Astigmatism is a common refractive error caused by a cornea or lens that has an irregular shape, so light is refracted poorly onto the retina. Many people with astigmatism need glasses or contact lenses to see clearly, but if you want to cure your astigmatism, either LASIK (laser-assisted in situ keratomileusis) or PRK (photorefractive keratectomy) can correct your vision.
LASIK is a popular procedure that works for most people, but not everyone. PRK works well for some groups who are not good candidates for LASIK, like people who have naturally thinner corneas or those who have chronic dry eyes. You may not be a good candidate for PRK in some cases either. There are still several vision correction surgeries you may benefit from in this case.
Your astigmatism may not need any treatment if it is mild. Many people report they are satisfied with glasses or contact lenses. If you want a more comprehensive solution to astigmatism, laser eye surgery is your best bet.
What Is Astigmatism? Is There a Cure?
Refractive errors like nearsightedness, farsightedness, and astigmatism blur your vision and make seeing at certain distances difficult. If your eye has an irregular shape, causing general blurry vision, you have astigmatism.
This condition comes in two basic types:
- Corneal astigmatism, which occurs when your cornea has an irregular shape.
- Lenticular astigmatism, when the lens in your eye has an irregular shape.
Astigmatism is typically treated with corrective eyewear like glasses or contact lenses. Like other refractive errors, this condition is very common and easy to diagnose and treat. If you have untreated astigmatism, you will struggle with blurry vision, and you may also suffer from headaches, eyestrain, squinting to see clearly, and eye discomfort.
While your optometrist will typically prescribe either glasses or contact lenses to compensate for the irregular shape of your eye and improve your vision, you may also consider a laser refractive surgery to correct the shape of the cornea. In most cases, this operation can completely correct astigmatism, effectively curing it.
Laser Surgeries That Can Cure Astigmatism
There is no known exact cause of astigmatism, so there is no specific approach to preventing this condition. It has long been considered very treatable, like other refractive errors. Most people with astigmatism have normal lives with the help of glasses or contact lenses.
There are two forms of laser eye surgery that can effectively cure astigmatism by reshaping the cornea. These are LASIK and PRK.
- Laser in situ keratomileusis (LASIK): This widely used type of laser surgery has helped people around the world achieve clearer vision by reshaping the cornea. A laser device will shave off a few layers of the cornea, which is over the pupil outside the eye. The process does not take long, and many refractive errors can be fixed, including astigmatism. Since astigmatism involves an irregularly shaped cornea, reshaping this small part of the eye will improve vision. You may not achieve 20/20 vision, but you can achieve enough visual clarity (typically 20/40 or better) to perform most activities without needing glasses or contact lenses. There are some instances when LASIK may not be right for you. You and your ophthalmologist may decide it’s not the ideal option for you if:
- You have a disease or take a medication that can affect wound healing.
- Your career prohibits refractive procedures, or you are in a very physically demanding field.
- You changed your glasses prescription in the past year, indicating that your eyes are still changing too fast for LASIK to work.
- You have thin corneas.
- You have already had a LASIK procedure in the past.
If you are over the age of 18, and your astigmatism does not exceed 3.0 diopters in magnitude, then chances are good that LASIK will work for you. Ask your optometrist or ophthalmologist for an evaluation, so you understand all your potential risk factors.
- Photorefractive keratectomy (PRK): Like LASIK, PRK uses a guided laser to shape off some layers of cells of the cornea, creating a regular shape that refracts light correctly onto the retina. As a result, this leads to clearer vision, usually 20/40 or better. While PRK is less popular than LASIK, it is also an effective treatment for refractive errors, including astigmatism. PRK is a better treatment for people who have chronic dry eyes or thin corneas. Unlike LASIK, PRK does not require cutting a flap in the cornea, so you are less likely to dislodge this flap later or have an overcorrection when too much of the inner cornea is removed. Like LASIK, there are some conditions that prevent you from being a good candidate for PRK. It may not be a good choice for you if you have:
- An unstable or consistently changing refractive error.
- A disease or medication that slows down your body’s ability to heal.
- A history of scarring easily.
- Corneal abrasions or a corneal disease.
- Advanced glaucoma.
- Uncontrolled diabetes.
- Hormonal changes (in pregnant or nursing women).
- Some eye infections or a history of chronic eye infections.
You may be a good candidate for PRK but not LASIK, so ask your optometrist about this option too. Like LASIK, PRK can successfully correct astigmatism, effectively curing it.
Other types of laser surgery, like LASEK (laser-assisted subepithelial keratectomy), Epi-LASIK, and small-incision lenticule extraction (SMILE) can also correct astigmatism using variations on laser surgery techniques. In some cases, you may prefer implantable contact lenses or clear lens extraction rather than a laser-based procedure. If you are a better candidate for these than PRK or LASIK, you can ask for more information from your optometrist or ophthalmologist.
Your Astigmatism May Not Need Any Treatment
While there is no way to prevent astigmatism if you are prone to this condition, you may not need laser surgery for most types of this condition. Many people are satisfied with glasses or contact lenses if they need vision correction. In some cases, an optometrist may diagnose a mild astigmatism, but the condition does not require any type of vision correction.
Many people who have astigmatism in one or both eyes require some type of eyewear so they can see clearly, and they may decide that they do not want to deal with wearing glasses or contact lenses most of the time. For most people, laser surgery corrects the astigmatism permanently, which means they are cured of this condition.
Laser surgery requires very little time in the operating room and minimal recovery at home. Many people who undergo LASIK return to work a day or two after the procedure. This ensures the overall cost stays low, and your life will barely be impacted by the procedure.
What Is Astigmatism? American Academy of Ophthalmology (AAO).
Astigmatism. (June 2019). National Eye Institute (NEI).
Astigmatism. (September 2019). Mayo Clinic.
LASIK. (March 2018). U.S. Food and Drug Administration (FDA).
Can LASIK Fix Astigmatism? (March 2018). All About Vision.
When is LASIK Not for Me? (July 2018). U.S. Food and Drug Administration (FDA).
What Is Photorefractive Keratectomy (PRK)? (September 27, 2017). American Academy of Ophthalmology (AAO).