What is the best solution for blurred vision caused by astigmatism? Your doctor is the best person to answer that question. When you start the conversation, you might be given several options that could help.

One solution is orthokeratology, but it is not designed for people with some types of astigmatism. (Learn more) LASIK surgery, on the other hand, is designed for astigmatism. (Learn more)

Both procedures come with risks, so you will need to consider your options carefully. (Learn more) Costs between the two can vary as well, and neither is typically covered by insurance. (Learn more)

Shot of an attractive young woman relaxing on her bed in the morning at home

Ortho-K Is Not Made for All Types of Astigmatism

 

Astigmatism refers to the shape of your eye. In most cases of astigmatism, the cornea of the eye is an unusual shape. That unusual shape causes light and images to move through the eye in a less than optimal fashion, and that can lead to images that are blurred or fuzzy.

There are other medical conditions that can lead to blurred vision. One such condition is myopia. If you have this condition, you may be able to see things clearly when they are close to your eyes. When things are farther away, they slip from sharp focus.

Orthokeratology, or ortho-k, involves wearing contact lenses at night to push against the cornea. According to the American Academy of Ophthalmology, this technique is mainly used to help people with myopia. In about two weeks of wearing the lenses, most people experience the maximum benefit of the procedure. In cited studies, most people achieve 20/40 vision or better with the specialized lenses.

Researchers writing in the journal Eye and Contact Lens report that some families use these lenses to curb myopia in their children. During the night, the lenses help to flatten the central portion of the cornea, while changing the corneal layers. The researchers are not certain how the lenses elicit these changes, but they feel confident that the lenses do have the potential to change the shape of growing eyes in kids. That could help these children to avoid the need for thicker and thicker glasses in order to see things far from them.

Some people with astigmatism also have myopia, and it is possible that the ortho-k lenses could help to amend the myopia to such a degree that the astigmatism changes are less noticeable and easier to live with. But much of the research done on the lenses has been performed on people with myopia, so truly understanding the benefit for those with only astigmatism is difficult.

The American Optometric Association reports that ortho-k can be used to treat low or moderate degrees of astigmatism. This is not a belief accepted by all researchers.

In the Journal of Optometry, researchers say that ortho-k is often recommended for people with astigmatism of 0.75 to 1.5 diopters. But the researchers in this study suggest that these values were created in an arbitrary manner, and that people with higher levels of astigmatism might also benefit from the use of ortho-k. Larger, national organizations like the American Optometric Association maintain that this is a procedure that works best for those with mild or moderate astigmatism.

Close-up blue eye

LASIK Is Designed for Astigmatism

 

During a laser-assisted in-situ keratomileusis (LASIK) procedure, a doctor makes a slice across the cornea and pulls up a flap of corneal tissue. Then, a laser pulses on the remaining cornea based on measurements taken before the surgery. When a precise amount of tissue has been removed, the flap is replaced and the eye is allowed to heal.

LASIK is also designed to help people with myopia. But according to the American Academy of Ophthalmology, it differs from ortho-k in the severity of astigmatism that can be corrected. LASIK can be used for people with astigmatism, depending on the machine. Some are able to make very precise measurements and tissue removals, which might be very helpful for those with higher levels of astigmatism.

People with levels of astigmatism up to 6 diopters can be treated with LASIK, according to the American Refractive Surgery Council.

LASIK is widely studied, and there is a great deal of information that suggests people who have this surgery are pleased they have done so. In fact, the American Refractive Surgery Council reports that 96 percent of patients who have had LASIK are satisfied with the results.

Newer forms of LASIK allow your doctor to map your eye and plan your surgery very carefully, based on your individual topography. This advanced layer of technology is not available with all LASIK surgeries, and it can come with a higher price tag, but it might be the intervention that works best for people with astigmatism.

Both Procedures Come With Risks

 

Both ortho-k and LASIK are made to help you see clearly without the constant use of glasses or daytime contact lenses. Both of these solutions are remarkable, but it is important to know that both come with risks. Some can be mitigated, while some cannot.

For LASIK, one of the major concerns involves surgery. This is a quick procedure that is over in minutes, but during that time, you will be sedated with medications, and your eye will be sliced with a machine. Some people are simply not healthy enough to move through this procedure and heal properly. Any surgery comes with risks, and LASIK is definitely a surgery.

Ortho-k comes with a risk of infection. As researchers writing in the journal Eye and Contact Lens point out, the infection that can take hold with the ortho-k lenses can be sight-threatening. Each night, you will place a device inside of your eye and it will remain there all night. During that time, bacterial cells can set up shop between the lens and your eye, and those cells can grow into colonies that take over your cornea and steal your sight away. Without proper sanitation protocols, those infections could be quite serious and hard to treat.

Sanitation protocols include:

  • Washing hands before touching the lens.
  • Washing the face before inserting or removing lenses.
  • Washing the lenses with bacteria-killing solutions.
  • Changing the lenses regularly.

Skipping some or all of these steps can lead to significant complications, and that means you will need to handle all of these steps every day. People who prefer to just drop into sleep without hassling over hygiene may find this to be a big drawback of ortho-k.

Ortho-k is also not a permanent correction for vision issues. As researchers found in a study published in the journal Investigative Ophthalmology and Visual Science, people who stopped wearing the lenses saw a return to baseline poor vision levels within one week. People who want to experience the benefits will need to follow the procedure for the rest of life.

For some people, that could be a benefit. As a doctor writing in Review of Optometry back in 2002 points out, our need for vision correction can change throughout our lifespan. We may have jobs that require long-distance vision as adults, such as long-distance trucking, and then retire to hobbies that require close vision work, like fly fishing. Corrections with LASIK may not allow us to change our mind about the optimal focus length. Ortho-k may allow for those changes.

Costs Between the Two Procedures Can Vary

Glasses can help to amend the blurriness that astigmatism can cause, and according to most insurance plans, glasses or daytime contact lenses are the preferred method of amending vision. Most insurance plans do not consider other methods of improving vision, such as ortho-k or LASIK, to be medically necessary. As a result, these providers usually ask patients to pay the bills on their own, and the bills for these procedures can be large.

Lenses for ortho-k cost about $2,000 per year, according to National Public Radio. There are additional costs involved with sanitizing the devices. None of these costs are paid for by insurance.

LASIK can cost between $1,000 to more than $3,000 for each eye, according to insurance provider VSP. This is a one-time cost, in most cases, but it is a steep amount of money for some families to pay out of pocket.

Which Plan Is Right for You?

 

No two eyes are exactly alike. The astigmatism issues you are living with might be very different than the issues someone else is living with, even if that person has astigmatism that is similar to yours.

That's why getting an examination from a qualified professional is so important. A medical professional can examine your eyes, look over your history, and help you understand what might be the best solution for your blurred vision and other astigmatism symptoms. Not all eye clinics offer an exam like this. We do.

We would like to connect you with a qualified ophthalmologist who can help you understand what you should do in order to clear up your vision and make your world crisp and clear once more. We can explain the risks and benefits of all the solutions we offer, and we can help you make a decision that is right for you and your eye issue. Call us to make an appointment. We would love to tell you more. 

We Promise Our Patients Peace of Mind
Consultation
Consultation

During the consultation, we will ask you about your eye health history and your medications, and perform some tests. You will then be examined by the surgeon who will discuss your treatment options. Your personal Patient Counselor will help you throughout the process.

Your Counselor can review payment options and schedule you for surgery and related appointments, such as pre- and post-operative exams. Prior to your procedure you will have a dilated eye exam, and you should discontinue wearing your contact lenses and begin taking eye drops as instructed.

Procedure
Procedure

Plan to be at the center for two to three hours the day of your procedure. ICL eye surgery is a fairly brief outpatient procedure. Your surgeon dilates your eyes, and gives you a local anesthetic to numb the area. A tiny incision is made, and the clear lens is slipped between your iris and your eye’s natural lens. The day of your procedure should be a day of rest.

Post Procedure
Post-Procedure

Your Patient Counselor will give you detailed post-operative instructions and eye drop regimen for your recovery. After ICL surgery, you’ll need several follow-ups with your eye doctor. Visual recovery is rapid, and you can expect noticeable improvement within a day or two. Most patients are generally able to return to their normal activities within two or three days following their procedure.

References

 

What Is Orthokeratology? (September 2018). American Academy of Ophthalmology.

The Role of Orthokeratology in Myopia Control: A Review. (July 2018). Eye and Contact Lens.

Ortho-K. American Optometric Association.

Correction of High Amounts of Astigmatism Through Orthokeratology. A Case Report. (October 2010). Journal of Optometry.

LASIK for Myopia and Astigmatism: Safety and Efficacy. (January 2015). American Academy of Ophthalmology.

Does My Eyeglass Prescription Qualify for LASIK? (February 2017). American Refractive Surgery Council.

LASIK Complication Rate: The Latest Facts and Stats You Should Know. (October 2017). American Refractive Surgery Council.

The Safety of Orthokeratology—A Systematic Review. (January 2016). Eye and Contact Lens.

Recovery of Corneal Irregular Astigmatism, Ocular Higher-Order Aberrations, and Contract Sensitivity After Discontinuation of Overnight Orthokeratology. (May 2008). Investigative Ophthalmology and Visual Science.

Which to Recommend: LASIK or Ortho-K? (October 2002). Review of Optometry.

Overnight Contacts Can Help Kids' Sight During Day, but Also Carry Risks. (May 2015). National Public Radio.

How Much Does LASIK Cost? VSP.