider peripheral vision and freedom during activities, and laser surgery can reduce long-term dependence on corrective lenses. We will help you weigh the pros and cons of each option based on your unique situation.
Yes, children can and should receive treatment for astigmatism if it affects their vision or development. Uncorrected astigmatism in children can interfere with learning and may lead to amblyopia, also known as lazy eye. Eyeglasses are the most common treatment for children, though older teenagers may be candidates for contact lenses. Laser surgery is typically not recommended until the eyes have finished growing, usually after age 18.
Getting Help for Astigmatism Treatment
If you are experiencing blurry vision, headaches, or other signs of astigmatism, we encourage you to schedule a comprehensive eye exam. Our eye doctor will test your vision, measure your astigmatism, and work with you to find the correction method that best fits your needs and lifestyle.