Astigmatism occurs when the cornea – the clear covering over your eye – is slightly irregular in shape, preventing light from focusing properly on the retina in the back of your eye. As a result, your vision may be blurry at any or all distances.
What causes astigmatism?
The majority of people with astigmatism are born with the condition. It’s thought that most people have some degree of astigmatism. It is most likely an inherited condition. Basically, the curve of either your cornea or lens is not an equal curved arc. Instead, the curve is unequal, such as a deeper bulge in the middle (as in a football-shaped cornea, rather than circular normal shape). This makes light coming into the eye focus at different points, rather than perfectly on the retina at the back of the eye. This creates blurred vision at some or all distances.
In addition to being born with it, you can develop astigmatism after having an eye disease, eye injury, or eye surgery.
If you’re over 40, your declining up-close vision isn’t due to developing astigmatism. That change would be presbyopia, but that’s a whole different condition.
What are the symptoms of astigmatism?
Of the three refractive errors with human vision, astigmatism is the least understood. If you have myopia, you can’t see well at distance. If you have hyperopia, you’re far-sighted and have trouble up close. With astigmatism, the person’s vision can be blurred or distorted to some degree at all distances. Because of this, people with astigmatism suffer from blurred vision, eye strain (from trying to force focus), headaches, squinting to try and overcome the distortions, and eye discomfort. These problems make it important for you to be sure your child has regular eye exams; astigmatism may be hindering his or her development in school.
How is astigmatism diagnosed?
At New York Laser Vision, we can diagnose astigmatism with a comprehensive eye exam. We’ll perform a variety of tests to measure your visual acuity. One of these will be to measure your cornea with a keratometer. We’ll check your refraction to determine how your eyes bend light, and how accurately they do so (refractive errors). It will become evident that you have astigmatism. Then we check the level of correction you’ll need to correct for your astigmatism. We’ll do that by flipping the multitude of lens options in front of your eyes and asking the ubiquitous, “Is that better or worse?” This is a phoropter.
What are the options for correcting astigmatism?
Astigmatism leads to refractive errors in your vision. Because of that, treatment options for astigmatism are similar to myopia (nearsightedness) and hyperopia (farsightedness). You can use eyeglasses, contact lenses, or four possible refractive surgeries, including replacing your misshapen lenses with artificial lenses.
- Eyeglasses — Eyeglasses are made with lenses that help compensate for the uneven shape of your eye. The lenses make the light bend into your eye properly. The same glasses can correct for near or farsightedness.
- Contact lenses — Formerly, only hard/rigid contact lenses could correct astigmatism. But now soft contact lenses called toric lenses can handle astigmatism, while also correcting for myopia or hyperopia. These contact lenses are different than typical lenses. Each lens has a tiny vertical line on it toward the edge of the lens. This line is to be oriented to the top of your eye when placing the contact lens onto your eye. The lens doesn’t rotate like a regular contact but stays oriented in that way to correct for the shape of the cornea.
- Refractive surgery — We can use a laser to reshape the curves of your cornea in refractive surgery. These are the types of refractive surgery for astigmatism:
- Laser-assisted in-situ keratomileusis (LASIK) — In this surgery, we make a thin, hinged flap in your cornea for access. An excimer laser then sculpts the shape of the cornea and the flap is replaced. In LASIK and the other laser surgeries that follow, the laser can make slits in the cornea called corneal relaxing incisions. These allow the cornea to attain a more normal round shape, correcting for astigmatism.
- Laser-assisted subepithelial keratectomy (LASEK) — Rather than creating a flap, in LASEK, the cornea’s thin protective cover (the epithelium) is loosened with alcohol. Then an excimer laser changes the curvature of the cornea. The loosened epithelium is then repositioned.
- Photorefractive keratectomy (PRK) — This is similar to LASEK, but the epithelium is removed. The cornea is then reshaped, and the epithelium will regrow over the next few weeks.
- Lens replacement — In these relatively new procedures, the natural lens is replaced with an artificial permanent contact lens. Recently, the Visian Toric Implantable Collamer Lens (ICL) was approved to treat patients with both myopia and astigmatism. These lens replacements are very similar to how cataract-clouded lenses are replaced with artificial intraocular lenses.
What happens if I don’t treat my astigmatism?
It’s not that your astigmatism changes. Your misshapen cornea or lens usually stays as is. So, not treating your astigmatism won’t make it worse, but it won’t make it better either. You’re simply looking at continually blurred vision, eyestrain, headaches, poor night vision, and constant squinting. And who doesn’t like all of that?
If your child has astigmatism and you’re not having it addressed, that could be hindering the child’s development in school.
These treatments we offer at New York Laser Vision are effective and easy to take. Why put up with blurry vision?
What is the cost of astigmatism treatment?
That depends. If you opt for contact lenses or eyeglasses, your costs are usually a couple of hundred dollars for eyeglasses or ongoing costs of buying contact lenses. These are not big dollar amounts. Laser surgery or lens replacement surgery is more expensive, but these are also permanent vision improvements, so you have a one-time cost.
The choice is yours. When you come in to see us, Dr. Giyaur and her team can give you an idea of how much your options for astigmatism correction will cost.
Are there any risks with treating astigmatism?
Eyeglasses and contact lenses are without any risk. There is some minimal risk with the laser procedures, but these have been performed millions of times around the world and have proven to be safe and very effective. Lens replacement is also minimally invasive, and you can even have the lenses replaced down the road should your vision change or if you need cataract surgery.
Schedule a Consultation
If you’re interested in learning more about treating your astigmatism please contact us for a consultation at 718-676-6464 or fill out our contact us form here. We will discuss your needs and concerns, and determine your best course of action.