Understanding Astigmatism -Diagnosis & Treatment

How Is Astigmatism Diagnosed?

People usually complain of blurred vision or children may fail their vision exam at school before they’re diagnosed with astigmatism.

The doctor may use one or more of these four tests to diagnose astigmatism and measure the severity.

Vision test. It's the simplest yet most important part of an eye exam. Using a standardized chart, patients read the letters they can see from 20 feet away. If your vision is 20/20, this means you can see at 20 feet what a normal eye can see from 20 feet. If your vision is 20/80, this means you can only see at 20 feet what a normal eye should be able to see from 80 feet away.

Refraction. The doctor uses loose lenses or a lens machine (phoropter) to hold corrective lenses in front of your eye. The doctor looks at the light reflex from your eye through a handheld device called a retinoscope to determine if any refractive error is present. Then the eye doctor will offer you different choices in lenses through the phoropter to refine the correction until you can see the vision chart clearly. After both eyes are measured your doctor will write a prescription for eyeglasses based on which corrective lenses worked for you.

Keratometry. This machine measures the curvature of your central cornea.  Corneas that have no astigmatism exhibit uniform or symmetrical curvature.  Corneas with astigmatism do not have uniform curvature. The keratometer determines the steepest and the flattest curves. These measurements tell your doctor about your corneas' shape and focusing power. The keratometer is also used to fit contact lenses and to monitor corneal curvature after eye surgery.

Corneal Topography. This advanced technology provides the most detailed information about the shape of a cornea. The patient looks at a visual target while the device collects thousands of tiny measurements. A computer then constructs a color map on the computer from the data. This corneal map allows the doctor to see a three-dimensional picture of your cornea. Such sophisticated measurements are important for planning refractive surgery and occasionally for fitting contact lenses.

What Are the Treatments for Astigmatism?

Astigmatism can be corrected with glasses, contact lenses, or surgery.

Eyeglass lenses are shaped to counteract the shape of the cornea that's causing blurred vision. Eyeglasses work well when the patient looks straight ahead. But, depending on the specific correction, the glasses can make the floor appear to tilt. Some doctors argue that people with very small amounts of astigmatism are best left untreated. Patients with significant astigmatism usually adjust to their first pair of glasses within a week or so. If things remain unclear ask your doctor to recheck the prescription and verify the correction in your new spectacles.