Astigmatism is a common visual imperfection characterized by an irregularly shaped cornea or lens, which prevents light from focusing correctly on the retina. Instead of a single focal point, light scatters, leading to blurred or distorted vision. While many individuals live with astigmatism, a frequent inquiry concerns whether this condition can worsen over time.
How Astigmatism Changes Over Time
The typical course of astigmatism varies considerably among individuals, often remaining stable for many. In young children, astigmatism can sometimes improve as the eye develops and grows. However, it can also emerge or increase during childhood and adolescence, particularly during periods of rapid growth.
For most adults, astigmatism tends to stabilize, with only minor fluctuations over many years. Subtle changes can occur with advancing age, as the eye’s structures naturally undergo alterations. These changes are typically gradual and may not always lead to a noticeable decline in vision quality.
Factors That Can Influence Progression
Several factors can influence how astigmatism progresses, extending beyond the eye’s natural development. Age-related changes within the eye significantly affect its shape and clarity. For example, the crystalline lens inside the eye can harden and change shape over time, contributing to shifts in astigmatism.
Certain eye conditions can directly cause or worsen astigmatism. Keratoconus, a progressive eye disease, involves the thinning and outward bulging of the cornea into a cone-like shape, leading to increasing and irregular astigmatism. Pterygium, a fleshy growth on the conjunctiva that can extend onto the cornea, may induce or alter astigmatism by changing the corneal curvature. Cataracts, which are clouding of the eye’s natural lens, can also introduce or modify existing astigmatism due to changes in the lens’s density and shape.
External factors, such as eye injuries or previous ophthalmic surgeries, can also impact corneal curvature and astigmatism. Trauma to the eye can cause permanent changes to the cornea’s shape, leading to new or increased astigmatism. Some types of eye surgery, while often performed to improve vision, can sometimes result in alterations to corneal shape that affect astigmatism. Genetics also play a role, as a predisposition to astigmatism and its potential severity can be inherited.
Signs of Worsening Astigmatism and When to See a Doctor
Recognizing the signs of changing astigmatism is important for maintaining optimal vision. Common symptoms that might suggest your astigmatism is worsening include a noticeable increase in overall blurriness, particularly at different distances. You might also experience increased distortion in your vision, especially at night or when looking at lights, which can appear streaky or have halos.
Other indicators include frequent headaches, often stemming from increased eye strain as your eyes work harder to compensate for the visual imperfections. Persistent eye fatigue, even after adequate rest, and difficulty with specific visual tasks like reading fine print or driving at night are also common. These symptoms suggest it is time to consult an eye care professional.
It is advisable to schedule an eye examination if you notice any new or worsening visual symptoms, even if you have had a recent check-up. Regular comprehensive eye exams are recommended to monitor eye health and vision changes, allowing for timely adjustments to prescriptions or identification of underlying conditions. Early detection and management of progressive astigmatism can help preserve visual comfort and clarity.
Options for Managing Progressive Astigmatism
When astigmatism progresses, various management strategies are available to improve vision and visual comfort. The most common approach involves updating your prescription for eyeglasses or contact lenses. New lenses are custom-ground to precisely correct the irregular curvature of your eye, ensuring light focuses accurately on the retina.
For more complex or higher degrees of astigmatism, specialty contact lenses can offer superior vision correction. Toric contact lenses are specifically designed with different powers in different meridians to correct astigmatism. Rigid gas permeable (RGP) lenses, which are firm and maintain a consistent shape, can also provide a smooth, uniform refracting surface over an irregularly shaped cornea, offering excellent visual acuity for many individuals.
Surgical interventions represent another avenue for managing progressive astigmatism. Refractive surgeries like LASIK (laser-assisted in situ keratomileusis) and PRK (photorefractive keratectomy) reshape the cornea using a laser to correct the irregular curvature. For individuals undergoing cataract surgery, toric intraocular lens (IOL) implants can replace the clouded natural lens and simultaneously correct pre-existing astigmatism. These surgical options aim to reduce or eliminate the need for glasses or contact lenses, but suitability is determined through a comprehensive consultation with an ophthalmologist.