Astigmatism: The Common Eye Condition You Might Not Know You Have

Astigmatism is a common diagnosis from routine eye exams, yet many people are unclear about what it means. Even after your optometrist provides a medical definition, you may only recall a comparison to a football-shaped eye and the term ‘astigmatism' itself. But it's not the entire eye that's shaped like a football – it's the lens. Here's a closer look at astigmatism, its symptoms, diagnosis, and treatment.

What is Astigmatism?

Astigmatism is often simplified using a football analogy, which optometrists use for patients' easy understanding. But it's essential to know that astigmatism is not an eye disease but an irregularity.

Light enters our eyes through the cornea and ultimately reaches the retina, which sends signals to the brain to interpret what we see.

Astigmatism occurs when light rays hit the retina at various points instead of a single point, resulting in “refractive errors”. This irregularity is due to the abnormal shape of the cornea or lens, causing these errors. Ideally, the cornea and lens should have a symmetrical, circular shape. But in astigmatism, the cornea or lens is wider from left to right than top to bottom, hence the football analogy.

Imagine a clock face. The distance between 12 and 6 is the same as the distance between 9 and 3. This symmetry does not exist in astigmatism.

The cause of astigmatism is yet to be determined, but researchers believe it could be genetic. Eye trauma has also been identified as a cause in some cases, but many instances remain unexplained.

Symptoms of Astigmatism

Astigmatism symptoms are relatively few and may go unnoticed without an eye examination. These include:

  • Blurred vision
  • Distorted or wavy vision
  • Headaches from eye strain
  • Pain in the head or eyes during or after reading or long screen time
  • Squinting to improve vision

If you experience discomfort, it's not the eye itself but the surrounding muscles straining to correct the visual distortion. Those with astigmatism may avoid reading or screen time to prevent associated headaches, not realizing that their condition can be corrected.

Diagnosing Astigmatism

Optometrists use several tools during a comprehensive eye exam to diagnose astigmatism. Visual acuity is assessed by reading letters across the room with one eye covered at a time. Depending on your performance, keratometry may follow to measure the cornea's curvature.

If you've been fitted for contact lenses, you've likely undergone keratometry. A corneal topographer provides a detailed contour map of the cornea. The phoropter tests refraction, where the optometrist alternates lenses in front of your eyes, asking which one appears clearer.

These combined tests help the optometrist diagnose astigmatism and obtain measurements for treatment.

Treating Astigmatism

Most astigmatisms can be treated similarly to nearsightedness or farsightedness, using glasses, contact lenses, or refractive surgery like LASIK, depending on the cornea or lens curvature.

For glasses or contacts, the axis measurements from the above tests help determine the corrective lenses' additional curvature.

Previously, hard contact lenses were the only option for those wanting to forgo glasses. But now, soft lenses can correct nearsightedness, farsightedness, and astigmatism. Hard lenses are reserved for severe astigmatism cases.

If you suspect you have astigmatism, consult your eye doctor and maintain regular eye exams. Your eye doctor will discuss the best options based on your specific condition and lifestyle needs.

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