Astigmatism (uh-STIG-muh-tiz-um) is a common, mild and generally easily treatable imperfection in the curvature of your eye. The condition can cause blurred vision.
Astigmatism occurs when the front surface of your eye (cornea) or the lens, inside your eye, has a slightly different surface curvature in one direction from the other. Instead of being even and smooth in all directions, the surface may have some areas that are flatter or steeper.
Astigmatism blurs your vision at all distances. Astigmatism is often present at birth and may occur in combination with nearsightedness or farsightedness. Often it’s not pronounced enough to require corrective action. When it is, your treatment options include corrective lenses and surgery.
Signs and symptoms of astigmatism may include:
When to see a doctor
If your quality of vision detracts from your enjoyment of activities or interferes with your ability to perform everyday tasks, see an eye doctor. An eye doctor can determine whether you have astigmatism, and if so, to what degree. He or she can then advise you of your options to correct your vision.
If you’re a healthy adult older than 40, have your eyes examined about every two to four years until age 55. After age 55, have them checked every one to three years for signs of eye disease or problems, and then every one to two years after age 65. If you have eye problems, such as astigmatism, you may need to have your eyes checked more frequently. If you’re at risk of certain eye diseases, such as glaucoma, or you have diabetes, check with your doctor to see how often you need to have your eyes examined.
Your eye has two parts that focus images — the cornea and the lens. In a perfectly shaped eye, each of these focusing elements has a perfectly smooth curvature, like the surface of a smooth ball. A cornea or lens with such a surface curvature bends (refracts) all incoming light the same way and makes a sharply focused image on the back of your eye (retina).
However, if your cornea or lens isn’t evenly and smoothly curved, the light rays aren’t refracted properly. This causes a refractive error. Astigmatism is one type of refractive error. In astigmatism, your cornea or lens is curved more steeply in one direction than in another. When the cornea has a distorted shape, you have corneal astigmatism. When the lens is distorted, you have lenticular astigmatism. Either type of astigmatism can cause blurred vision. Blurred vision may occur more in one direction — either horizontally, vertically or diagonally.
Astigmatism may occur in combination with other refractive errors, which include:
Astigmatism may be present from birth, or it may develop after an eye injury, disease or surgery. Astigmatism isn’t caused or made worse by reading in poor light, sitting too close to the television or squinting.
To diagnose astigmatism, your eye doctor may:
To measure the change in corneal surface curvature, a process called corneal topography is used. Corneal topography uses a videokeratoscope, which is a keratoscope fitted with a video camera.
The goal of treating astigmatism is to address the uneven curvature that’s causing your blurred vision. Treatments include wearing corrective lenses and undergoing refractive surgery.
Wearing corrective lenses treats astigmatism by counteracting the uneven curvature of your cornea. Types of corrective lenses are:
Contact lenses are also used in a procedure called orthokeratology, or Ortho-K. In orthokeratology, you wear rigid contact lenses for several hours a day until the curvature of your eye improves. Then, you wear the lenses less frequently to maintain the new shape. If you discontinue this treatment, your eyes return to their former shape. Wearing contact lenses for extended periods of time increases the risk of infection in the eye.
This astigmatism treatment method corrects the problem by reshaping the surface of your eye. Refractive surgery methods include:
Radial keratotomy is a procedure that was used in the past to correct astigmatism. However, it’s not commonly performed anymore.