Q: Does astigmatism go away?
A: Sorry, no. In fact, sometimes astigmatism gets worse with age... but slowly. It is probably partly hereditary and partly environmental. Most astigmatism can be easily corrected with glasses, contact lenses and refractive surgery; but significant astigmatism won’t go away on its own. Fortunately, it is not a fatal condition!
Q: Please explain what is meant by the term “mixed astigmatism,” and if this condition can be treated with LASIK?
A: In mixed astigmatism, the unequal curvature of the cornea (and sometimes also the lens inside the eye) causes one meridian of the eye to be shortsighted and a second meridian (perpendicular to the first) to be longsighted.
Mixed astigmatism usually can be successfully treated with LASIK, but results might be less predictable than surgical correction of simple shortsighted astigmatism. Your eye care professional can discuss this with you in detail at your LASIK consultation.
Q: I have astigmatism. Would you recommend wearing contact lenses or just glasses?
[Read more about toric contacts for astigmatism.]
Q: My eye care professional told me in my eye exam that my astigmatism has gotten worse. Is this normal? I thought astigmatism is not supposed to change.
A: When it comes to your eyes, it’s always best to trust your eye care professional rather than what you hear elsewhere.
Astigmatism is a very common vision problem. In fact, most people have some. When you have astigmatism, light does not focus to a single point in your eye. Instead, it causes blurred vision because the front of the eye is shaped more like an egg than a round ball.
Unfortunately, astigmatism can (and often does) change throughout your life, usually for the worse with age. But astigmatism is not a disease and can be corrected with glasses, contact lenses or refractive surgery
Q: Our son is almost 10 years old, and he had his first eye exam recently because he failed a school vision screening. The eye care professional said he has a lot of astigmatism in one eye, and a lesser amount in the other, and that he needs to wear glasses all the time because he has “lazy eye” in the eye with more astigmatism.
The eye care professional went on to say that the lazy eye might be permanent because the astigmatism wasn’t detected sooner. Is this true?
A: It’s true that uncorrected astigmatism can cause amblyopia (or “lazy eye”). In the past, it was believed that there is a “critical period” in childhood during which amblyopia treatment must begin or decreased vision will be permanent. Many people believed this critical period ended around ages 7- 9.
But recent studies of brain function and a phenomenon called neuroplasticity are dispelling the belief that amblyopia treatment is ineffective beyond a certain age in childhood.
Be sure your son wears his glasses full-time and sees an eye care professional for routine exams to monitor his vision development. Initially, he should be seen more frequently than once a year.
You also might want to take him to an eye care professional who specialises in children's vision and amblyopia treatment. A program of prescribed visual activities (called vision therapy), along with full-time wear of glasses, often is more effective at reducing or eliminating amblyopia than simply wearing prescription glasses.
Q: Will my astigmatism worsen if I don’t wear my glasses all the time? If I do wear my glasses all the time, will this somehow reduce my astigmatism, or will it make my astigmatism worse? Are there any medications that can reduce astigmatism?
A: Wearing or not wearing your glasses will not make your astigmatism better or worse. If your astigmatism worsens, this will occur whether or not you wear your glasses. At present, there is no known medicine that can reduce astigmatism.
But I recommend that you do wear prescription glasses or contact lenses (or consider LASIK or other vision surgery to correct your astigmatism) if your vision is bothersome without corrective lenses. Also, even mild uncorrected astigmatism often causes headaches and eye strain.
And, depending on the severity of your astigmatism, it may be dangerous (and illegal) for you to drive without corrective lenses.
Q: I’ve worn glasses before, but I was just prescribed glasses for astigmatism for the first time. My new glasses make me dizzy when I wear them. I’ve had them for three days. Will this feeling go away, or should I go back to my eye care professional?
A: It’s true that sometimes it takes a period of adjustment to get used to glasses that correct astigmatism — especially if you have moderate or severe astigmatism or a significant change in your astigmatism prescription.
Since it’s been three days and you are still uncomfortable (assuming you are wearing the glasses full-time), I recommend you return to your eye care professional to make sure your new eyeglasses prescription is correct and your lenses were made properly.
Q: At what age can children have LASIK surgery to correct astigmatism?
A: You don’t want to proceed with LASIK surgery until you are reasonably certain your child’s eyes have stopped changing. Many kids who have astigmatism also have some nearsightedness, which often continues to worsen in the teen years. In most cases, the minimum age for LASIK is 18 years, and some people should wait longer.
Q: My eye care professional told me that I have astigmatism in one eye and said I could get glasses if I wanted to. He didn’t seem too worried about it. Should I get glasses?
A: If you have only mild astigmatism in one eye, you see acceptably well without glasses (6/12 or better, which is the legal requirement for driving), and you are not bothered by eye strain or headaches as the day goes on, prescription eyeglasses certainly are optional. But if your vision bothers you or you experience headaches or eye strain, I recommend them.
If you are uncertain, you might want to go back to your eye care professional and have them show you again how much better you will see with prescription lenses. This can be demonstrated in the exam room without the need for you to purchase glasses first.
Q: My glasses prescription says the axis of my astigmatism is 140 degrees. But when I got my glasses checked, the optician said the axis is 160 degrees. Is it harmful to wear these glasses? Will it make my astigmatism worse?
A: It won’t harm your eyes or make your astigmatism worse, but wearing glasses with an incorrect astigmatism axis of this magnitude (depending on the amount of astigmatism you have) will usually cause blurred vision, eye strain and other discomfort. Return to your eye care professional as soon as you can to recheck your prescription and the glasses.
Q: I had cataract surgery in both eyes, and it feels like I see less well now than before the surgery. I was told I have irregular astigmatism. I did get glasses, which corrected it somewhat, but without them my vision is worse than it was before cataract surgery. Can anything be done?
A: You may have more than one type of astigmatism since your cataract surgery. Glasses can correct regular astigmatism, but they usually cannot correct irregular astigmatism.
Sometimes, astigmatism (both regular and irregular astigmatism) is induced by cataract surgery. This is because an incision must be made in the front of the eye for the surgery, and as this wound heals it can change the curvature of the clear front surface of the eye (cornea). Also, sometimes astigmatism can be caused by the placement of the lens implant inside the eye or the implant itself.
If you are unhappy with your vision without corrective lenses after cataract surgery, often there are options to improve your eyesight with a follow-up refractive surgery procedure. If you’ve not yet discussed this possibility with your cataract surgeon or a refractive surgeon who performs LASIK, PRK and other vision correction procedures, I recommend you do so.
Q: At what age does astigmatism usually occur? I’ve been wearing glasses since I was about 9 or 10, and I started wearing contacts at 16. I’m 22 now. In the past couple of years I’ve been told that I have astigmatism.
A: Astigmatism often begins in early childhood, but it can occur at any age. Sometimes, wearing contact lenses can cause astigmatism, especially if the amount of oxygen reaching your corneas is significantly reduced for extended periods. This contact lens-induced astigmatism usually is temporary, but it could possibly be permanent.
If your astigmatism continues to change, ask your eye care professional if your contact lens wear might be a factor and if you should try a different type of lens or cut back on how long you wear your lenses.
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Page published in March 2022
Page updated in March 2022