Astigmatism (uh-STIG-muh-tiz-um) is a common imperfection in the curvature of your eye.
Like a camera, the eye has a cornea (viewfinder) and a lens. Astigmatism occurs when this cornea (Corneal Astigmatism) or the lens (Lenticular Astigmatism), inside your eye, has a slightly different surface curvature in one direction from the other.
People with astigmatism often have blurred vision which can be associated with fatigue, eyestrain, and distorted vision. In most cases, astigmatism is present from birth. It can also develop after an eye surgery (like previous RK/Radial Keratotomy or poorly done Cataract surgery), disease or injury.
In majority of cases, the shape of the cornea decides vision. Nearsighted corneas are steep or more curved, farsighted corneas are flatter and astigmatic corneas are shaped like an American football (oval) as opposed to being shaped like a basketball (spherical).
Astigmatism may therefore occur in combination with other refractive errors, like nearsightedness (Myopia) or Farsightedness (Hyperopia) and even Presbyopia (After 40 reading glasses).
Astigmatism can be diagnosed during your routine eye exam in most cases but advanced diagnostic technologies like Focused Keratometry, Corneal topography (very much like the earth’s land topography or shape),3 dimensional tomography and refraction (Glasses or contact lens prescriptions) can further detail the specifics towards measurement, type of astigmatism and treatment modalities. These technologies also help rule out any pathology like Keratoconus that may be associated with Astigmatism (note Keratoconus can be treated without transplants using cutting edge technology like Lasers and Miniature plastic rings in the cornea).
Except for El Greco’s success with his paintings (which today we understand resulted from his Astigmatism), most people I have seen with astigmatism usually suffer in their work and life. So I would suggest that you do seek correction.
The surgical options for Astigmatism can include Advanced (No-Cut) LASIK techniques and also Laser–Lens (Cataract) based techniques.
I like to further divide surgical options into:
I. Patients with no Cataracts (young patients) who can avail of all forms of Advanced Lasik surgeries including “No-Cut” techniques.
II. Patients with Cataracts who can take advantage during cataract surgery and have special TORIC lens implanted to correct astigmatism and cataracts both.
III. Patients can also have combination Lasik +Cataract surgery: In cases of previous cataract surgery with residual astigmatism, they can have Lasik surgery while patients with previous Lasik surgery with astigmatism can during their cataract surgery have Toric lens implant. Also, in some cases of high astigmatism, they can plan for staged cataract and Lasik surgery, both in sequence.
The final aim always being to see without any glasses.
In summary then, Astigmatism is a visual handicap that can adversely affect life’s functions and in most cases is treatable with modern technologies.
Even patients with previous surgery ie. Lasik or cataract surgery and even Radial Keratotomy surgery can have Advanced Laser surgery to reach their goals of vision without glasses.
So make sure your cornea is basketball shaped to enjoy the football season.
— Arun C. Gulani, M.D., M.S.
Director & Chief Surgeon: Gulani Vision Institute, Jacksonville
