One of the most common vision conditions, astigmatism of one or both eyes affects close to 30% of the population. It’s caused when the cornea is shaped more like an oval than a sphere, which alters the way the light “refracts” (bends) around the inner surface of the eye to the back of the retina. Instead of one clear focal point of light, individuals with astigmatism have two different focal points, which causes blurred vision.
You can read more about astigmatism, its causes, and symptoms in our post Blurred Visions Near or Far…
3 Astigmatism Treatment Options
In today’s post, we’re focusing on three different astigmatism treatment options.
Eyeglasses are almost always the first-line treatment method for astigmatism, especially if it is diagnosed when you are still a child. During your eye exam, we’ll determine the degree of astigmatism you have. The less spherical your cornea or lens is (the more oval or football-like they are) the more severe your astigmatism – and the more blurry your vision will be.
The eye exam allows us to determine the “refractive error” or degree of curvature. Your lenses are specifically designed and shaped to counteract that curve, bending the light into a single point again. In the beginning, eyeglasses can typically return a patient’s vision back to 20/20. However, more severe astigmatism may require surgical interventions. Also, astigmatism often becomes more severe with age, so most patients require stronger and stronger lens prescriptions as they get older.
Contact lenses are another treatment option for patients with astigmatism. However, there is a catch. Remember that we treat astigmatism using soft contact lenses shaped specifically to correct the curvature in your lens or cornea? If that curvature is too slight, contact lenses may not be an option for you yet.
To treat astigmatism with contact lenses, we use a special type of contact called a toric lens. It is shaped to counteract your lens/cornea curve and weighted to stay in place. Your astigmatism has to reach a specific refractive error to be effective and correct blurred vision. Before that, contact lenses may not be effective and more of a nuisance.
There is also another contact option that uses a hard or rigid contact lens and a process called orthokeratology. The hard lens is worn at night while you sleep and fitted to alter the shape of your lens and cornea so it goes back to the normal, spherical shape. Then you remove the lens during the day. Over time, this can correct your cornea/lens shape and you use the lenses less and less frequently.
It’s sort of like braces and a retainer to fix crooked teeth. While the braces eventually come off, you still have to use the retainer as needed to keep teeth from migrating back to their original position. The same is true with orthokeratology. If you stop wearing the corrective rigid lenses at night altogether, your astigmatism will return back to its original degree. Typically, we only recommend orthokeratology for patients with fairly mild astigmatism as it isn’t as successful with more severe astigmatism.
Surgical options for correcting astigmatism
Once you reach 26 years of age, your eyes have stopped growing and most prescriptions have stabilized. At this point, you may be a candidate for one of the following surgical options for correcting astigmatism. There are four different types of surgery, and your ophthalmologist can discuss them all and determine which one is best for your astigmatism.
These surgeries are all very successful and popular ways to treat astigmatism in adults. As such, plenty of less-qualified or newly qualified surgeons offer “discount” options. Be very careful. Yes, laser surgeries have a good track record, but that is only the case when you’ve found a qualified surgeon. Do your homework and be wary of discounted or cheap surgeries as you typically get what you pay for.
- LASIK Laser-assisted in situ keratomileusis (LASIK) is a surgical procedure used to re-sculpt the affected lens or cornea to be spherical again. It is done by making a small flap over the cornea, reshaping the cornea, and then replacing the flap where it heals on its own with post-operative care and supervision. The procedure is completely pain-free and only takes about 30 minutes per eye. It is very successful at treating most cases of astigmatism and often restores patients’ vision back to 20/20 or very close to it. As with any surgery, the healthier you are the better. Read our 8 Criteria For a LASIK Surgery to see if you fit the bill. If so, it’s time to start scheduling consultations with board-certified LASIK surgeons in your area.
- PRK Photorefractive keratectomy (PRK) is another type of laser surgery. Instead of making a flap to expose the cornea, with PRK, there is no flap. Instead, the thin, outermost layer of the cornea, called the epithelium, is gently removed to provide the necessary access to the part of the cornea that the doctor reshapes with the laser. The epithelium regenerates naturally within a few days. Again, your ophthalmologist can help you determine whether PRK or LASIK is best for you, based on the degree of your refractive error, the shape of your eye, and other factors. For example, PRK is often recommended for patients with dry eyes or who have thin corneas.
- SMILE Small incision lenticule extraction (SMILE) is the third surgical option. It uses a different type of laser than LASIK or PRK called a femtosecond laser. The surgeon uses two different cuts to expose the cornea and then the laser removes a small portion of the cornea to reshape it. Studies are showing positive results with SMILE methods and patients tend to have a lower risk of developing dry eye afterward, although healing time is slightly longer than with PRK or LASIK.
- Astigmatism and Cataract Combination If you are an older patient who has astigmatism and cataracts, your doctor will probably recommend combining surgeries. While we are in there removing your cataracts, we can use PRK or LASIK to reshape your cornea. Or, in some cases, we’ll recommend implanting a special astigmatism-correcting lens called a toric intraocular lens. Again, decisions like this are made on a case-by-case basis.
Learn More About Correcting Astigmatism At Atlantic Eye Institute
Have you been diagnosed with astigmatism? The team at Atlantic Eye Institute can help you determine which options are best for you. We have the best board-certified ophthalmologists in the area, as well as a spectacular team of optometrists, making us a one-stop location for all of your eye and vision care needs. Contact us to schedule an appointment or to book your free LASIK consultation.