Astigmatism – causes, symptoms, astigmatism test, treatment [EXPLAINED]

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Astigmatism manifests as a distortion of vision. The correct human eye is built in such a way that a sharp image of the observed object is obtained on the retina. It is possible thanks to the structure of the eye which enables the focusing of all the light rays falling into the eye in its focus. What is Astigmatism? How is it manifested and how is it treated?

Astigmatism – what is it?

Astigmatism (corneal ataxia) is a defect in which your vision becomes distorted as a result corneal imbalancemore specifically, there is a disadvantage in which the power of the optical system of the eye is unable to form a spot image on the retina due to power differences for different sections of the optical system. The cornea should have even curves, as does the ball. In some people with astigmatism, the cornea is more like a rugby ball, which prevents the eye from properly focusing the light rays. This results in blurred vision.

Eye astigmatism is very often associated with far-sightedness and myopia. In the case of myopia in one axis and hyperopia in the perpendicular axis, such an atrophy of the eye is called mixed (mixed astigmatism). It is measured with cylindrical diopters. Astigmatism is also a physiological condition that occurs in every human being – each of us has 0,5 diopters. Up to 1 diopter astigmatism is defined as low astigmatism, up to 2 high astigmatism, and up to 3 is very high astigmatism.

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Astigmatism – types

Regular astigmatism occurs in most cases. It is characterized by the fact that the cross-sections of the optical system of the eye – where the optical power is the smallest and the greatest – are oriented perpendicular to each other. Consequently, the magnitude of astigmatism is equal to the difference in refractive power between the two sections with the highest and the smallest value – the so-called main sections that form a right angle.

Regular astigmatism can come in three forms:

1. regular simple astigmatism (consistent with the rule) – the cornea is steeper vertically than horizontally. This causes a greater vertical refraction of light,
2. regular inverse astigmatism (against the rule) – occurs when the refraction of light is greater in the horizontal plane,
3. regular oblique astigmatism – occurs when the axis is in the ranges between simple and inverse regular astigmatism.

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There is also a division of astigmatism due to the location of the foci in the main sections (clinical classification):

1. Ordinary short-sighted astigmatism – we talk about it when one of the foci lies on the retina, the other in front of the retina (in one main view the eye is regular and in the other it is short-sighted),
2. complex myopic astigmatism – occurs when both foci lie in front of the retina (in both main sections the eye is short-sighted),
3. Ordinary long-sighted astigmatism – occurs when one of the foci lies on the retina, the other behind the retina (in one main view the eye is regular and in the other it is hyperopic),
4. complex hyperopic astigmatism – both foci lie behind the retina (in both main sections the eye is supersighted),
5. mixed astigmatism – one of the foci lies in front of the retina, and the other behind it (in one main view the eye is short-sighted and in the other it is hyper-sighted).

The medical literature also distinguishes corneal, lenticular and mixed astigmatism. Corneal astigmatism – the most common one, it is estimated that it accounts for about 98% of all cases. This defect is due to the abnormal shape of the cornea, which then resembles a rugby ball. Lenticular astigmatism is quite rare. This defect is an abnormality in the lens of the eye. In mixed astigmatism, there is an abnormal structure of the lens along with a distortion of the cornea.

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Astigmatism – causes of development

The exact cause of astigmatism is not known. However, it is known to be inherited and occurs when the surface of the eye (the cornea) or the lens of the eye just behind it does not have a regular, “spherical” shape, but resembles a rugby ball. This scatters the light entering the eyethat does not focus properly on the retina, resulting in a blurry image.

Eye injuries often result in an uneven surface of the cornea, which results in irregular astigmatism with more focal lengths. Keratoconus, a condition that causes the cornea to form a cone, can also be a cause of astigmatism. This results in much more severe astigmatism, which may need to be corrected with special contact lenses or surgery. However, it is less common.

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Main symptoms of astigmatism:

1. blurred vision when observing objects near and far,
2. vision as in a fog, the so-called fog on the eye (both from far and near),
3. tension in the eyeballs,
4. eye pain,
5. headaches (in the forehead area),
6. seeing stars as spots
7. rubbing the eyes,
8. squinting eyes
9. itching, burning, watery eyes
10. seeing straight lines as curves
11. tilting the head
12. more frequent blinking,
13. no simultaneous sharp vision of vertical and horizontal lines,
14. general eye fatigue or significant eye strain during visual exertion,
15. quick fatigue when reading,
16. mylenia liter,
17. reduced level of understanding of the text being read,
18. problems with concentration,
19. disturbed sense of space (blurred contours).

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If astigmatism is accompanied by other eye defects, which is quite a common phenomenon, the correct diagnosis requires specialist consultation and appropriate tests.

Astigmatism and age

It is estimated that about 50% of newborns have astigmatism at birth. By the age of 5, this number drops to 20%. It is caused by the growth and development of the organism. Astigmatism in a child up to 4,5. r. f. is usually against the rule, later the rule-compliant astigmatism prevailed. In school-age people (5–18 years of age) the cornea is flatter and the astigmatism values ​​are low according to the rule, the astigmatism is reduced.

In the 18–40 age range, the cornea is already quite stable, the most common form of astigmatism is consent-to-rule astigmatism. In people over 40 years of age there is a steep cornea (mainly in the horizontal section) and the astigmatism axis is shifted in the direction against the rule.

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Astigmatism test – diagnosis

Due to the fact that astigmatism most often occurs with hyperopia or myopia, it is difficult to diagnose. Therefore, it is best to consult an ophthalmologist or optometrist. He will conduct specialized tests to diagnose the disease. What are the methods for determining astigmatism?

1. keratoscope: this is the tool of the Portuguese ophthalmologist A. Placido. It is in the form of a disc with white and black circles. During the examination, the doctor observes the shape of the reflections of the circles on the cornea,
2. Ophtalometr Jawala: examines the degree and axis of eye astigmatism,
3. computer videokeratography (the most accurate method): the image of the Placido disk thrown on the surface of the cornea is used for the examination, then it is recorded by a webcam, sent to a computer and analyzed. The result is a map of the cornea, a cross-section of the surface of the cornea, a map of digital values ​​of the curvature of the cornea.

All the above-mentioned methods are painless and consist only in observing the eye by an ophthalmologist using various types of instruments.

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Astigmatism – choose glasses or contact lenses?

Ocular correction is the most frequently used form of correcting typical refractive errors such as myopia. To correct non-folded eye astigmatism, only lenses are used. In the case of complex inconsistencies, both spherical and cylindrical correction is used.

In practice, the spherical-cylindrical combination is provided by toric lenses (cylindrical lenses) which have a different radius of curvature at each meridian. This type of contact lens has a thicker bottom zone to prevent lens rotation in the eye. This enables a constant and predictable orientation of the lens, which in turn ensures better visual acuity. In most cases, glasses can be successfully replaced with properly selected contact lenses (cylindrical lenses).

Currently, there is a large selection of contact lenses that should be selected for you depending on your vision defect and after consulting your ophthalmologist. If there is a slight (up to about 1 diopter) astigmatism, glasses are usually only worn for learning, driving a car, or working at a computer. And almost every person has the so-called physiological astigmatism – up to approx. 0,5 diopters.

Surgical (refractive) treatment of astigmatism (radiant keratotomy): was a method popular in the 70s, a method of correcting astigmatism, consisting in making several deep incisions in the cornea (up to 95% of its thickness) radiating around the pupil in order to change its focusing power of light rays.

Treatment of astigmatism with laser methods:Currently, the most frequently used refractive surgery procedures are procedures using the excimer laser – PRK and LASIK. It is used to alter the curvature of the cornea.

1. LASIK (laser assisted in situ keratomileusis), i.e. the laser at the site of keratomillosis, is a two-stage technique, the aim of which is to model the surface of the cornea so that it can properly focus the image on the retina.
2. PRK (photo – refractive keratectomy), also known as photorefractive keratectomy, is a treatment on the cornea, the aim of which is to properly model the central surface of the cornea with a laser beam so that it focuses the image precisely on the surface of the retina.

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Home vision training may be advisable for strabismus, as it prevents complications such as a lazy eye. They are also a form of rehabilitation and part of the treatment in the early stages of this disease. Visual training can also work in the case of eye defects such as myopia. It is also recommended as a form of prophylaxis, as well as a way to care for eye hygiene, especially in the case of people working a lot in front of the computer. Appropriate eye exercises are also recommended for children, including visually impaired children.

Astigmatism in children affects the reluctance to learn, takes away energy, people driving motor vehicles often have impaired visual acuity and feel more tired, which is a hazard on the road. It is important to choose the right contact lenses or glasses.

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