Understanding Astigmatism: Symptoms, Causes, & Treatment

What Is Astigmatism?

Astigmatism is a common eye condition that can cause blurry vision. How common is it? We surveyed 450 people who wear prescription glasses or contact lenses and found that nearly half (48%) have astigmatism.

Astigmatism occurs when the eye isn’t perfectly round. For example, instead of being shaped like a sphere, the eyeball is shaped more like an egg.

When your cornea and/or lens are not round, light refracts differently creating two images that overlap and cause blurry vision.

A perfectly round eyeball distributes light evenly throughout your cornea for clear vision. If your eye is shaped more like an egg or football, the light entering your eye will bend more in one direction.

The two general types of astigmatism are:

Horizontal: Your eye is wider instead of taller.
Vertical: Your eye is taller instead of wider.

For many people, the astigmatism isn’t severe enough to warrant corrective action; however, if you do have a more severe astigmatism, it is treatable with corrective lenses or refractive surgery, like LASIK.

What Causes Astigmatism?

People who have astigmatism are often born with it and may experience near or farsightedness as well.

We surveyed 217 people with astigmatism and 45% said they were diagnosed with the condition before they were 13. If you have astigmatism at birth, it can change as you age, which is why it’s important to get annual eye exams.

While astigmatism is often present at birth and is a hereditary disease, it can also occur later in life due to eye injury, disease, or surgery.

Astigmatism is not caused by reading in poor light or staring at a digital screen too closely.

In rare cases, astigmatism can be caused by an eye condition called keratoconus, which is characterized by a thinning and cone-shaped cornea and high astigmatism. This condition can significantly affect the visual acuity of an individual and may require specialized treatment.

Astigmatism Symptoms

Signs and symptoms of astigmatism can vary depending on the person and their age, and may include:

Blurry vision
Eyestrain, including fatigue and burning eyes
Headache
Difficulty focusing
Trouble with night vision
Squinting to see clearly
Light sensitivity
Poor depth perception
Eyes that feel heavy
Difficulty seeing distant objects

We asked the 217 people with astigmatism what the first sign was that there was something wrong with their vision. The most common answer by far was trouble seeing objects far away (44%).

If you have a child, take note if they complain of struggling to see the whiteboard at school, have difficulty reading, or they struggle to see people’s faces clearly.

If you or your child are experiencing any of the above symptoms, contact your neighborhood EyeCare Center to schedule an exam, where an optometrist can discuss how to correct astigmatism if it’s present.

What Does the World Look Like to Someone with Astigmatism?

To someone with astigmatism, the world may appear blurry or distorted, with objects appearing stretched or smeared in a particular direction. The extent of the distortion depends on the severity of the astigmatism.

Mild astigmatism might cause only slight blurring, while more severe astigmatism could lead to significant visual distortions. Unlike nearsightedness and farsightedness, astigmatism causes vision to be blurry at any distance. In some cases, it may also cause you to see double.

How Eye Doctors Test for Astigmatism

There are several astigmatism tests that your eye doctor can give to assess whether the condition is present.

Refraction: As the name suggests, this test checks to see if you have a refractive error. During this test, you'll look at an eye chart through different lenses. Your eye doctor will then ask you which lens makes your vision clearer.
Visual acuity: This test measures how well you can see details from a distance using an eye chart to help determine the degree of your astigmatism (if any).
Keratometry: This test uses a tool called a keratometer to measure the curvature of your cornea.
Slit lamp test: This test uses a microscope with a bright light that looks closely at the structures in the front and insides of your eye. It helps your eye doctor determine overall eye health and diagnose eye disease and other conditions like astigmatism.

Children born with astigmatism may not know their vision is blurry, therefore it’s important their eyes are screened starting at six months old to diagnose any issues early on. If you or your child are experiencing symptoms of astigmatism, schedule an eye exam that checks visual acuity, light refraction, and the curvature of your eye.

How to Correct Astigmatism

Your eye doctor can help determine whether you have astigmatism using the tests above. In some minor cases, corrective action may not be needed. However, if your astigmatism is affecting your ability to perform everyday tasks, your eye doctor may prescribe corrective lenses, or recommend surgery.

There are different types of corrective lenses to help astigmatism including:

Regular contact lenses: For less severe astigmatism, regular or soft contact lenses may help correct your vision.
Hard contact lenses: These contacts are a durable option that can correct most astigmatism and often provide clearer vision. In more severe cases of astigmatism, your eye doctor may prescribe toric contact lenses. Their refractive power specifically addresses the differences between the vertical and horizontal planes in your eye that cause astigmatism and blurry vision.
Glasses: Eyeglasses prescribed for astigmatism have cylindrical lenses that correct light refraction to give you clear vision. Your prescription may be different for each eye, so it’s important to get an eye exam to thoroughly check both eyes.

Of the 217 people with astigmatism, a large majority (82%) say they wear prescription glasses to correct their vision.

LASIK (Laser-assisted in-situ keratomileusis) surgery is another option for correcting astigmatism. A surgeon cuts a flap in your cornea, shapes and smooth the cornea with a laser, and repositions the flap to correct your vision. Other types of refractive surgeries include:

Laser-assisted subepithelial keratectomy (LASEK)
Photorefractive keratectomy (PRK)
Small-incision lenticule extraction (SMILE)

Tips for Living with Astigmatism

If you have an astigmatism, there are ways that may help ease the affects including:

Reading and working in proper lighting
Reducing screen time or taking regular breaks from the screen
Increasing the size of text on your computer or device for easier reading
Wearing corrective lenses
Getting regular eye exams and following the recommended treatment plan to manage astigmatism and prevent it from getting worse

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