What is Astigmatism?

Astigmatism occurs when light is not evenly focused on the retina and results in blurred vision at all distances. All ages are affected and 30-60% of adults have some degree of astigmatism.Correcting Astigmatism Diagram

Surgical Correction of Astigmatism

  • Cornea based astigmatism correction
    • Arcuate or Limbal based corneal relaxing incisions for astigmatism
    • LASIK or PRK for astigmatism
  • Intraocular Lens Based Astigmatism Correction: Toric Intraocular Lenses

Glasses and contact lenses have been traditional methods to correct astigmatism. We now have technologies to correct astigmatism with refractive surgical procedures which allow patients with astigmatism to see clearly without glasses. There are 2 parts of the eye that may contribute to astigmatism: The cornea, and the crystalline lens; and refractive surgery for astigmatism can be performed on the cornea(including corneal relaxing incisions, or laser refractive surgery including LASIK or PRK) or on the lens at the time of intraocular lens insertion(e.g. toric intraocular lenses).

Corneal procedures for astigmatism are office-based procedures with eye drop anesthesia and can be performed on all ages over 21 years old. Most commonly, astigmatic correction is laser-based and performed along with LASIK or PRK when combined with correction for near-sightedness (myopia) or farsightedness (hyperopia). When treating astigmatism alone, options include femtosecond laser arcuate keratotomy with the Intralase laser or timbal-based relaxing incisions performed with diamond blade incisions. These procedures correct astigmatism by relaxing the steep area on the cornea which causes the focus to be blurred. Corneal procedures for astigmatism are most commonly performed at the time of LASIK or PRK.

When cataracts are present, astigmatism correction can be done with corneal procedures, as above, at the same time as intraocular lens insertion. We now have intraocular lenses approved for the correction of astigmatism (toric intraocular lens) which are now available with single vision IOLs, and also with presbyopic IOLs (multifocal, accommodating, and extended depth of focus). This enables us to correct vision for distance and near for near-sighted, far-sighted, astigmatic, and presbyopic eyes. Freedom from glasses is now possible in most circumstances. Dr. Goldberg will carefully analyze your visual needs and advise which of the many options for astigmatism correction is right for you.