Key takeaways:
Astigmatism develops when the cornea or lens of your eye changes shape.
Astigmatism causes blurred or distorted vision, eyestrain, and headaches.
Astigmatism can be treated with eyeglasses, contact lenses, or surgery.
Vision changes are one of those things you should never ignore. Blurry vision is a common sign of many eye conditions — from common ones, like cataracts, to serious conditions, like retinal detachment.
One of the most common reasons for blurry vision is a refractive error. Most people recognize refractor errors like myopia (nearsightedness) and hyperopia (farsightedness). But fewer people are familiar with astigmatism.
Astigmatism is also a refractive error. It often develops as people get older. So, if you’ve recently been diagnosed with astigmatism, here’s how to get your vision back in focus.
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What is astigmatism?
Astigmatism is a change in the shape of your cornea, lens, or both. Your eyeball should have a globe shape — like a basketball. But with astigmatism, it becomes more oblong-shaped — like a football.
When the cornea or lens isn’t curved evenly, light entering your eye bends the wrong way. Normally, light enters your eye and hits the retina (the back layer of your eye). The retina turns light into electrical signals and then passes these signals to your brain so you can see.
But if you have a refractive error like astigmatism, the light hitting your retina is bent out of shape. Your retina sends these distorted signals to your brain, so you see images that look blurry or distorted.
What causes astigmatism?
Some people are born with astigmatism. You can also develop astigmatism later in life. Astigmatism tends to develop naturally as you get older. One study showed that 1 in 4 people between the ages of 25 and 59 had astigmatism. But for people over the age of 60, that number doubles to 1 in 2 people.
It’s not clear why some people develop astigmatism and others don’t. You’re more likely to develop it if:
Other people in your family have astigmatism
You’ve had eye surgery or an eye injury in the past
You have a history of keratoconus (a genetic condition)
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Reading in dim light and sitting too close to a screen don’t cause astigmatism. It’s also a myth that wearing your glasses or contacts will make your astigmatism worse.
What are the symptoms of astigmatism?
Some people don’t have any symptoms from their astigmatism. If there’s only a slight change in your eye’s shape, you might not notice any changes in your vision.
But if you have a moderate or severe astigmatism, you’ll notice symptoms like:
Blurry vision
Trouble seeing at night
Headaches
Squinting
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How do you diagnose astigmatism?
Your eye doctor can diagnose astigmatism during an eye exam. First, you’ll read an eye chart. Then, they’ll ask you to read the eye chart while looking through lenses of different strengths. This tool is called a phoropter.
Your ability to see the eye chart more clearly with lenses allows your eye doctor to figure out if you have an astigmatism or another refractive error.
Your eye doctor may also use specialized equipment like keratometry and topography to help diagnose refractive errors. These tests aren’t painful and will help your eye doctor pinpoint your astigmatism.
Who needs treatment for astigmatism?
You should get treatment if astigmatism is causing vision changes. You should also get treatment if you have headaches or eyestrain — even if your vision changes are less bothersome.
Young children should always get treatment for astigmatism, even if it’s mild. If left untreated, astigmatism in young children can lead to amblyopia.
Amblyopia (also called “lazy eye”) develops when the connection between your eye and brain doesn’t develop the right way. Astigmatism can lead to amblyopia. Amblyopia can cause permanent vision loss.
How do you treat astigmatism?
Eyeglasses, contact lenses, and surgery are all options to treat astigmatism. Some people are interested in more natural ways to correct their astigmatism, like eye exercises or vitamins. But right now, there’s no evidence that these natural treatments can correct astigmatism.
Eyeglasses
Eyeglasses are a safe way to treat astigmatism. They’re also the most cost-effective option. But sometimes glasses can’t completely correct astigmatism.
Contact lenses
Soft toric contact lenses can fully correct astigmatism. Toric contact lenses have a special shape that specifically corrects astigmatism. If your astigmatism is more severe, your eye doctor may recommend a rigid gas-permeable lens, a special type of contact lens.
Surgery
Refractive surgery, like LASIK, treats certain types of astigmatism. During LASIK, a laser reshapes the cornea so light enters your eye correctly. But refractive surgery isn’t right for everyone. Your eye doctor can help you decide if it’s the right option for you.
If you need cataract surgery, your surgeon can correct your astigmatism at the same time. This can either be done by placing a special type of intraocular lens or by reshaping your cornea with precise incisions during surgery.
How to read your prescription
Most people opt for eyeglasses or contact lenses to treat astigmatism. You may be wondering what the different numbers on your prescription mean. Each number gives information about your vision and the type of lens you need to correct astigmatism and other refractive errors:
Sphere refers to the lens power needed to correct the amount of nearsightedness or farsightedness you have. If you’re nearsighted, the number will be negative. If you’re farsighted, the number will be positive. The further the number is from zero (whether positive or negative), the stronger the lens you need. The sphere may be different for your right and left eye.
Cylinder tells how much astigmatism you have.
Axis is a number between 1 and 180. It describes the direction of your astigmatism.
Add may appear on your prescription if you’re using bifocals. It tells the extra lens power needed for close-up vision.
Frequently asked questions
Surgery, like LASIK or photorefractive keratectomy (PRK), is the only option to cure astigmatism. But some people may still develop or notice worsening astigmatism as they get older, even if they had surgery in the past.
Corrective lenses can help you see clearly, but they can’t cure astigmatism. Eye exercises and vitamins also can’t cure astigmatism.
Colored contacts for astigmatism (called toric lenses) used to be expensive because they were difficult to make. The market for this product was small, and the added expense made it hard for manufacturers to keep making them.
Surgery, like LASIK or photorefractive keratectomy (PRK), is the only option to cure astigmatism. But some people may still develop or notice worsening astigmatism as they get older, even if they had surgery in the past.
Corrective lenses can help you see clearly, but they can’t cure astigmatism. Eye exercises and vitamins also can’t cure astigmatism.
Colored contacts for astigmatism (called toric lenses) used to be expensive because they were difficult to make. The market for this product was small, and the added expense made it hard for manufacturers to keep making them.
The bottom line
Astigmatism is a type of refractive error that causes blurry and distorted vision. Some people are born with astigmatism, while others develop it over time, especially as they get older. If you notice symptoms of astigmatism, be sure to visit your eye doctor. Treatment for astigmatism includes glasses, contacts, or refractive surgery.
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References
American Academy of Ophthalmology. (n.d.). Astigmatism.
Boyd, K. (2024). What is keratoconus? American Academy of Ophthalmology.
Lazarus, R. (n.d.). Astigmatism: Top 9 FAQs. Optometrists Network.
National Eye Institute. (2022). How the eyes work.
Vitale, S., et al. (2008). Prevalence of refractive error in the United States, 1999-2004. JAMA Ophthalmology.
