Astigmatism occurs when the cornea (front surface of the eye) or the lens inside the eye has an irregular shape. Instead of being perfectly round like a basketball, it’s more oval, like a football. This uneven curvature causes light to focus improperly on the retina, leading to blurry or distorted vision at all distances.

About 1 in 3 people has some degree of astigmatism. It often occurs alongside nearsightedness (myopia) or farsightedness (hyperopia).

1. What are the common symptoms of astigmatism?
2. What are the types of astigmatism?
3. What causes astigmatism?
4. Can astigmatism be prevented?
5. How is astigmatism diagnosed?
6. What are the treatment options for astigmatism?
7. Can astigmatism get worse over time?
   

1. What are the common symptoms of astigmatism?

People with astigmatism may experience:

1. Blurry or distorted vision: Objects may appear fuzzy, stretched, or wavy at all distances (near and far).
2. Eye strain or discomfort: Your eyes may feel tired, especially after reading, using screens, or driving.
3. Headaches: You may feel frequent headaches, particularly after visual tasks (reading, computer work, or watching TV).
4. Difficulty seeing at night: Increased glare from headlights, streetlights, or oncoming traffic can cause discomfort in night vision.
5. Squinting to see clearly: You may unconsciously squint to try to sharpen blurry images.
6. Trouble focusing on fine details: You may have eyestrain when doing close-up work (sewing, crafting, or using a smartphone).

Mild astigmatism may not cause noticeable symptoms, but uncorrected cases can lead to chronic eye fatigue.

2. What are the common types of astigmatism?

• Corneal and lenticular astigmatism: Corneal astigmatism is caused by an irregularly shaped cornea, while lenticular astigmatism is caused by an irregularly shaped lens inside the eye.
• Regular and irregular astigmatism: Most people have regular astigmatism, where the curvature is even but mismatched, such as being more curved in one direction (such as vertical) than in another direction (such as horizontal). For irregular astigmatism, the principal meridians are not perpendicular, often due to corneal scarring (e.g., from keratoconus, trauma, or surgery like corneal transplants). It causes more unpredictable vision issues.

3. What causes astigmatism?

1. Genetic Factors (Most Common)

• Parents with astigmatism may pass it to children.

2. Acquired Causes

• Eye injuries (scratches or scarring on the cornea).
• Eye diseases (e.g., keratoconus - thinning & bulging of the cornea).
• Eye surgery (e.g., cataract surgery may induce temporary astigmatism).

But if someone says reading in dim light or sitting too close to the screen can cause astigmatism. Don't believe it. These habits may cause eye fatigue, but they will not change the shape of the cornea.

4. Can astigmatism be prevented?

Since astigmatism is usually genetic or related to eye structure, it can’t be prevented. However, regular eye exams ensure early detection and proper correction to maintain clear vision.

5. How is astigmatism diagnosed?

An eye doctor (optometrist or ophthalmologist) can confirm astigmatism using

1. Visual acuity test (eye chart reading).
2. Keratometry (measures corneal curvature).
3. Autorefractor (quickly estimates prescription needs).
4. Corneal topography (detailed 3D map of the cornea, useful for surgery planning).

Children should have their first eye exam by age 3 to detect vision problems early.

6. What are the treatment options for astigmatism?

1. Non-Surgical Corrections

1.1 Eyeglasses:

• Special toric lenses correct the uneven focus.

1.2 Contact Lenses:

• Toric soft lenses: They are for mild to moderate astigmatism.
• Rigid gas permeable (RGP) lenses: They are better for severe cases/keratoconus.
• Orthokeratology (Ortho-K): Overnight rigid lenses temporarily reshape the cornea.

2. Surgical Options

• LASIK/PRK Laser Surgery: It can reshape the cornea permanently.
• Astigmatic Keratotomy (AK): It uses tiny corneal incisions to adjust curvature.
• Toric IOL Implants: It corrects astigmatism during cataract surgery.

7. Can astigmatism get worse over time?

Not wearing glasses will not worsen astigmatism, but uncorrected astigmatism can lead to persistent eye fatigue and headaches. For astigmatism values, most people's astigmatism values tend to stabilize in adulthood, but keratoconus can progress without treatment. Therefore, timely diagnosis and use of glasses are important.

Although astigmatism cannot be prevented, clear vision can be achieved through scientific correction. If symptoms such as blurred vision and eye fatigue occur, it is recommended to seek medical attention promptly and choose glasses, contact lenses, or surgery according to the doctor's advice. Especially for children and patients with high astigmatism, regular checkups are crucial.