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If you struggle to see clearly without the use of glasses or contacts, astigmatism could be to blame. This is a disorder involving the shape of your eye, and it causes images to appear dim or out of focus. (Learn more) Astigmatism symptoms can involve more than simple blurred vision. In time, astigmatism can cause other symptoms that impede your ability to enjoy your life. (Learn more)
If you have astigmatism, there are treatments that can help to improve your vision, including surgery. (Learn more) Before you schedule surgery, you should understand the risks and benefits involved with this delicate procedure. (Learn more)
You'll need to prepare for your surgery, and that may include switching from contacts to glasses for a few weeks (Learn more) You may also need to determine how to pay for your care, as your health insurance may not cover the costs. (Learn more)
Astigmatism Involves the Shape of Your Eye
A healthy human eye is shaped like a marble. The surface and the center of the eye are perfectly round, and light moves into that surface evenly. Just as a chip or a bubble in a marble changes the way light moves through, an irregularity in the human eye can also shift the path of light that enters the eye.
When light is diverted from an ideal path, images that enter the eye don't appear crisp and clear. Instead, they may seem blurry or fuzzy, and that may persist until it is corrected with special lenses or surgery.
There are two main types of astigmatism. The first, corneal astigmatism, involves a misshapen cornea. For people with this type of astigmatism, the cornea is not round like a marble. Instead, the cornea is oblong, like a football.
The second type of astigmatism, lenticular astigmatism, involves misshapen lenses in the eye. Rather than being round, the lens is somehow curved or shifted. When the curve of the lens of the eye and the curve of the cornea do not match, astigmatism takes hold.
Experts writing for Review of Ophthalmology point out that there is another form of astigmatism, known as irregular astigmatism. People with this form of astigmatism may claim that vision corrected with glasses remains shadowy or fuzzy, while contact lenses may provide sharper vision. This type of astigmatism can be caused by prior vision correction surgeries, cataracts, and more.
A final type of astigmatism, known as keratoconus, causes the cornea to grow thin and cone-shaped. According to the American Optometric Association, this type of astigmatism causes poor vision that can't be clearly corrected with glasses. In order to get clear vision, people with this type of astigmatism need contact lenses or, in severe cases, corneal transplants.
Astigmatism can, and often does, work in conjunction with other vision problems. You may have nearsightedness complicated by astigmatism, or you may have farsightedness complicated by astigmatism. They way your vision looks due to astigmatism can vary, depending on these additional factors. For example, in a study in the Journal of Optometry, researchers found that the strength of the blur caused by astigmatism was different among several different combinations of astigmatism and other vision issues.
Astigmatism Can Progress With Time
Mayo Clinic reports that astigmatism can cause a variety of symptoms.
- Eye pain
- Distorted vision, especially in low light
While you can't make astigmatism worse by reading in low light, squinting, or sitting too close to the television, the symptoms caused by astigmatism can make it hard for you to enjoy your everyday life. You may find that these symptoms grow harder and harder to ignore as time goes on.
You may need glasses or contact lenses to sharpen your vision, and your prescription may change with time. When that happens, you may need new glasses or contacts to correct for the vision shift. That changing prescription could be caused by other vision issues that contribute to low vision, such as myopic changes, but they could also be caused by astigmatism-related issues.
Astigmatism Can Be Treated
Glasses and some types of contact lenses can help you to see clearly despite astigmatism, but they are not considered treatments for astigmatism. They do not change the shape of the eye, and they do not correct a mismatch in curvature between the cornea and the lens of the eye.
Some types of contact lenses can help to amend the shape of the eye. These rigid contact lenses are worn at night, and they temporarily change the shape of the eye. When you awaken in the morning, you might see clearly due to this change in shape; however, in the evening, when your eye returns to its accustomed shape, the blur may return.
Astigmatism is measured in diopters. The American Refractive Surgery Council reports that people with astigmatism up to six diopters may be considered treatable, as long as their nearsightedness or farsightedness is not too extreme.
In topography-guided LASIK, surgeons use a machine to measure the shape of the structures of the eye, and the data generated by those measurements is used to guide the machines during the surgery process. This can be a good option for people with astigmatism, as the machine allows doctors to perform very precise adjustments during surgery, carefully matching tissue removal with unusual eye shapes.
In a study of the efficacy of this type of surgery, published in Ophthalmology Times, researchers found that all of the people with astigmatism who had this surgery achieved 20/20 vision. Studies like this demonstrate just how powerful this surgery can be in helping people to overcome vision problems caused by astigmatism.
The use of computers in LASIK surgery for astigmatism is not new. Back in 2002, researchers writing in Ocular Surgery News discussed the use of software to amend aberrations in shape in those with astigmatism. Since that time, doctors have become adept at both measuring the shape of the eye and using technology to help them find the right surgical approach.
Even though LASIK can be very helpful in the treatment of many kinds of astigmatism, it is not the right approach for every person and every set of eyes. For example, according to research cited by Science Daily, people who have severe astigmatism may not be considered good candidates for LASIK. They may benefit from a surgery that involves placing a new lens inside of the eye. In this study, only 60 percent of people could achieve 20/40 vision with glasses or contacts before surgery. Five years after surgery, 57 percent achieved 20/40 vision without the use of glasses or contacts.
This is a remarkable result. Few of these people were able to see clearly even with glasses before the surgery. After it, some didn't need glasses or contacts at all. If you have severe astigmatism and LASIK isn't right for you, studies like this should give you hope that your doctor will be able to offer you a solution that might help.
Understand the Risks and Benefits of LASIK Surgery for Astigmatism
LASIK surgery is a permanent correction of the shape of your eye, and it is designed to reduce your reliance on glasses and contact lenses. For many people who have LASIK, the surgery completely amends their ability to see clearly. For example, in a study published in the journal Investigative Ophthalmology and Visual Science, researchers found that among people with high astigmatism, 73.8 percent of people achieved 20/20 vision after surgery.
This is impressive, and it does indicate that at least some people emerge from surgery without the need to wear glasses or contacts at all. But this kind of outcome does not happen for all people.
The American Refractive Surgery Council reports that less than 5 percent of people come out of surgery with vision that is worse than the vision they had with their prescriptions before surgery. In other words, some people end up seeing worse after surgery.
When this happens, your doctor may be able to provide you with dry-eye treatments. When your eyes are gritty and dry, which is common after surgery, your vision can seem cloudy and blurred. Providing you with therapies that boost the production of tears could make that blurriness fade.
Your doctor may also be able to provide you with a second surgery to remove yet more tissue to help clear your vision. This is not the right option for all people, but it could be worthwhile if you struggle with your vision after LASIK and your eyes are healthy enough for a second surgery.
In time, you may need to wear reading glasses, even after LASIK. As we age, the muscles that stretch and pull the lens of the eye can weaken, and the lens can grow stiffer. That makes it hard to see things close up, and it can require the use of reading glasses. This is not an issue that can be prevented or corrected with LASIK.
It's also important to note that not all people are considered good candidates for surgery. As the Federal Aviation Administration tells pilots considering surgery, you may be declined for surgery if you:
- Have a history of corneal ulcers.
- Have eye diseases, such as glaucoma, dry eye, herpes simplex, or keratoconus.
- Have a health condition such as AIDS, lupus, or diabetes.
- Have a history of side effects while using steroids.
- Use an acne medication such as Accutane.
LASIK surgery can also cause complications that could stick with you. For example, the Federal Trade Commission reports that some people develop an inability to see clearly at night after surgery. They may struggle to drive at night due to periodic blindness caused by bright lights. Some people also develop a decrease in contrast sensitivity, which can make objects seem fuzzy even in bright light.
Before you schedule surgery, you will need to ensure that you can live with these complications if they happen to you. The risk may be low, but it still exists. If you cannot handle the idea of these low risks, it might be best to avoid surgery.
Prepare for LASIK Surgery With a Doctor's Help
If you choose to move forward with surgery, you'll need to work with a doctor. As part of your preparation, you will go through a lengthy eye examination with a qualified professional.
As a doctor writing for Cataract and Refractive Surgery Today points out, a doctor might check your eyes closely for keratoconus, as well as ensuring that your corneas are neither too steep nor too thin. These are issues that can play a role with astigmatism, so your doctor will want to check your eyes closely to ensure that they are not happening to you.
If you wear contact lenses, your doctor will ask you to stop wearing them for a few weeks before your examination. As the U.S. Food and Drug Administration points out, some contacts can change the shape of your corneas. Removing those lenses before your examination can ensure that your doctor takes accurate measurements. You will need to leave those contacts out before your surgery too, so your corneas are in their normal shape during the surgery.
You will need a ride home from surgery, as the medications used during the procedure may make driving unsafe for you. You may also be asked to avoid using lotions, creams, makeups, and other similar items on your face on the day of surgery and while you heal.
The surgery itself takes just minutes, and your doctor will use numbing drops and medications to keep you from feeling pain during the procedure. You may be asked to look at a bright light during surgery, and some people find it uncomfortable to look at this light for long periods, but you should not feel pain during the procedure.
After the procedure, you may feel discomfort. Your doctor can provide you with medications to ease that pain.
You Will Need to Pay for Care
According to the American Refractive Surgery Council, LASIK costs about $4,500. In most cases, insurance companies consider this a cosmetic procedure, and as a result, they do not pay for the surgery. It's likely you will need to pay for this procedure on your own.
Some providers offer payment plans, so you can get the care you want without breaking your budget. Others offer special discounts for people who pay in cash, schedule at a specific time, or have a specific coupon code. Deals like this can save you a great deal of money. You may need to delay surgery until the deal is ready for you to take, but that delay could put the surgery within a budget you can afford.
Let Us Help
At NVISION, we know that life with astigmatism can be difficult. We'd like to help. Our surgeons can explain your options for LASIK surgery, and we can help you understand whether or not the surgery is right for you. We can also explain our payment options that make covering the cost of surgery easy. Please contact us to find out more about how we can help.
Astigmatism. (April 2017). Healthline.
A Rational Approach to Irregular Astigmatism. (September 2011). Review of Ophthalmology.
Astigmatism. American Optometric Association.
Influence of Different Types of Astigmatism on Visual Acuity. (July 2017). Journal of Optometry.
Astigmatism. Mayo Clinic.
Does My Eyeglass Prescription Qualify for LASIK? (February 2017). American Refractive Surgery Council.
Topography-Guided LASIK Rivals SMILE for Myopia, Myopic Astigmatism. (March 2018). Ophthalmology Times.
Software Aims to Reduce Astigmatism After LASIK. (December 2002). Ocular Surgery News.
Patients Unsuitable for LASIK Could Benefit From Vision Correction Surgery Using Intraocular Lenses. (October 2016). Science Daily.
Comparative Study of the Outcome of LASIK in Moderate Versus High Astigmatism. (April 2014). Investigative Ophthalmology and Visual Science.
LASIK: What to Do When Your Expectations Aren't Met. (October 2018). American Refractive Surgery Council.
Information for Pilots Considering Laser Eye Surgery. Federal Aviation Administration.
The Basics of LASIK Eye Surgery. (August 2012). Federal Trade Commission.
High Regular Corneal Astigmatism. (May 2016). Cataract and Refractive Surgery Today.
What Should I Expect Before, During, and After Surgery? (July 2018). U.S. Food and Drug Administration.
LASIK Cost: Finding Ways to Pay for Vision Surgery. (March 2016). American Refractive Surgery Council.