Astigmatism – Diagnosis and Treatment
Diagnosis
Eye doctors diagnose astigmatism through a detailed eye exam. They check for symptoms like blurred or distorted vision, trouble seeing at night, and headaches.
The exam includes a refraction test to measure how light bends in the eye. Doctors use keratometry to check the cornea’s curvature. A visual acuity test with an eye chart shows how clearly you see.
Table: Common Tests and Their Purposes
| Test Name | Purpose |
|---|---|
| Refraction | Finds refractive errors |
| Keratometry | Measures cornea shape |
| Visual Acuity Chart | Checks sharpness and clarity of vision |
These tests help doctors find vision problems like nearsightedness, farsightedness, amblyopia, or keratoconus. A thorough diagnosis helps doctors choose the right treatment for astigmatism, whether it is caused by genetics, injury, or changes in the cornea or lens.
Treatment
Glasses and Contact Lenses
Most people manage astigmatism with corrective lenses. Eyeglasses use shaped lenses to focus light on the retina.
This clears up vision and makes daily tasks easier. People often get prescription glasses that also correct nearsightedness or farsightedness.
Contact lenses are another choice. Soft contact lenses help with mild to moderate astigmatism. Toric lenses are made for astigmatism and provide a better fit and sharper vision. Rigid gas-permeable lenses work well for people with irregular corneas.
These lenses let oxygen reach the eye and give sharp vision, but they can take time to get used to.
Orthokeratology (Ortho-K) uses hard contacts to reshape the cornea overnight. People wear these while sleeping, which temporarily improves their vision during the day.
The effect does not last if you stop using the lenses, and the eye returns to its previous shape.
Table: Types of Corrective Lenses
| Type | Best For | Notes |
|---|---|---|
| Eyeglasses | Most cases | Easiest to use, low risk |
| Soft contact lenses | Mild/moderate cases | Comfortable, various styles |
| Toric lenses | Moderate/severe cases | Designed for astigmatism |
| Rigid gas-permeable | Irregular corneas | Sharper vision, less comfy |
| Ortho-K lenses | Temporary correction | Wear at night, not permanent |
Wearing contact lenses can raise the risk of eye infections, especially if worn for long hours or while sleeping (except for Ortho-K as directed). Regular eye exams and good hygiene help keep your eyes healthy.
Surgical Options for Vision Correction
Some people choose refractive surgery for a longer-lasting solution. Surgeons use lasers or other tools to change the cornea’s shape so light focuses correctly.
Doctors first check if you are a good candidate with a full eye exam.
Key Surgical Choices:
LASIK (Laser-Assisted In Situ Keratomileusis): Surgeons create a thin flap in the cornea, use a laser to reshape it, and put the flap back. Recovery is usually quick.
LASEK (Laser-Assisted Subepithelial Keratectomy): Doctors loosen the top cornea layer with a liquid, use a laser to reshape it, then move the layer back.
PRK (Photorefractive Keratectomy): Doctors remove the top cornea layer, reshape the surface with a laser, and let the outer layer grow back. A bandage lens may help comfort for a few days.
Epi-LASIK: A tool separates a thin cell sheet before laser treatment. Doctors replace the sheet afterward.
SMILE (Small-Incision Lenticule Extraction):
Surgeons use a laser to remove a small piece of corneal tissue through a tiny cut. This option works best for mild nearsightedness.
Other choices, like clear lens extraction or implantable contact lenses, are less common.
Each surgery has pros, cons, and different recovery times. Side effects can include dry eyes, glare, halos, infection, or changes in vision correction. Rarely, vision loss can happen.
List: Possible Side Effects After Surgery
- Over- or under-correction of vision
- Dry eye
- Starbursts or halos at night
- Eye infection
- Scarring
Getting Ready for Your Eye Exam
Steps You Can Take Before Your Visit
You can take a few simple steps before your eye appointment to make your visit smoother. Use the table below to organize important details and items to bring:
| Item to Prepare | Example |
|---|---|
| List of Symptoms | Blurry vision, headaches, eye strain |
| Important Life Events or Stress | Moving, new job, recent illness |
| Current Medications and Supplements | Allergy meds, vitamins, pain relievers |
| Written Questions for the Doctor | Ask about causes, treatments, and tests |
Tips:
- Write down changes in vision, headaches, squinting, eye pain, fatigue, or other symptoms.
- Bring a list of all medicines, supplements, and their dosages.
- Note any big changes or stress in your life.
- List all questions about eye health, causes of your symptoms, and treatment options. You can also ask about insurance coverage for procedures.
Questions you may want to ask your doctor include:
- What could be causing my vision changes or discomfort?
- Are there different possible causes for my symptoms?
- Will I need tests, and which ones?
- Is this eye issue likely to last?
- What treatment options are available?
- Are there activities or restrictions I should follow to protect my eyesight?
- Should I see another type of eye specialist?
Questions Your Eye Care Professional Might Ask
During your visit, the eye doctor—such as an optometrist or ophthalmologist—will want to understand your situation better.
Expect them to ask:
- When did you first notice vision changes, eyestrain, or headaches?
- Do these issues happen all the time, or only sometimes?
- How bad are the symptoms?
- Has anything made your vision or fatigue better or worse?
- Do you ever have to squint or feel tired eyes?
- Do you have other health issues that could affect your eye care?
The doctor asks these questions to choose the right tests and make a care plan. Give clear and honest answers to help the specialist understand your needs.
Bringing notes or a symptom diary can also help during the appointment.
