Astigmatism is one of the most common vision conditions. It affects millions of people of all ages. The good news is that with proper treatment, most people with astigmatism can enjoy clear and comfortable vision.
Understanding how astigmatism works and what causes it to change over time can help you take control of your eye health. Regular eye exams and the right vision correction make a big difference in how well you see every day.
Astigmatism is a refractive error caused by an irregularly shaped cornea or lens. In a healthy eye, the cornea and lens are smooth and evenly curved in all directions. This allows light to focus clearly on the retina at the back of the eye.
When you have astigmatism, the cornea or lens is curved more steeply in one direction than the other. Think of it like a football shape instead of a round basketball. This uneven curve causes light rays to focus at multiple points instead of one. The result is blurry or distorted vision at all distances.
There are different types of astigmatism based on where the irregular curve is located. Corneal astigmatism happens when the front surface of the eye, called the cornea, has an uneven shape. Lenticular astigmatism occurs when the lens inside the eye is irregularly curved.
Astigmatism can also be classified as regular or irregular. Regular astigmatism means the curves are consistent and can usually be corrected with standard glasses or contact lenses. Irregular astigmatism has uneven curves that may require specialty lenses for clear vision.
Astigmatism can affect anyone at any age. Many people are born with some degree of astigmatism. It often runs in families, so if your parents have astigmatism, you may be more likely to have it too.
Astigmatism frequently occurs alongside other refractive errors. You may have astigmatism along with nearsightedness, which makes distant objects blurry. Or you may have it with farsightedness, which affects close-up vision. Adults over 40 may also develop presbyopia, an age-related condition that makes it hard to focus on nearby objects.
For most people, astigmatism stays relatively stable over time. Small changes are normal as you age. However, certain factors can cause astigmatism to increase or change more noticeably.
Regular eye exams help your eye doctor track any changes in your astigmatism. Catching changes early allows for timely updates to your prescription. This keeps your vision clear and comfortable.
As we get older, our eyes naturally change shape. The cornea may become slightly more curved or irregular over time. These changes can lead to new astigmatism or cause existing astigmatism to increase.
Age related changes to the lens can also affect astigmatism. The lens becomes less flexible with age. This is part of why many adults develop presbyopia in their 40s. Regular eye exams help monitor these natural changes so your prescription stays current.
Trauma to the eye can change the shape of your cornea. Even minor injuries may cause scarring that leads to irregular astigmatism. If you experience an eye injury, see your eye doctor right away for an evaluation.
Some eye surgeries can also affect astigmatism. Cataract surgery, corneal transplants, and other procedures may change the shape of the cornea. Your eye doctor will monitor your vision carefully after any eye surgery and adjust your treatment plan as needed.
Certain eye conditions can cause astigmatism to worsen over time. Keratoconus is one of the most common causes of progressive astigmatism. This condition causes the cornea to thin and bulge forward into a cone shape. Keratoconus usually starts in the teenage years and may progress into the 30s or 40s.
Other conditions that can affect astigmatism include pellucid marginal degeneration and corneal scarring from infections or injuries. If you have been diagnosed with any of these conditions, your eye doctor will work closely with you to manage your vision.
While lifestyle factors do not directly cause astigmatism, they can affect how you experience your symptoms. Spending many hours on digital devices can lead to eye strain and fatigue. This may make the effects of astigmatism feel more noticeable.
Working in poor lighting conditions can also strain your eyes. Taking regular breaks during close work and ensuring good lighting can help reduce eye fatigue. These habits support overall eye comfort even if they do not change your actual astigmatism.
If your astigmatism is changing, you may notice certain symptoms. Paying attention to these signs can help you know when to schedule an eye exam:
If you notice any of these symptoms, schedule a comprehensive eye exam. Do not wait for your next routine appointment if your vision has changed significantly. Early detection allows your eye doctor to update your prescription and check for any underlying conditions.
Adults with astigmatism should have a comprehensive eye exam at least once every one to two years. Your eye doctor may recommend more frequent visits if your prescription changes often or if you have other eye health concerns. Children should have their first eye exam by age one, then again before starting school, and regularly throughout their school years.
Eyeglasses are the most common way to correct astigmatism. Your eye doctor will prescribe lenses that compensate for the uneven curve of your cornea or lens. The lenses bend light so it focuses correctly on your retina, giving you clear vision.
Modern lens technology offers many options for people with astigmatism. Single vision lenses correct vision at one distance. Progressive lenses correct vision at all distances and are a good choice for adults who also have presbyopia. The optometrists at Insight Vision Center Optometry can help you choose the best lens options for your needs and lifestyle.
Soft toric contact lenses are designed specifically to correct astigmatism. Unlike regular soft lenses, toric lenses have different powers in different parts of the lens. They are weighted or shaped to stay in the correct position on your eye.
Toric soft lenses are available in daily disposable, two week, and monthly replacement schedules. Your eye doctor will help you find the type that works best for your eyes and wearing habits.
For people with higher amounts of astigmatism or irregular astigmatism, specialty contact lenses may provide better vision than standard soft lenses. Scleral lenses are large diameter gas permeable lenses that vault over the entire cornea. They rest on the white part of the eye, called the sclera. This creates a smooth optical surface that can correct even complex astigmatism.
Dr. Nathan Schramm, OD, FSLS, FBCLA and Dr. Thanh Mai, OD, FSLS, FIAOMC have advanced fellowship training in fitting scleral lenses and other specialty contact lenses. They work with patients who have keratoconus, irregular astigmatism, and other complex vision needs.
Some people with astigmatism may be candidates for refractive surgery. Procedures like LASIK and PRK use laser technology to reshape the cornea. This can reduce or eliminate the need for glasses or contact lenses in many cases.
Not everyone is a good candidate for refractive surgery. Your eye doctor can help you understand if these procedures might be an option for you based on your eye health, prescription, and lifestyle. People with certain conditions like keratoconus are generally not candidates for LASIK.
In some cases, vision therapy can help people with astigmatism manage their symptoms more effectively. Vision therapy is a program of exercises designed to improve how the eyes work together and how the brain processes visual information.
Vision therapy may be especially helpful when astigmatism occurs alongside other vision problems like eye teaming or focusing difficulties. Dr. Valerie Lam, OD, FAAO, FOVDR leads the vision therapy program at Insight Vision Center Optometry and can evaluate whether vision therapy might benefit you or your child.
There is no known way to prevent astigmatism. Most astigmatism is present from birth or develops naturally during childhood. While you cannot prevent astigmatism, regular eye exams can catch it early so you can get the vision correction you need.
No. Wearing glasses does not make astigmatism worse. Glasses simply correct your vision so you can see clearly. Without correction, you may strain your eyes more, which can cause discomfort. Wearing the correct prescription helps you see comfortably and reduces eye strain.
Regular spherical contact lenses may not fully correct astigmatism. If you have mild astigmatism, you might get acceptable vision with regular soft lenses. However, toric or specialty lenses are designed to correct astigmatism and usually provide sharper, more stable vision. Your eye doctor can recommend the best type of lens for your prescription.
Children may not realize their vision is blurry because they do not know what normal vision looks like. Signs that your child may have uncorrected astigmatism include squinting, sitting very close to the TV, holding books close to their face, complaints of headaches, and difficulty in school. Regular pediatric eye exams can detect astigmatism even in young children who cannot read an eye chart.
No, astigmatism and lazy eye are different conditions. Astigmatism is a refractive error caused by the shape of the cornea or lens. Lazy eye, also called amblyopia, happens when one eye does not develop normal vision during childhood. However, uncorrected astigmatism can contribute to amblyopia if one eye has significantly more astigmatism than the other.
Most people adjust to new glasses within one to two weeks. When you first start wearing glasses for astigmatism, objects may seem tilted or warped. This is normal and usually improves as your brain adapts to the new prescription. If you still have trouble after two weeks, contact your eye doctor.
