Studies show astigmatism affects between 30% and 60% of adults in Europe and Asia, making it one of the most common vision problems worldwide. Your eye’s shape, especially when the cornea or lens isn’t perfectly round, causes this refractive error that blurs or distorts vision at any distance. People can develop astigmatism from birth or get it later in life, and it affects both children and adults.
Your eyes might be dealing with astigmatism if you notice blurred vision, eyestrain, headaches, poor night vision or catch yourself squinting more than usual. The sort of thing I love about treating astigmatism is that once you understand why it happens in your eye, finding the right treatment becomes clearer. Doctors recognise two main types corneal and lenticular astigmatism and each needs its own approach to vision correction.
The condition often shows up among other vision problems like nearsightedness or farsightedness. That’s why you need a detailed assessment from expert surgeons with advanced diagnostic technology to find the best treatment for your specific case. This piece will give you a full picture of astigmatism types, why they happen, and the treatment options available today.
Understanding Astigmatism and How It Affects Vision
Let’s understand what happens in an astigmatic eye by first looking at how vision normally works. Your eye is a complex organ that has several parts working together to create clear images. Here’s how astigmatism disrupts this process and affects your daily vision.
Astigmatism meaning and simple refractive error
Astigmatism is a common refractive error that happens when your eye can’t focus light evenly onto the retina. It’s not a disease but an imperfection in the way your eye bends light. This condition affects approximately 13 percent of refractive errors in the human eye. Astigmatism makes vision blurry at all distances, not just near or far. You might have astigmatism among other refractive errors like myopia (nearsightedness) or hyperopia (farsightedness). This mix can make your vision needs more complex and needs a full picture to correct properly.
Your cornea and lens shape’s effect on light focus
A perfectly working eye has a cornea (the clear front surface) and lens with spherical curves, much like a basketball. These parts bend incoming light rays evenly and focus them right onto the retina at the back of your eye. This creates sharp, clear images.
The cornea or lens (sometimes both) has an irregular curvature—more like a rugby ball or football than a round sphere in astigmatic eyes. Light entering your eye can’t focus to a single point on the retina because of this irregular shape. Light rays focus at multiple points and create overlapping images instead. Picture this: a normal eye has a single radius of curvature. An astigmatic eye has different curvatures in different directions. Some parts of what you see might be clear while others stay blurry, which distorts your vision.
Common symptoms: blurred vision, eye strain, headaches
Early diagnosis and proper treatment need you to spot astigmatism symptoms quickly. You’ll notice consistently blurred or distorted vision, whatever the distance. Things might look wavy, stretched, or partly clear and partly blurry.
Other common symptoms include:
- Your eyes feel strained and uncomfortable, especially after focusing for long periods
- Headaches, usually in the front of your head
- You have trouble seeing at night or notice glare around lights
- You squint to see more clearly
- You feel tired, especially after visual tasks like reading or computer work
Regular eye exams become vital. Learning how astigmatism affects your vision helps you find the right way to correct it. The condition is common, but its effects vary by a lot from person to person. You need a personalised assessment to get the best treatment.
What Causes Astigmatism: Genetics, Injury, and More
Image Source: WebMD
Your astigmatism can come from many sources, ranging from genes to physical changes in your eye. Eye specialists use this knowledge to find the right treatment for each patient’s condition.
Congenital vs acquired astigmatism
Some people are born with astigmatism (congenital), while others get it later (acquired). Genes play a big role in congenital astigmatism. Twin studies show that approximately 60% of the variance comes from hereditary factors. Your risk doubles if your parents have astigmatism compared to those with non-astigmatic parents. The genetic impact on corneal astigmatism shows 48% heritability.
Race affects your chances of getting astigmatism. Studies reveal higher rates in African American and Hispanic children compared to non-Hispanic Caucasian children. Most cases start during childhood, but astigmatism can develop at any age due to environmental factors.
Keratoconus and other corneal conditions
Keratoconus stands out as the most common corneal disorder that leads to astigmatism. This condition makes your cornea thinner over time and bulges outward like a cone, which creates irregular astigmatism. Young patients get it most often. The condition usually starts during puberty and might stabilise by their thirties or forties.
Scientists have linked keratoconus to several factors, even though people often call it non-inflammatory:
- Genetic predisposition (8% of cases come from genetic mutations)
- Chronic eye rubbing
- Associated conditions including atopic dermatitis, allergic rhinitis, asthma, Down syndrome, and Ehlers-Danlos syndrome
Other corneal conditions can cause astigmatism too. These include pellucid marginal degeneration (affecting the peripheral inferior cornea), keratoglobus (diffuse corneal thinning), and posterior keratoconus (abnormal posterior corneal curvature).
Post-surgical and trauma-related astigmatism
Physical injuries can change your vision significantly. Research on patients with known pre-injury vision found that 21% developed astigmatism after blunt injuries. Small, hard objects like game marbles and stones caused these vision changes most often. Eye surgeries can reshape your cornea. Cataract surgery, LASIK, glaucoma treatments, and other procedures might cause astigmatism by changing corneal curvature. The size and location of incisions during cataract surgery can affect corneal shape and might create new astigmatism or make existing ones worse. We have a long way to go, but we can build on this progress. Modern surgical techniques at prominent eye centres keep getting better. They reduce surgery-related astigmatism through careful planning and advanced technology.
Types of Astigmatism Explained by Eye Surgeons
Eye doctors group astigmatism into different types based on the affected eye part, curve pattern, direction, and where light focuses in the eye. Each type needs its own testing and treatment plan.
Corneal vs lenticular astigmatism
Your eyes can have two main forms of astigmatism depending on which part isn’t shaped right. Corneal astigmatism affects your eye’s clear front surface and is the most common type. Lenticular astigmatism happens when the lens inside your eye has shape problems. Both types make it hard to focus light properly, but doctors test and treat them differently.
Regular vs irregular astigmatism
The curve pattern helps define astigmatism types. Regular astigmatism shows principal meridians (steepest and flattest curves) that stay at right angles, making your eye shaped more like a football than a perfect sphere. This type affects about one-third of people worldwide and usually responds well to standard vision fixes.
Irregular astigmatism happens when these principal meridians aren’t at right angles, which creates multiple uneven curves. Eye injuries, scars, or conditions like keratoconus often cause this less common type that might need special treatment.
With-the-rule, against-the-rule, and oblique types
Regular astigmatism breaks down into three types based on meridian direction:
- With-the-rule: Your eye’s vertical curve is steeper than the horizontal one (like a football lying sideways). Children get this type most often.
- Against-the-rule: The horizontal curve is steeper (picture a football standing up). Older people tend to have this type more.
- Oblique astigmatism: The main curves sit between 30-60° and 120-150°, like a tilted football.
Simple, compound, and mixed astigmatism
Light focus points determine these final types:
- Simple astigmatism: One curve focuses light correctly on the retina while the other doesn’t.
- Compound astigmatism: Both curves focus light wrong in the same way (either both in front or both behind the retina).
- Mixed astigmatism: One curve focuses light in front of the retina and the other behind it.
Eye surgeons use these classifications to create exact treatment plans for each patient. Modern diagnostic tools give them a full picture of your astigmatism type and help them find the best way to fix your vision.
How Astigmatism Is Diagnosed in a Clinical Setting
Eye doctors use several specialised clinical procedures to measure how light enters and focuses in your eye when diagnosing astigmatism. They need different diagnostic techniques to spot both the presence and severity of astigmatism types.
Visual acuity and refraction tests
Your diagnostic experience starts with a visual acuity test that uses Snellen’s chart or E-chart. Eye specialists record your uncorrected, best-corrected, and pinhole visual acuity. These measurements show your basic visual performance before any specialised testing begins.
A refraction test comes next to determine your exact prescription for corrective lenses. Your eye doctor might use an automated refractor to measure light reflexion from your retina. They could also do a manual assessment where you look through different corrective lenses while reading a distant chart. This helps identify if you have astigmatism among other vision problems like nearsightedness or farsightedness.
Keratometry and corneal topography
Eye doctors use specialised instruments to measure your cornea’s curvature for an accurate diagnosis. Keratometry helps assess the corneal curvature and shows different power measurements along various axes a clear sign of astigmatism.
Corneal topography provides more detail by creating computerised 3D maps of your cornea. This advanced technology spots subtle corneal distortions that basic tests might miss. Research comparing keratometry and corneal topography shows the agreement limits between these instruments are nowhere near precise enough for clinical use, with mean location differences of 19 degrees for the steep meridian and 17 degrees for the flat meridian.
Axis and cylinder measurements in prescriptions
Your astigmatism prescription includes specific details that describe your condition:
- Cylinder (CYL): Shows how much lens power you need to correct your astigmatism. A higher number means stronger astigmatism.
- Axis: A number between 1 and 180 degrees that shows exactly where astigmatism appears on your cornea. The number 90 shows the vertical meridian, while 180 shows the horizontal meridian.
These measurements help create corrective lenses that fix your specific type of astigmatism.
Recommended Treatments for Each Type of Astigmatism
Every type of astigmatism has treatments that work, and options range from non-invasive to surgical solutions. Astigmatism varies between patients, and so do the treatments. Our expert surgeons at Precision Vision London identify your specific type and recommend the best solution – from advanced laser eye surgery to lens implants.
Eyeglasses with cylindrical correction
Prescription eyeglasses are the quickest way to correct astigmatism. Astigmatism glasses use cylindrical lenses that balance out irregular curves in your cornea or lens, unlike regular lenses. Your prescription includes a “cylinder” value that suggests the amount of astigmatism and an “axis” value in degrees that shows its orientation. These elements work together and bend light properly onto your retina.
Toric contact lenses: soft, RGP, and hybrid
Toric contact lenses correct astigmatism by using different powers in horizontal and vertical meridians. These specialised lenses include:
- Soft toric lenses: They’re comfortable and have weighted bottoms to stop rotation
- Rigid Gas Permeable (RGP): They give sharper vision for higher astigmatism and keep their shape instead of conforming to irregular cornea
- Hybrid lenses: They mix RGP centre with soft lens outer ring to provide comfort and stability
Orthokeratology (Ortho-K) for temporary reshaping
Ortho-K uses specially designed rigid lenses you wear overnight to reshape your cornea temporarily. These lenses correct mild to moderate corneal astigmatism up to 1.75 diopters and let you see clearly during the day without glasses or contacts. The benefits reverse – your cornea slowly returns to its original shape when you stop wearing the retainer lenses.
Laser eye surgery: LASIK, PRK, and SMILE
Laser procedures reshape your cornea permanently to fix astigmatism:
- LASIK: It creates a thin corneal flap before reshaping the tissue underneath
- PRK/LASEK: It reshapes directly under the corneal epithelium
- SMILE: The newest and least invasive option uses a small incision to remove tissue
ICL surgery and toric IOLs for complex cases
Toric intraocular lenses (IOLs) are a great way to get results for severe or irregular astigmatism. These customised implants correct astigmatism among other vision problems. Studies show toric IOLs can reduce astigmatism to less than 0.50 diopters in 95% of patients and improve uncorrected vision by a lot.
Choosing the Right Vision Correction at Precision Vision London
Expert guidance plays a vital role in finding the perfect astigmatism correction. Your trip toward clear vision at Precision Vision London starts with a personalised approach that matches your unique visual needs.
Personalised treatment planning with expert surgeons
Our ophthalmologists create fully customised treatment plans by assessing your corneal structure, refractive error severity, and lifestyle needs. They get into key factors like your age, lens status, and astigmatism symmetry.
Advanced diagnostic technology for accurate mapping
Precise diagnosis creates the foundations of successful astigmatism correction. Corneal topography helps us generate detailed three-dimensional maps that show subtle corneal irregularities other simple tests might miss. Advanced Scheimpflug tomography gives us detailed information about your corneal structure’s makeup and enables precise treatment.
Suitability assessments for laser and lens-based options
Your prescription needs to stay stable for at least one year before treatment. We look at your past refraction details to establish stability patterns. Laser vision correction works best for patients under 45, while lens-based solutions benefit those over 45 more.
Post-treatment care and long-term follow-up
Research shows astigmatism treatments remain stable with proper follow-up care. Our steadfast dedication goes beyond the procedure itself. Book your personalised consultation today and get clarity on your vision through our detailed assessment process that will give optimal outcomes for your unique astigmatism type.
Conclusion
Millions of UK residents have astigmatism, yet many don’t need to live with its symptoms. This common refractive error happens when your cornea or lens develops an irregular shape. Light doesn’t focus properly on your retina. People with untreated astigmatism face daily challenges like blurred vision, headaches, and eye strain.
Your specific type of astigmatism matters to get the right treatment. A full picture of your condition helps create the best treatment plan. This includes checking if you have corneal or lenticular astigmatism, regular or irregular patterns, or other vision issues. Precision Vision London uses advanced diagnostic technology to map your cornea’s shape accurately.
Treatment choices depend on your unique condition. Many patients do well with eyeglasses that have cylindrical correction. Toric contact lenses are excellent options when fitted correctly. Laser procedures like LASIK, PRK, or SMILE can reshape your cornea permanently. These eliminate the need for glasses or contacts completely. Toric intraocular lenses work great for people with severe or complex astigmatism. Studies show these specialised implants reduce astigmatism to less than 0.50 diopters in most cases.
Expert surgical assessment makes a huge difference, whatever type of astigmatism affects your vision. Precision Vision London’s ophthalmologists look at your age, lens condition, corneal structure, and lifestyle needs. This helps them recommend the best treatment for you. Better vision changes your daily life completely. Tasks become easier and activities become fun again. Astigmatism might be common, but you don’t have to accept poor vision. Book your detailed consultation at Precision Vision London today. Our team creates personalised solutions for every type of astigmatism.
Key Takeaways
Understanding your specific astigmatism type is crucial for choosing the most effective treatment, as different types require tailored approaches for optimal vision correction.
- Astigmatism affects 30-60% of adults and occurs when your cornea or lens has irregular curvature, causing blurred vision at all distances.
- Five main types exist: corneal vs lenticular, regular vs irregular, with-the-rule vs against-the-rule vs oblique, and simple vs compound vs mixed.
- Treatment options range from eyeglasses and toric contact lenses to laser surgery (LASIK, PRK, SMILE) and specialised lens implants.
- Advanced diagnostic technology like corneal topography creates precise 3D maps essential for accurate diagnosis and treatment planning.
- Expert surgical assessment considers your age, corneal structure, and lifestyle to recommend the most suitable correction method
Modern astigmatism treatments achieve excellent results, with toric IOLs reducing astigmatism to less than 0.50 diopters in 95% of patients. The key to successful treatment lies in comprehensive assessment by experienced eye surgeons who can identify your specific astigmatism type and create a personalised treatment plan using advanced diagnostic technology.
FAQs
Q1. What are the main types of astigmatism? The main types of astigmatism include corneal and lenticular astigmatism, regular and irregular astigmatism, with-the-rule, against-the-rule, and oblique astigmatism, as well as simple, compound, and mixed astigmatism. Each type affects vision differently and may require specific treatment approaches.
Q2. How is astigmatism diagnosed? Astigmatism is diagnosed through a comprehensive eye examination that includes visual acuity tests, refraction assessments, keratometry, and corneal topography. These tests help determine the presence, type, and severity of astigmatism by measuring how light enters and focuses within the eye.
Q3. Can astigmatism be corrected with laser eye surgery? Yes, laser eye surgery can correct astigmatism. Procedures such as LASIK, PRK, and SMILE can reshape the cornea to address the irregular curvature causing astigmatism. The suitability of laser surgery depends on the individual’s specific type and degree of astigmatism, as well as other factors like corneal thickness and overall eye health.
Q4. Are there non-surgical options for treating astigmatism? Yes, there are several non-surgical options for treating astigmatism. These include prescription eyeglasses with cylindrical lenses, toric contact lenses (available in soft, rigid gas permeable, and hybrid varieties), and orthokeratology (Ortho-K), which involves wearing specially designed contact lenses overnight to temporarily reshape the cornea.
Q5. How often should I have my eyes checked if I have astigmatism? If you have astigmatism, it’s generally recommended to have your eyes checked at least once every one to two years. However, more frequent check-ups may be necessary if you experience changes in vision, are undergoing treatment, or have other eye conditions. Regular examinations help monitor any changes in your astigmatism and ensure your correction remains appropriate.
