When You Optometrist Says You

Have Astigmatism Don’t Start

Planning an Eye Funeral

Often patients who have changed to a new optometrist find themselves being alarmed when told they have astigmatism. Frequently it is the first time they are aware of a new eye condition and it is cause for concern. In most cases, their eye doctor did not mention they had astigmatism in years past, probably because it was a low amount. On occasion, the patient believes they are being told they have a stigmata and are even more upset.

Astigmatism can be caused by curvature on the corneal tissue on the front of the eye, or by the curvature and light bending power of the lens inside the eye. About 2/3 of astigmatism is caused by unequal curves on the corneal tissue on the front of the eye. Normally, this is regular astigmatism meaning there are two different curvatures that follow a smooth pattern. It can best be visualized as an eye that is shaped like a tennis ball being squeezed on top and bottom to produce two different curvatures. Irregular astigmatism does occur in some eye diseases like kerataconus and occasionally after corrective eye LASIK surgery and corneal transplants. This is a form of astigmatism you should be concerned about. It is more like the shape of a potato with dips, valleys, and hills representing the curvature. Obviously it is hard to grind a corrective lens to this shape and often gas permeable rigid contact lenses are required to achieve crisp vision. New alternatives today include the SynergEyes contact lenses that have a soft contact lens skirt surrounding a rigid gas permeable center. Since the human tears have the same light bending capacity (index of refraction) as the cornea, when the tears fill in between the contact lens and the eye a new smooth surface is produced. If you have irregular astigmatism ask your optometrist about the new options available to see clearly.

Astigmatism is common in moderately high amounts in infants and toddlers. It often self corrects. Your optometrist may want to closely follow your child’s vision and delay eyeglasses for a few years. If the astigmatism is judged to be too high by your eye doctor or persists past the first few years of childhood, it needs to be corrected with prescription eyeglasses.

In some cases when a very young child is incapable of wearing glasses contact lenses may be used

Children may be fit with contact lenses for astigmatism that can be worn for 30 days without removing, or with daily disposable contact lenses that are removed every day by the parent. Large amounts of uncorrected astigmatism can result in a lazy eye. This can result in permanent vision loss, and with high astigmatism in both eyes it could result in bilateral loss of acuity. With proper treatment by your optometrist this is a completely preventable type of partial blindness.

Once you aware you have astigmatism there is no need for panic. You probably have had it for a number of years. Most of the population has at least some small amount of astigmatism. In most cases it changes very slowly over time. Over the course of a lifetime you will blink your eyes millions of cycles. The pressure exerted by the eyelid as it rubs across the cornea over years of blinking probably contributes to very slow changes in astigmatism. While there is no evidence supporting my theory, I do believe that tilting your head and paper along with other postural and ergonomic factors cause a slight blurring of your vision at an angle that can cause astigmatism to develop or change. Blurred images to the retina tissue inside the eye are known to cause near sightedness. Large degrees of astigmatism are found in several Native American populations, especially in the four corners area bordering Colorado. These are genetic passed on through the generations.

In most cases there is no alarm needed if you find out you have astigmatism. It will probably show only small changes over long periods of time, and in many cases stabilizes for years. When in doubt call your optometrist back and explain your concerns.