Astigmatism

For an image to be seen clearly, the horizontal and vertical rays of light that reach the eye's optical system must form a focal point on the retina.

Astigmatism is a refractive defect whereby the horizontal and vertical rays of light have different points of focus on the retina. It can be associated with both myopia and hypermetropia. 

Causes of astigmatism

In the majority of cases, it is due to a lack of symmetry (toricity) in the cornea which gives it an oval or elliptical shape that impedes proper focus on objects.

The cause of this irregularity is usually genetically determined, although it can also arise as a consequence of trauma, after an eye operation like cataract surgery, due to cornea ulcers or dislocation of intraocular lenses, etc. 

An eye with astigmatism sees distorted images given that it cannot focus properly neither far nor near. Objects may appear much longer or wider, sometimes letters and numbers get confused and, on occasions, shadows may even appear. 

The most common signs and symptoms of astigmatism are:

• Blurred or distorted vision
• Tired eyes
• Forcing your eyes to see
• Headache

Interesting fact: It is believed that the Italian painter Amedeo Modigliani may have suffered from astigmatism due to the distorted images in his works. 

Astigmatism cannot be prevented by can be detected with a full eye exam.

In childhood, an uncorrected astigatism may cause lazy eye (amblyopia). This situation can be avoided by correcting it with glasses before the age of 8. For this reason, it is essential to have an eye check-up, even in the absence of any symptoms.

A symptom of astigmatism is blurred vision both in both farsight and nearsight. 

A high astigmatism that develops over time in association with myopia in particular may indicate the presence of a pathological change in the cornea like keratoconus.

The current treatment options for correcting astigmatism are: 

• Correction with glasses and/or contact lenses 
  This is the simplest way of correcting astigmastism.
   
• Laser cornea surgery
  LASIK, PRK and SMILE are most commonly used in an astigmatism operation for their safety and efficacy.
   
• Intraocular lenses
  In selected cases, there are other surgical techniqes like toric, either phakic (conserving the crystalline lens) or pseudophakic intraocular lens implants (after the extraction of the crystalline lens or cataract).