Astigmatism is a common cause of blurry or distorted vision, and the good news is that it is usually very treatable with updated eyeglasses, contact lenses, or laser vision correction, depending on your prescription and eye health. Astigmatism happens when the clear front surface of the eye or the lens inside the eye is curved more in one direction than another, so light does not focus cleanly on the retina, and your vision may look smeared or shadowed at any distance.
At Wellish Abrams Vision Institute, your eye doctor starts by confirming whether astigmatism is present, how much you have, and how it fits with any nearsightedness or farsightedness. From there, your care team can recommend a plan that fits your eyes and your lifestyle, whether that means a refined glasses prescription, specialty contact lenses, or a conversation about refractive surgery options like LASIK.
Key things to know up front:
- Astigmatism is a refractive error, not a disease, and many people are born with it.
- Mild astigmatism may not need treatment if you are comfortable and seeing clearly.
- Night driving trouble, headaches, or squinting are all signs that it is time for an eye exam.
What Is Astigmatism?
Astigmatism is very common. It often occurs alongside nearsightedness or farsightedness, and many people do not realize they have it until a comprehensive eye exam detects it. In many cases, it is present from birth, although it can also develop after an eye injury, eye surgery, or certain corneal conditions.
Signs and Symptoms You Might Notice
People experience astigmatism in different ways, and symptoms can develop slowly. Common signs include:
- Blurry or distorted vision at one or more distances
- Words that seem to run together when you read
- Eye strain or a feeling of tired eyes after close work
- Frequent headaches, especially after screens or reading
- Squinting to try to “find” clear focus
- Difficulty with night driving, bright headlights, or glare
Mild astigmatism sometimes causes very subtle symptoms. That is one reason regular eye exams matter, even if you feel like you are seeing well enough to get by.
Types of Astigmatism and What Your Prescription Means
Astigmatism can come from different parts of the eye.
- Corneal astigmatism happens when the cornea, the clear front surface of the eye, has uneven curvature.
- Lenticular astigmatism comes from an irregular shape in the lens inside the eye.
On your glasses or contact lens prescription, you may see:
- Sphere (SPH), which shows the nearsighted or farsighted part of your correction.
- Cylinder (CYL), which shows the amount of astigmatism corrected.
- Axis, which describes the orientation of that astigmatism correction.
Understanding these numbers can make astigmatism feel less mysterious, and your eye doctor can walk through exactly what they mean for your daily vision.
Astigmatism in Children
Signs in children may include:
- Squinting or tilting the head when focusing
- Sitting very close to the television or holding books close
- Rubbing the eyes often
- Avoiding reading or schoolwork that requires visual focus
In some cases, uncorrected astigmatism in one eye can contribute to amblyopia, often called “lazy eye,” which is another reason early detection matters. A comprehensive eye exam allows the doctor to adjust the prescription and monitor the eyes’ development.
How We Diagnose Astigmatism at Wellish Abrams Vision Institute
The only way to know for sure whether you have astigmatism is to have an eye exam with objective measurements and a careful eye health evaluation. At Wellish Abrams Vision Institute, an astigmatism evaluation may include:
- Measuring how your eyes focus light at different distances
- Using lenses in a phoropter to refine your prescription
- Checking how your eyes work together as a team
- Looking at the front of the eye with a microscope to rule out conditions that can change corneal shape
- In some cases, mapping the cornea with corneal topography if contact lenses or refractive surgery are being considered
These tests are painless and provide your doctor with the information needed to recommend the clearest and most comfortable correction for you.
Why Night Driving Can Feel Harder with Astigmatism
- Make headlights and streetlights look smeared or streaky
- Increase glare and halos around lights
- Reduce contrast, so signs and lane markings seem less crisp
If you find yourself dreading night driving or squinting through glare, it is a strong sign that it is time to update your prescription and discuss astigmatism treatment options.
Astigmatism Treatment Options
The goal of treatment is straightforward. Your care team wants to give you the clearest, most comfortable vision possible in a way that fits your lifestyle.
Eyeglasses
For many people, eyeglasses are the simplest and most reliable way to correct astigmatism. Updating your prescription can reduce blur, eye strain, and discomfort while night driving.
Modern lens designs can include:
- Lenses that correct both astigmatism and nearsightedness or farsightedness
- Progressive lenses for people who also need help with close work
- Coatings that reduce glare from screens and headlights
Contact Lenses
If you prefer not to wear glasses, contact lenses are another strong option. To correct astigmatism, your doctor may recommend:
- Soft toric lenses, which are shaped and weighted to stay in the right position on the eye
- Rigid gas permeable lenses, which can give crisp vision for some people with higher or more irregular astigmatism
If your astigmatism is irregular due to corneal shape changes, specialty lens designs, or larger-diameter lenses may provide better clarity than standard soft contacts.
Orthokeratology and Corneal Reshaping Lenses
Orthokeratology, often called ortho k, uses specially designed rigid lenses that you wear overnight to gently reshape the cornea. During the day, you can see clearly without glasses or daytime contacts. Ortho-K is non-surgical and reversible, which makes it appealing for some adults and for certain children whose eyes are still changing.
Not everyone with astigmatism is a candidate for orthokeratology, so your doctor will talk through how much astigmatism you have, the health of your cornea, and what kind of vision you want during the day.
Laser Vision Correction and Other Refractive Surgery
For some adults, refractive surgery can correct astigmatism by reshaping the cornea so that light focuses more accurately. LASIK and related procedures are designed to reduce or eliminate the need for glasses or contacts by reshaping the cornea.
Refractive surgery is not right for everyone. A comprehensive evaluation at Wellish Abrams Vision Institute will review:
- Your prescription and whether it has been stable
- Corneal thickness and shape
- Tear film quality and any dry eye symptoms
- Other eye conditions, such as keratoconus, glaucoma, or cataract
If surgery is not a good fit, your doctor will walk you through other options that can still provide excellent vision.
FAQ: Astigmatism
Can astigmatism go away on its own?
Astigmatism usually does not disappear on its own. However, it can be very stable and often stays at about the same level for years. When treatment is needed, most people see clearly with glasses or contact lenses, and some are good candidates for surgery.
Is astigmatism serious?
Astigmatism is common and usually not dangerous on its own. The main concern is how much it affects your vision and comfort. If you notice headaches, eye strain, or trouble with driving or reading, it is worth treating so you can see more comfortably.
Do I always need surgery to fix astigmatism?
No. Most people manage astigmatism very well with eyeglasses or contact lenses. Surgery is one option for adults with healthy eyes who want to reduce their dependence on glasses or contacts, but it is not required.
Can LASIK treat astigmatism?
For many adults, yes. LASIK reshapes the cornea so that light focuses more precisely, and it can be effective for certain ranges of astigmatism when the prescription is stable and the eye is healthy. A detailed exam is needed to confirm whether you are a candidate.
Why is night driving harder with astigmatism?
Astigmatism can reduce contrast and create streaks, halos, or glare around lights. This becomes more noticeable at night, when pupils are larger, and more of the irregular corneal surface is involved in focusing light.
Can children have astigmatism?
Yes. Many children are born with some astigmatism. If left uncorrected, it can affect schoolwork and, in some cases, contribute to amblyopia. Routine pediatric eye exams are the best way to detect and treat it early.
How do I know which astigmatism treatment is right for me?
The best option depends on how much astigmatism you have, whether you also have nearsightedness or farsightedness, your corneal shape and eye health, and how you feel about glasses, contacts, or surgery. An eye exam is the starting point for that discussion.
Take the Next Step for Clearer Vision
If you think astigmatism is affecting your vision, schedule an eye exam at Wellish Abrams Vision Institute, so your doctor can confirm your prescription, check your eye health, and walk you through astigmatism treatment options that match your goals, from updated eyeglasses and contact lenses to a refractive surgery evaluation if you are a candidate.