Astigmatism is a common and generally treatable imperfection in the curvature of your eye that causes blurred distance and near vision. Astigmatism occurs when either the front surface of your eye (cornea) or the lens, inside your eye, has mismatched curves. Instead of having one curve like a round ball, the surface is egg shaped. This causes blurred vision at all distances.
Q: How will I know if I have / my child has Astigmatism?
A: Typically patients with astigmatism can manage all day to day activities without any need of spectacles (they tend to squeeze/ squint the eye to temporarily improve vision). Its only when ocular demand increases (like excessive computer vision work / TV/ reading work ) that they get tired. Tiredness increases more in evening hours because muscles are already exhausted during the day.
Q: How can it be corrected?
A: It can easily be corrected by wearing spectacles. But often it is very difficult to motivate the patient to wear the glasses regularly because he/she is can manage most daily activities by forcing the eye temporarily. Motivation is the key to treatment of symptoms. In later stages (>21 years of age) wave front guided corrective procedure can be done to remove astigmatism in non-spectacle compliant patients.
Q: How can I motivate my child to wear glasses even when I / my child can manage all daily activities?
A: Motivation can be done by making the child understand the need for glasses and by giving him ample opportunity to select a frame of his/ her choice so that it enhances child appearance and he/she wants to wear a glass. Other small rewards like “letting the child see TV only when he/she wears a glass” can also help in motivation.
Q: What are implications of astigmatism?
A: Astigmatism is usually very easily corrected with glasses but it has to be monitored regularly because high astigmatism (>2 D) with irregular axis can often be a red flag sign of corneal thinning disease called keratoconus.
Q: What tests are needed to evaluate if I have high astigmatism?
A: Corneal tomography and pachymetry are 2 important tests to be done in case of high astigmatism. These tests help in analysing the risk of keratoconus and also to see the progression.
Q: What precautions have to be taken while getting spectacles made?
A: While we take utmost care in our refractions. We advise post mydriatic test (we call you again for final prescription after effect of cycloplegic drops wears off) in selected patients. Occasionally, in high astigmatic patients we do tests for checking corneal cylinder to improve accuracy in refraction.
Spectacle frame should not be too large in size because sometimes centration of cylindrical axis does not correctly fit in a large frame. Always get frame centre marked by optician in case of astigmatism.
Q: What happens after I get my spectacle number changed/ get a new glass made?
A: Most of astigmatism patients initially take some time to adjust to the new frame/ changed glass power. This usually takes about 3-4 days. During which it is normal for patient to find the floor / stairs slanted. These symptoms last not more than 3-4 days. In case you feel symptoms to persist then contact your ophthalmologist for checking the lens centration and glass power again.
Q: What can I do to prevent worsening of astigmatism?
A: Wearing a correct powered spectacle is the easiest way to prevent further increase in astigmatism. One should not rub the eyes too much as this might worsen the situation. Use lubricant eye drops in case you feel any itching or irritation in eyes.
Q: Can nutrition help in reducing the astigmatism?
A: Wholesome diet of green leafy vegetable, fruits and protein are very important for ocular health and may prevent further deterioration. However the chances of complete disappearance of astigmatism by nutrition alone is unlikely.
Q: Can ocular exercises help in reducing astigmatism?
A: Exercises do not help in relieving the magnitude of astigmatism but they do help relieving symptoms of ocular fatigue in case poor accommodation and convergence. Usually most patients respond well to spectacle therapy alone. In case symptoms do not get relieved by spectacles then ocular exercises are advised after complete ORTHOPTIC EVALUATION which checks the muscle balance of eyes.