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What is Astigmatism?

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Young lady undergoing eye exam.

Astigmatism is a very common refractive error that causes blurry vision both at a distance and close-up. It might be so mild that you don’t notice it, or it could cause enough disruption to your vision that your optometrist recommends glasses, contacts, or laser eye surgery to correct it.

Around 36% of Americans have some degree of astigmatism. This means they have an imperfection in the curve of either their cornea or the lens of the eye. In a regular cornea or lens, this curve should be smooth, like a baseball. But with astigmatism, the curve is more like a football.

That irregular curve changes how light enters the eye, resulting in blurred or fuzzy vision at all distances. In some people, their astigmatism occurs along with being nearsighted (difficulty seeing things at a distance) or farsighted (trouble focusing on things close-up). But for others, astigmatism might be their only refractive error.

How Do I Know If I Have Astigmatism?

An eye exam is the best way to know for sure if you have astigmatism, since your vision symptoms could have another cause. 

In an exam, your optometrist will have you read an eye chart to test the clarity of your vision and will also assess any refractive error. They may measure the shape of your cornea with a keratometer or create a 3D map with corneal topography

Common symptoms of astigmatism can include:

  • Blurry or distorted vision
  • Headaches
  • Eye strain
  • Eye discomfort
  • Squinting
  • Trouble seeing at night
Illustration of normal eye on the left and an eye on the right with astigmatism.

How Do I Know if My Child Has Astigmatism?

Whether they’re learning to walk or discovering the joy of reading, your child’s vision is essential in their development.

We recommend your child have an eye exam every year once they enter school. Their first exam should be between the ages of 6 months and one year old, with their next exam between age 3 and 5, unless their optometrist or pediatrician recommends otherwise.

Your young child may not realize they have a vision problem or may not be able to articulate the issue. Be aware of the following signs that they may not be seeing clearly:  

  • Squinting
  • Frequent eye rubbing
  • Poor ability to track an object
  • Sitting very close to the TV or other screens
  • Difficulty reading

Astigmatism, or any other refractive error, should be corrected in your child to support their healthy development, and to avoid the possibility of vision loss due to amblyopia. Also known as lazy eye, amblyopia can happen when the eyes have very different prescriptions. If not treated, the weaker eye can lose vision permanently over time.

What Causes Astigmatism?

Some people are born with astigmatism, but it can also develop following an eye injury that causes scarring, after an eye surgery, or as a result of an eye disease such as keratoconus.

If your parents have astigmatism, it’s more likely you will, too.

Contrary what you may have once heard from your parents, you won’t cause astigmatism to develop by sitting too close to the television, reading in dim light, or squinting. 

How Is Astigmatism Treated?

If you had an eye exam and learned you had mild astigmatism, but you don’t notice it and it doesn’t affect your vision, you don’t need to do anything at all.

But if you’re noticing symptoms, from blurry vision to headaches or eye strain, your optometrist will likely recommend glasses or contacts to give you clear vision. Glasses and contacts are the simplest and least-invasive way to correct astigmatism. 

Depending on the severity of your astigmatism, laser eye surgery may be an option, too. A consultation with your eye doctor can help you understand if you’re a good candidate for laser vision correction.

About Contact Lenses for Astigmatism

The irregular curve of an eye with astigmatism tends to be harder to fit for contact lenses than a regular eye. But there are several options for contact lenses your optometrist may recommend to correct your astigmatism comfortably.

Toric lenses are specially designed for astigmatism. They’re made to sit in a particular orientation on your eye so the proper correction sits where it needs to. Because of this, torics often take longer to fit to your eyes than regular contacts. If you wear toric contacts and notice they shift out of place when you blink, see your eye doctor about finding a better fit.

Rigid gas permeable lenses (RGP), also known as gas permeable lenses (GP) can provide even sharper vision than toric lenses. These lenses retain their own spherical shape as they sit on the eye’s surface. Because of their rigid construction, RGP lenses feel a bit different in the eye than soft contacts. Some people can’t get used to the sensation and will prefer toric lenses. 

Hybrid lenses might be recommended by your optometrist if soft toric lenses and RGP lenses weren’t providing you the clear vision you hoped for. Hybrid lenses have characteristics of both soft and rigid lenses. When they’re fitted correctly, they provide both crisp vision and the comfort of soft lenses.

Scleral lenses are specialty contacts that may be suitable for people with a very high astigmatism prescription. These are extra-large contacts that sit on the white part of your eye (called the sclera) rather than the cornea. 

They vault over the cornea and hold a layer of fluid between the contact and the eye’s surface. This fluid layer both helps correct the irregular curve and provides extra comfort to the eye. These custom-made lenses aren’t typically necessary for moderate cases of astigmatism; your eye doctor will let you know if they are worth considering.

Orthokeratology (Ortho-K) for Astigmatism

Orthokeratology, or ortho-k, is a type of contact lens therapy. The ortho-k lenses are worn overnight to reshape the corneas so that the next day, vision is corrected without needing to wear glasses. 

Ortho-k can be used to correct both nearsightedness and astigmatism, depending on the amount of correction needed. However, ortho-k treatment is much more expensive than toric or RGP lenses, so it may not be the ideal corrective option for most patients.

See Your Optometrist for an Eye Exam

Are you noticing new vision symptoms, or wondering if it’s time to have your glasses or contacts prescription updated? We’d love to see you for an eye exam so we can help you see better. Request an appointment at one of our Nevada locations today.

Written by Daniel Rowan

Reno optometrist, Dr. Daniel Rowan, was raised in Western Canada and attended Norwich University in Vermont on a hockey scholarship. After obtaining a Bachelor of Science degree in both biology and sports medicine, he received his Doctor of Optometry (OD) degree from the New York College of Optometry in 2001. He performed rotations in a Queens VA hospital, specializing in glaucoma care, and an outpatient eye clinic in the Bronx. Immediately after graduating, he moved to Nevada and is now considered a top Reno optometrist. He is a member of the American Optometric Association and is board-certified by the National Board of Examiners in Optometry for the treatment and management of ocular diseases.
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