Astigmatism: what is it? See symptoms, diagnosis and surgery

Vision is one of the most important senses of the human body, as it is responsible for about 85% of the information processed in the brain.

Therefore, vision problems can cause discomfort and, in some cases, hinder the performance of activities. Among the changes is astigmatism, a very common condition that leaves the image distorted and blurred.

Do you suffer from this condition and would you like to understand it better? Then check out this article in full!

What is astigmatism?

Astigmatism is an ophthalmological condition, in which the surface of the eye (cornea), which should be rounded and smooth, has an oval shape, causing a disturbance of vision.

In these cases, a refractive error occurs, in which the eye is unable to uniformly converge light on the retina .

As a consequence, the person sees the images out of focus, making things appear distorted and blurry, both for objects that are far and near.

This condition can occur in children or adults and its incidence is quite common. The origin of the problem is, in most cases, hereditary, but astigmatism also develops due to some type of eye trauma.

Treatment is done with slows to correct vision or, in some cases, surgery.

Types

There are several classifications for astigmatism, which are defined through clinical factors ( myopia and associated hyperopia) and the characteristics that each one presents.

Among the most well-known nomenclatures we have:

Myopic astigmatism

It is characterized by two simultaneous refractive errors, such as astigmatism and myopia (difficulty seeing distant objects). This visual anomaly is more frequent in children, causing cognitive difficulties at school due to poor quality of vision.

Hyperopic astigmatism

It is considered a very common condition in both sexes and, as the name says, it is the combination of astigmatism and hyperopia (difficulty in seeing nearby objects).

When present in children, this condition must be corrected before 6 years of age, as it can cause great loss of vision (amblyopia).

Regular or internal astigmatism

Astigmatism cases that result from a difference in corneal curvature can be classified as regular, also called interns. Most of these cases are hereditary.

Irregular or external astigmatism

Astigmatism considered irregular is one in which the meridians are different, that is, the curvature of the eye ends up not being uniform.

It can be considered a rarer type of astigmatism and its cause can be natural or also due to inflammation.

Childhood Astigmatism

Specifically in this case, early detection and treatment is essential. According to data from the Ministry of Health, 30% of school-age children have some eye condition, which ends up influencing school performance.

It is important to emphasize that the first ophthalmological consultation should take place in the child’s first year of life, regardless of never having had complaints about it, after all, most children do not know how to explain whether they see well or badly, since for them their vision is “normal”.

Ophthalmic problems in children are usually solved with the introduction of glasses.

For the smaller ones, there are special, rubberized and more resistant frames, which may contain elastics that attach to the back, in order to prevent falls.

What is high astigmatism?

Astigmatism is a condition that results from changes in the cornea and that cause vision deviations. The person with high astigmatism has greater difficulty in seeing, due to the greater degree, and a feeling of aggravated image distortion.

In cases of higher degrees, a characteristic that must be taken into account is that the lenses end up getting thicker.

Thinking about it, several companies and brands ended up developing an ideal lens type for each range of astigmatism degree.

Now when you go to have your frame made you already know that you should pay attention to this.

What is the difference between astigmatism and myopia?

Astigmatism and myopia are two conditions that cause difficulties to see, however, with different aspects. The main characteristic that differs from the conditions is the way the person sees.

In astigmatism, light forms multiple focal points on the retina. This makes the patient see blurred objects over long or short distances.

Myopia, on the other hand, is a hereditary condition, in which the eye is slightly longer than the ideal, causing difficulties to see from afar. In general, it is common for the change to stabilize at around 20 to 25 years – that is, the degree does not change anymore.

Astigmatism and farsightedness

Hyperopia, unlike myopia, is the condition that causes difficulty in seeing nearby objects, especially in reading.

Like astigmatism, hyperopia is a condition that can be reversed with refractive surgery, in which the surface of the cornea is remodeled.

In addition, the difficulty in seeing can be corrected with the use of eyeglasses or contact lenses.

What causes astigmatism?

Astigmatism is a condition that occurs when there is a refractive error due to the curvature of the cornea. As a consequence, the vision may be distorted.

In many cases, this condition has been present since birth and can coexist with other changes such as myopia and hyperopia.

Read more: Diabetes can lead to vision loss

Risk factors of astigmatism

Astigmatism is a very common condition and, in most cases, the person is born with the change. That is, the chances of developing this vision change are highly related to family history.

However, there are some conditions beyond that that can assist in the process of developing astigmatism. Are they:

  • Refractive errors, such as myopia;
  • Premature delivery;
  • Advanced age;
  • Other eye diseases, such as keratoconus (degenerative disease);
  • Itchy eyes (itchy eyes);
  • Eye trauma or surgery.

Symptoms

Among the most common symptoms of astigmatism is blurred or duplicated vision, with more than one focal point. In some cases, depending on the degree of disability, this change may not be noticed.

Here are some of the symptoms of the condition:

Reading difficulty

The main characteristic of astigmatism is the difficulty in seeing, with the sensation of blurred vision, which can be near or far.

Photophobia

Another factor that can cause discomfort for astigmatism patients is photophobia, or sensitivity to light. It can be in varying degrees, causing mild discomfort or extreme aversion to any luminous incidence.

Difficulty seeing objects near or far

The ideal is that the eyes have the same curvature in all directions, which causes the light to be focused on the retina. When this does not happen, the result is refractive problems and difficulties in seeing, in the case of astigmatism, both near and far.

Worsening of visual perception at night

This condition can also be called nictalopia and is caused by dysfunction of the rods (cells responsible for vision in dark environments). Some diseases can trigger this condition or in some cases due to dystrophies of the retina.

Tired eyes and headaches

These symptoms can occur due to the effort made to see, as is the case of hyperopia, myopia and astigmatism.

How is the diagnosis of astigmatism made?

At the first sign of blurred or blurred vision, it is important to see an ophthalmologist.

Some eye tests can be applied in order to diagnose astigmatism. Among the forms of verification we have:

Vision test

At that first moment, the doctor will recommend that you read a standard diagramming poster, which is positioned about 5 meters away.

With this, he will be able to define if his vision is adequate or to measure what his eye capacity would be.

In some cases, such as children, it may be necessary to apply a pupil dilating eye drop. The procedure facilitates the observation of the ocular structure and assists in the diagnosis of vision changes.

Normally, the pupil remains dilated for 12 to 24 hours.

Refraction test

In this second moment, the ophthalmologist will use a lens machine, called a phoropter, in order to determine which lens fits best for your vision.

It is from this non-invasive procedure that the doctor will define the degree of ophthalmology. While the doctor changes the lenses, the patient has to go indicating the best option for his vision.

In some cases, it may be necessary to use the retinoscope (portable device to examine the retina) to refine the diagnosis. In addition, it may be necessary to use eye drops in children and young people in order to dilate the pupil for a more accurate diagnosis.

Keratometry

This procedure aims to measure the corneal curve. The ophthalmologist can do the test in order to adjust the contact lenses and check if there is a need for corneal correction surgery.

Corneal topography

The topography exam measures the curvature of the cornea using equipment that can even diagnose several corneal pathologies.

This procedure serves as a complementary exam in order to assess the need and possibility of surgery or not.

The topography of the cornea can also assist in the diagnosis of keratoconus, a disease quite associated with astigmatism, through specific measurements of the cornea.

Is there a cure?

No . However, patients who have this dysfunction can resort to correction methods, with the introduction of prescription glasses or contact lenses. In addition, there is the resource of surgery, both with laser and intraocular lenses.

Treatment: how to correct astigmatism?

The treatment of astigmatism can be done through the use of contact lenses or eyeglasses.

It is worth remembering that these options serve as an aid to improve vision, however, they do not cure the condition. For this, it is necessary to resort to surgery that modifies the curvature of the cornea.

Eyeglasses

The eyeglass lenses of a person with astigmatism must be curved in order to counteract the shape of the cornea that is impairing vision.

If your grade is higher, it may take a longer time before you get used to the glasses.

If, for some reason, you feel that your eyesight has not improved with use, ask your ophthalmologist to reevaluate your prescription.

Contact lenses

This is another resource that aims to help the astigmatism correction process. If your grade is higher, it is recommended that you look for rigid and gas- permeable contact lenses .

However, there are some contraindications related to the use of lenses, among which we can mention: presence of allergy , intense exposure to smoke or very dry environments and lack of lubrication of the eyes (tears).

Contact lenses that act in the correction of astigmatism can be divided into two classes: rigid and gelatinous.

The use and choice depends on the degree of astigmatism. While the gelatinous ones are ideal for approximately 1 degree, the rigid ones are indicated for higher degrees.

Eye surgeries

For many people, not having to wear prescription glasses or contact lenses seems impossible. However, there are currently super-refined surgery techniques for ophthalmic correction. Among the types of techniques we can mention:

Refractive laser surgery (Lasik)

This technique aims to reshape the cornea so that it focuses better on the rays of light.

To perform the procedure, the doctor applies eye drops that cushions the eyes and, soon after, uses the laser to shape the cornea in the ideal position.

After the procedure, the ophthalmologist may recommend the use of an anti-inflammatory eye drops and antibiotics .

The procedure takes about 20 minutes and, in general, allows normal vision in less than 24 hours.

PRK (Photorefractive Keratectomy)

This technique has the function of removing the epithelium from the cornea and, in most cases, the patient ends up dispensing with the use of prescription glasses.

However, it is necessary to pay attention to one factor: this surgery can only be performed by people with astigmatism below 4 degrees.

The procedure is quick, lasting around 10 minutes to be performed on both eyes.

SMILE (small lenticular extraction)

This procedure is used in eye surgeries in order to treat refractive errors. The technique has the same principle as Lasik, however, it is considered less invasive and simpler, and can be done at once.

In addition, this technique allows for faster recovery.

After the procedure, the ophthalmologist can indicate the use of an anti-inflammatory eye drops and antibiotics to be used in the days following the surgery.

Intraocular lens

This surgery has been performed since the 70s in Europe and, currently, it has been the first option of correction to higher degrees.

The procedure is performed under local anesthesia, being painless and with an average duration of 20 to 30 minutes.

Sight recovery is slow, taking around 30 days to stabilize healing.

On average, the implant corrects up to 90% of the degree and, if necessary, it is possible to perform the correction of the residual degree.

What is the best lens for those with astigmatism?

When searching for contact lens models, you will see that the range of options is wide. This is because each has its own durability and protection factor, in addition to the design, which aims to improve the quality and functionality of the lens.

Toric lenses

Toric lenses have a specific shape and are different from other contact lenses. This option can be used in astigmatism and its tolerance will depend on the patient’s sensitivity.

They can be gelatinous or rigid and the choice depends on the degree of the patient.

Jellies, in general, are indicated for those who use up to 1 degree. Above that, the rigid is more suitable.

Living with vision changes

After receiving the result with the indication of astigmatism, some people may be uncomfortable having to wear glasses or contact lenses. However, currently there are several types of frames and materials, which can fit with you.

So, research frames and test your options to find out what suits your needs best.

Some tips to help you live well, whether with glasses or contact lenses, are:

Take care of contact lenses

Most complaints related to contact lenses are itching and infections due to misuse and neglect of them.

To improve this, you must always wash and rinse the lenses after use and remember to never sleep with the lenses in your eyes.

Consult your ophthalmologist regularly

The medical recommendation is that visits to the ophthalmologist occur annually, even if no new complaints are made.

It is necessary to be aware of the appearance of new complications and, in some cases, the worsening of existing conditions, such as changes in degree.

Don’t forget to use eye drops

If you wear contact lenses, then it is important to know that the eyes need to be constantly hydrated in order to prevent friction between the eyelid and the cornea.

In addition, keeping your eyes lubricated helps to nourish and protect eye structures.

Using eye drops recommended by the ophthalmologist is essential.

Don’t leave without glasses or lenses

Failure to wear glasses or lenses does not interfere with the evolution of the problem. However, being without glasses can cause daily discomfort, such as difficulty seeing, redness in the eyes or headache .

Prognosis

Techniques aimed at treating and improving vision are increasingly common. The procedures have a low risk for the patient and with rapid recovery.

However, like any surgery, however simple it may be, it may pose risks of infection.

In general, 98% of patients who perform the procedure achieve good enough vision, to the point of dispensing with the use of glasses or lenses.

Although changes may occur over the years (change in degree), astigmatism is a condition that corresponds well to treatment, both with glasses and lenses and with surgery, without causing future implications.

Complications

People who suffer from this condition and do not seek treatment can develop other eye diseases, such as:

Amblyopia

Astigmatism can develop into amblyopia (decreased vision in only one eye). This condition can lead to the use of tampons, eye drops and, in more extreme cases, surgical intervention may be necessary.

Read more: Alzheimer’s: memory loss and vision problems are symptoms of the disease

How to prevent or astigmatism?

Preventive measures are not yet known to reduce the chances of developing astigmatism. However, with a complete and routine eye exam, it is possible to detect vision deviations and treat them early.

Common questions

Who has astigmatism has sensitivity to light?

People who have astigmatism are more likely to develop photophobia (sensitivity to light). This is due to the shape of the cornea, since light enters and is lost in the retina, making it difficult to see and focus.

To avoid worsening this condition, it is recommended to use a computer or cell phone with low brightness, so as not to harm the pupil.

Do lenses and glasses cure astigmatism?

No . However, both eyeglasses and contact lenses are used to treat this condition. Surgery is able, in most cases, to permanently correct vision, eliminating the use of glasses and lenses.

Can astigmatism come back after surgery?

Most patients who undergo surgery do not need the glasses after the operation. If there is any variation in vision, there is the option of having a surgical retouch after a few months. That is, opting for surgery is a step to get rid of the use of glasses or contact lenses.


Astigmatism is a condition that can affect people of all ages, from children to adults.

With this in mind, we emphasize the importance of conducting tests frequently, in addition to seeking an ophthalmologist to answer your questions.

Detecting the condition early, prevents it from progressing to other eye diseases.

So if you know someone who suffers from eye problems, share this article so you can get help!

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