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EspañolAstigmatism symptoms: What are the early signs of astigmatism?
Overview: What does astigmatism feel like?
Astigmatism is a common eye condition that causes blurry vision no matter the distance from the object being seen. It is caused by an irregular shape of the cornea, a vision condition called corneal astigmatism. However, astigmatism can also be due to a lens deformity, or lenticular astigmatism. Normally, the cornea and the lens focus light rays on a single point at the back of the eye called the focal point. With astigmatism, the cornea's irregular shape focuses the light in two different focal points. What does this mean? It usually means that things are blurry or more blurry vertically or horizontally. Because of blurred vision, people with uncorrected astigmatism may have symptoms of eye strain, such as headaches. Most people will be diagnosed and treated by an optometrist. Eyeglasses or contact lenses are usually enough to fix the problem.
Key takeaways:
Astigmatism is a health condition that can affect anyone regardless of age, sex, race, or ethnicity.
Early signs of astigmatism include blurry vision.
Astigmatism usually does not require immediate medical attention.
Astigmatism is caused by deformities in the cornea, lens, or retina of the eye. You may be at risk for developing astigmatism symptoms if you have family members with astigmatism or excessive near- or far-sightedness. Other risk factors include eye surgery, eye injury, or cornea disorders such as keratoconus.
Astigmatism requires a medical diagnosis.
Astigmatism generally requires treatment. Astigmatism symptoms typically resolve with treatment in less than a day.
Treatment of astigmatism may include corrective lenses, refractive surgery, or lens replacement.
Untreated astigmatism could result in complications like lazy eye (amblyopia), distorted vision, crossed eyes (strabismus), or seeing multiple images when there’s one object (polyopia).
Save on prescriptions for astigmatism with a SingleCare prescription discount card.
What are the early signs of astigmatism?
The universal symptom of astigmatism is blurry vision that is not affected by distance. The blurring is usually along one axis (horizontal or vertical). Objects may appear elongated on the horizontal or vertical axis.
Other astigmatism symptoms
Blurred vision is the most prominent symptom of astigmatism.
Other symptoms include eye strain symptoms such as:
Eye discomfort
Eye pain
Eye heaviness
Headache
Difficulty staying focused
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Types of astigmatism: How can I tell which one I have?
There are several types of astigmatism based on the type of refractive error. All types of astigmatism cause blurred vision, but only a specialist can determine the type.
To understand the types of astigmatism, one must first understand how it works. The cornea should have a surface like the outside of a sphere. If the cornea is too flat, the eye focuses the light behind the retina. This causes far-sightedness (hyperopia and presbyopia). Close objects are fuzzy and distant objects are sharp and clear. If the cornea is too steep (too much of a curved surface), the light focuses in front of the retina, causing myopia or near-sightedness. Objects close to the eye are clear and sharp, but objects in the distance are blurry. In astigmatism, the cornea has more of a football shape. One axis is steep and the other is shallow, so the eye focuses the light on two places.
In people with “by-the-rule astigmatism”, the steepest part of the cornea is oriented on the vertical axis and the shallow part on the horizontal access, like a football lying on the ground. There’s more blur on the vertical axis. By-the-rule astigmatism is the most common type of astigmatism. Most children and young adults have by-the-rule astigmatism.
In people with “against-the-rule astigmatism”, the steepest part of the cornea is oriented on the horizontal axis and the shallowest part on the vertical axis, like a football standing up. The blurriness is primarily on the horizontal axis. This is less common, but it’s the most common type of astigmatism in very young children and older adults.
In people with oblique astigmatism, the axes are oriented like an “X.” They aren’t vertical or horizontal but crisscross the eye. Correcting this type of astigmatism requires a more complex lens.
Irregular astigmatism, usually caused by damage to the cornea, is hard to picture. Imagine a cross. Now bend each part of the cross in odd directions so that all four parts veer off in their own direction at irregular angles. Blurriness is a bit all over the place. Irregular astigmatism can’t always be corrected with eyeglasses or even soft lenses. People with irregular astigmatism may need specialized hard contact lenses.
Astigmatism can also be simple, compound, or mixed.
Simple astigmatism means that one axis focuses light on the retina (clear vision), and another axis focuses light somewhere else (blurry vision). People with simple astigmatism have almost normal vision, but it’s blurry in one direction. They will need lenses that correct vision on one axis but have no correction on the other.
Compound astigmatism means that both axes focus light somewhere in front of or behind the retina. Everything is blurred in the distance, or everything is blurred close up. These people will need lenses that have one correction along one axis and a different correction along the other axis.
A person with mixed astigmatism is both near-sighted and far-sighted because the cornea and lens focus light in front of the retina (near-sighted) and behind the retina (far-sighted). These people need lenses that correct for near-sightedness on one axis and correct for far-sightedness on another.
When to see a doctor for astigmatism symptoms
Always see an optometrist if there are vision problems. See a primary care doctor or eye doctor (ophthalmologist) if there are other symptoms like eye pain or a sudden change in vision.
Optometrists diagnose astigmatism using a visual acuity test and a cross-cylinder test. People will look at a chart of letters through a large device with multiple lenses called a phoropter. To correct astigmatism, the optometrist will use three separate lenses interchangeably until the astigmatism is corrected. This is usually all the testing needed to correct regular astigmatism with eyeglasses or contact lenses. In children, the optometrist may use a slit-lamp exam to measure refractive error.
For irregular astigmatism or before refractive surgery or lens replacement, an optometrist or ophthalmologist will perform tests that give more accurate measurements of astigmatism. These include:
Retinoscopy and refraction: Using a slit-lamp exam, an optometrist or ophthalmologist shines a light into the retina and uses lenses to determine refractive error
Keratometry: An optometrist or other healthcare professional uses a specialized instrument called a keratometer to map the precise curvature of the cornea—keratometry is a standard procedure to fit contact lenses
Corneal topography: More likely to be used before LASIK surgery or lens replacement, a corneal topographer is a camera that produces an extremely accurate 3D map of the surface of the eye and a highly accurate calculation of astigmatism.
Pachymetry: Often used before refractive surgery, a technician or other healthcare professional uses a pachymeter to measure the thickness of the cornea
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Complications of an astigmatism
The complications of untreated astigmatism include:
Eye strain
Distorted or defective vision
“Lazy eye,” a condition in which one eye is not used
Strabismus, or crossed eyes
Polyopia, a condition in which people see multiple images
How to treat astigmatism symptoms
In most people, astigmatism is corrected with glasses or contact lenses that have toric lenses (a lens with two perpendicular orientations). Some cases of astigmatism may not be correctable with eyeglasses or soft lenses, such as extreme astigmatism, oblique astigmatism, or irregular astigmatism.
Other treatment options include:
Incision surgery (keratotomy) or laser surgery, including photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK), to change the shape of the cornea
Refractive lens exchange, a surgical replacement of the biological lens with a toric lens, usually in the setting of cataract surgery
Living with astigmatism
Astigmatism is a chronic and often lifelong medical condition. In the vast majority of cases, astigmatism is correctable with eyeglasses or contact lenses. However, astigmatism does change over time, particularly in children and older adults. Regular eye exams are necessary to stay on top of these changes.
Most importantly, get regular eye exams
Vision is one of our most precious gifts. To preserve that gift, see an optometrist regularly. Many people aren’t fully aware that their vision is going bad or that there may be other problems with their eyes.
If you wear glasses or contact lenses, have eye exams at least once every one or two years. Astigmatism does change over the years, sometimes dramatically.
If you don’t wear corrective lenses, have an eye exam every five years if you’re younger than 40.
People without corrective lenses between the ages of 40 and 54 should have an eye exam every four years.
People without corrective lenses between the ages of 55 and 64 should have an eye exam every one to three years.
Seniors should have their eyes examined every one to two years, even if they don’t wear glasses.
RELATED: Eye health 101: how to protect vision and keep eyes healthy
FAQs about astigmatism symptoms
What triggers astigmatism?
Astigmatism is usually inherited. Many people are born with it. In some cases, astigmatism may be due to an eye injury, eye surgery, or another eye condition such as a deformed cornea (keratoconus).
What should you avoid if you have astigmatism?
People with astigmatism due to an eye disease called keratoconus should ask their optometrist or ophthalmologist about proper eye care to avoid complications.
What makes astigmatism worse?
Astigmatism can be caused or worsened by injury, surgery, or some eye conditions. , In addition, astigmatism usually worsens with age, sometimes dramatically. By-the-rule astigmatism is the most common form of astigmatism in children and adults up to the age of 50. In older adults, the most common form is against-the-rule astigmatism. In those cases, astigmatism may rotate where it may not get worse, but the old corrective lenses won’t work anymore.
What’s next? Additional resources for people with astigmatism symptoms
Tests and diagnostics
Corneal topography, American Academy of Ophthalmology
Pachymetry, American Academy of Ophthalmology
Retinoscopy, American Association for Pediatric Ophthalmology and Strabismus
Treatments
Astigmatism, StatPearls
Overview of refractive surgery, American Family Physician
Refractive lens exchange, Cleveland Clinic
Scientific studies and clinical trials
Epidemiology and burden of astigmatism: a systematic literature review, Optometry and Vision Science
More information on related health conditions
Eye health 101: how to protect vision and keep eyes healthy, SingleCare
Glaucoma treatments and medications, SingleCare
Macular degeneration treatments and medications, SingleCare