Can Astigmatism get worse?

Astigmatism is a type of refractive error. A term used to describe the mismatch between the focusing power of the eye and the length of the eyeball. Clear vision is dependent on light entering the eye to focus at a sharp point on the sensory retina lining the inside of the eyeball. If light focuses too early this results in myopia, or short-sightedness. Meaning, the eyeball is too long for the focusing strength of the eye. If you focus light to a point too late, this is hyperopia, or long-sightedness (the eyeball is too short).

This is different from both myopia and hyperopia. For people that have astigmatism, light focuses not only at the wrong point within the eye but at many different points. Astigmatism can be present in conjunction with both myopia and hyperopia. Arising from an irregularly shaped cornea or lens. The transparent dome of light-transmitting tissue at the front of the eye. A smaller proportion of astigmatism cases may be due to the lens inside the eye refracting light unevenly. This is lenticular astigmatism and tends to be less common than corneal astigmatism.

The Astigmatism Analogy

Astigmatism is often explained with the analogy of a ball. In the case of a soccer ball, the lines of curvature are the same no matter which way you run them across the ball. This would be an eye without astigmatism. An astigmatic eye is shaped like an AFL football. Where the lengthways axis of the football is a flatter curve than the axis running from side to side. In the case of the cornea, light entering the steeper meridian of the eye would refract more sharply than light entering along the flatter curve. Resulting in two different focal points within the eye. Understanding the type of astigmatism of an individual eye can play a part in guiding your eye doctor to decide on the best treatment. Studies have found that this condition is an inheritable trait amongst many families. Although there is still no guarantee that it passes on to later generations. Higher prevalence is present in infants. This becomes less common in early school years as the eye develops and changes. However, the development in adulthood is not uncommon.

Symptoms include:

  • Blurry, distorted vision
  • Increased difficulty with vision at night-time (such as driving at night)
  • Headaches and eyestrain
  • Glare sensitivity, especially from oncoming headlights or street lamps at night

Can Astigmatism Get Worse?

So, can astigmatism get worse? It is possible for all types of refractive error to worsen with time. Including astigmatism. The exact cause of this progression is not fully understood. Research indicates that the most influential factor is the concurrent presence of myopia.

There is some suggestion that:

  • Ethnicity,
  • Age,
  • Gender, and
  • The axis of astigmatism may also play a role in the likelihood of progression.

However, this is not yet well-established in the scientific literature. Several eye conditions are associated with astigmatism. The most common of these being a corneal thinning eye disease known as keratoconus. As the keratoconus progresses, it can cause astigmatism to get worse. Often inducing very high degrees.

Options for treatment

Many people will have some degree of astigmatism without even realising. Since low amounts don’t tend to affect vision much and can go uncorrected. For patients noticing blurred vision or headaches, treatment is often first suggested in the form of glasses or contact lenses after your optometrist diagnoses astigmatism. Very high degrees of astigmatism can be addressed with optical correction. Options in soft contact lenses become very limited past -2.75 dioptres. Prescriptions past this will often need to consider custom-made soft lenses or hard (rigid gas permeable) contacts. Despite this, glasses and contact lenses do not suit all lifestyles and activities. Fortunately, we now have access to surgical options, such as refractive surgery. Both for patients who find spectacles inconvenient, or those unable to wear contact lenses:

  • LASIK and PRK laser eye surgery

LASIK and PRK laser eye surgery techniques can correct degrees of astigmatism up to about -5D. This will depend on the anatomy of each individual eye, such as the thickness of corneal tissue available for reshaping with the laser.

  • SMILE® eye surgery

This is a minimally invasive technique that sculpts the inner layers of the corneal tissue through a keyhole incision. SMILE® offers shorter recovery times, reduced risk of complication, and can correct astigmatism up to around -3D.

  • Refractive lens exchange

Same as a cataract surgery procedure and often recommended for older patients. Particularly for whom, presbyopia (the natural age-related decline of near focus) has developed. By removing the eye’s natural lens inserting and a synthetic intraocular lens (IOL) in its place, calculated to correct for the eye’s prescription. The amount of astigmatism corrected depends on the parameters of the IOL design.

  • Intraocular contact lens (ICL) procedure

An intraocular contact lens (ICL) procedure involves inserting a thin synthetic lens between the coloured iris and the eye’s natural lens. An ICL can correct astigmatism of up to around -4D depending on the manufacturer’s parameters.

Looking for astigmatism treatment options past ordinary glasses and contact lenses? Contact Eye Laser Specialists for your complimentary eye exam and consultation to discuss how eye surgery can help you on 1300 297 583

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About the expert

Dr Anton van Heerden, MBCHB; FRANZCO
Ophthalmologist & Laser Eye Surgeon

Based in Melbourne, but with a reputation that transcends borders, Dr Van Heerden sets the highest bar for laser vision correction surgery in Australia. While his skills and experience are second to none, it is his fun, caring and down to earth nature that truly set’s him apart from the rest. You can sit back and enjoy the journey knowing every detail has been carefully considered.

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