What Causes Astigmatism to Worsen? Our Optometrist Answers Your Questions!

Do you find yourself squinting at your computer? Does blurry vision make road signs hard to read, no matter how close you get? You might be dealing with astigmatism, one of the most common vision problems. While it’s often stable, it can change, leading to concerns about worsening vision.

As your partners in eye care, we at Kodak Lens Vision Centres want to provide clarity. We’re answering your top questions about what astigmatism is, what causes it to change, and how you can maintain clear, comfortable vision.

What is astigmatism?

Astigmatism is not an eye disease, but a common refractive error. It’s a small imperfection in how your eye focuses light.

In a perfect eye, the cornea (the clear front surface) and the lens of the eye (the internal focusing part) are perfectly round, like a basketball. This shape bends light evenly to a single, sharp focal point on the retina, giving you clear visual acuity.

With astigmatism, the cornea or lens is shaped more like a football: more curved in one direction than the other. This irregular shape prevents light from focusing correctly, creating multiple focal points instead of one. The result is blurred or distorted vision at all distances. Your eye doctor can diagnose this during a routine eye exam using a visual acuity test (the eye chart) and a refraction test (the “which is clearer, one or two?” test).

What causes astigmatism?

Astigmatism is caused by an irregular, non-spherical curve in one of two places:

1. Corneal Astigmatism: The most common type, where the cornea itself is irregularly shaped.
2. Lenticular Astigmatism: This is less common and occurs when the lens inside the eye is misshapen, and the eye’s lens has an irregular or non-uniform curvature.

Most people are born with astigmatism, and your family history plays a significant role. It often occurs along with nearsightedness (myopia) or farsightedness (hyperopia).

Can rubbing eyes cause astigmatism?

Yes, this is a key factor. While eye rubbing alone is unlikely to cause astigmatism in a healthy eye, frequent and hard rubbing puts physical pressure on the cornea. Over time, this can change the cornea’s shape, either inducing astigmatism or making existing astigmatism worse.

Astigmatism symptoms: What you should look out for

If astigmatism is very mild, you might not notice any symptoms. However, as it becomes more pronounced, you’ll likely experience:

• Blurred or Distorted Vision: This is the hallmark symptom. Lines may appear fuzzy, and objects can look stretched.
• Eyestrain or Discomfort: Your eyes may feel tired, especially after focusing on digital screens or reading. This digital eye strain is a common complaint.
• Headaches: Persistent eye strain from the effort to focus can trigger tension headaches.
• Squinting: You may instinctively squint to try and bring objects into sharper focus.
• Difficulty with Night Vision: You might see more glare or halos around lights, making driving at night difficult.

Astigmatism vs normal vision: What’s the difference?

Here’s a simple breakdown:

Can astigmatism worsen?

Yes, astigmatism can change and potentially worsen over time. While it tends to be relatively stable for many adults, it’s not uncommon for your prescription to change.

This is why regular eye exams are so crucial. A routine eye exam isn’t just about checking your prescription; it’s about monitoring your overall ocular health for any changes that could signal a problem.

What can cause astigmatism to worsen?

 Several environmental factors and health conditions can cause your astigmatism to progress:

• Growth & Aging: Prescriptions often change during the growth spurts of childhood and the teen years. Likewise, as we age, the lens inside our eye can change shape, leading to Lenticular astigmatism.
• Keratoconus: This is a key cause of worsening, progressive astigmatism. It’s a condition where the cornea thins and begins to bulge outward in a cone shape.¹ Advanced tools like corneal topography are used to map the cornea and diagnose it.
• Eye Trauma / Surgery: Any eye trauma or corneal injury can physically change the cornea’s shape. Surgeries like cataract surgery or a corneal transplant can also induce or alter astigmatism.
• Frequent Eye Rubbing: As noted, this can physically warp the cornea over time, especially in eyes already weakened by conditions like keratoconus.
• Other Corneal Conditions: Diseases like Fuchs’ endothelial dystrophy or corneal scarring can also alter the cornea’s shape.

What can astigmatism lead to, if untreated?

Ignoring astigmatism, especially in children, can lead to several complications:

• Amblyopia (“Lazy Eye”) in Children: If one eye has significantly more uncorrected astigmatism, the brain may “ignore” the blurry image from that eye. This can lead to permanent vision reduction if not treated early with corrective lenses.
• Chronic Eye Strain and Headaches: The constant effort to focus can lead to persistent discomfort that interferes with school, work, and daily life.
• Worsening of Visual Symptoms: Your blurry vision and difficulty with night vision will likely become more prominent.
• Squinting Habit: This can become a semi-permanent habit and even cause facial discomfort.

How to “cure” astigmatism

While astigmatism isn’t technically “curable” like a disease, it is highly correctable. Vision correction options range from temporary management to permanent surgical solutions.

Management Options (Temporary Correction)

Eyeglasses: The simplest solution. Prescription lenses are crafted to counteract the irregular shape of your eye.

Contact Lenses:

1. Toric Lenses: These are soft contact lenses designed specifically for astigmatism.
2. Rigid Gas Permeable (RGP) Lenses: These “hard” lenses are excellent for high or irregular astigmatism as they hold their shape.
3. Specialty Contact Lenses: This includes scleral lenses that vault over the cornea, often used for keratoconus.

• Orthokeratology (Ortho-K): Wearing custom RGP lenses overnight to temporarily reshape the cornea for clear vision during the day.

Surgical Options (Permanent Correction)

For those seeking a more permanent solution, several refractive surgery procedures are available:

• Laser Refractive Surgery: These procedures permanently reshape the cornea.
1. LASIK Eye Surgery: A popular option that reshapes the tissue under a corneal flap.
2. PRK Eye Surgery (Photorefractive Keratectomy): Reshapes the cornea’s surface without creating a flap.
• Refractive Lens Exchange (RLE): This is similar to cataract surgery. The eye’s natural lens is replaced with an artificial intraocular lens (IOL). A Toric IOL can be used to correct astigmatism at the same time.
• Implantable Contact Lenses (ICL): A Phakic Intraocular Lens (ICL) is a thin, biocompatible lens that is surgically placed inside the eye (behind the iris) to provide clear vision without removing your natural lens.²

Protecting Your Vision: A Note on Eye Health

While you can’t change your genetics, you can take steps to protect your visual health.

• Protect yourself from UV Rays: Wear sunglasses with 100% UV protection to guard against ultraviolet rays.
• Use Protective Eyewear: Use safety goggles during sports or high-risk activities to prevent eye injuries.
• Eat for Your Eyes: A diet rich in vitamins A, C, and E, and omega-3 fatty acids supports overall eye health.
• Take Screen Breaks: When using digital devices, follow the 20-20-20 rule: every 20 minutes, take a 20-second break to look at something 20 feet away. Artificial tears can also help with dryness and digital eye strain.

Your Vision is Our Focus

Astigmatism is a very manageable condition. While it can worsen, the key to maintaining clear, comfortable vision is proactive care. Don’t let blurry vision or eye strain become your new normal. The most important step you can take is to schedule a routine eye exam.

At Kodak Lens Vision Centres, our dedicated eye doctors can perform a comprehensive check up using tools like a phoropter and slit lamp exam to assess your ocular health, update your contact lens prescriptions, and discuss all your vision correction options.

Schedule your appointment today for clear, comfortable vision!

Astigmatism FAQ

How does astigmatism affect vision?

It causes blurred vision at all distances. This can also cause image distortion (stretching), streaks or halos around lights (poor night vision), difficulty seeing fine detail, and significant eye strain and headaches from the constant effort to focus.

Is astigmatism genetic?

Yes, astigmatism is often hereditary. A strong family history of astigmatism is a major risk factor.

Can astigmatism go away?

No, not usually. Astigmatism is a structural issue caused by the irregular, non-spherical shape of the cornea or lens. This shape does not typically revert to a perfect sphere on its own. It is considered permanent for most individuals.

References

1. American Academy of Ophthalmology. (2023, November 2). What is Keratoconus? https://www.aao.org/eye-health/diseases/what-is-keratoconus
2. U.S. Food and D rug Administration. (2021, March 8). Phakic Intraocular Lenses. https://www.fda.gov/medical-devices/LASIK/phakic-intraocular-lenses