Astigmatism is a common refractive error where the eye’s front surface, the cornea, or the lens inside the eye, has an irregular curvature. This prevents light from focusing correctly on the retina, leading to blurred or distorted vision at various distances. While astigmatism is frequently managed with corrective lenses, a sudden and noticeable worsening of vision can be a cause for concern. This article explores reasons why astigmatism might suddenly worsen.
Understanding Astigmatism and Its Changes
Astigmatism typically remains stable or progresses gradually over a person’s lifetime. Minor fluctuations can occur, often due to natural aging processes that subtly change the shape of the cornea or lens. This slow progression is normal.
However, a significant, rapid change in astigmatism is not typical and warrants attention from an eye care professional. Unlike slow shifts, a sudden worsening indicates an underlying issue affecting the eye’s ability to focus light.
Key Causes of Sudden Worsening
Keratoconus
Keratoconus is a progressive eye disease where the cornea, the clear front part of the eye, gradually thins and bulges outward into a cone shape. This creates irregular astigmatism, which can worsen rapidly, distorting vision. The disease often starts in the late teens or early twenties and can progress quickly in younger individuals.
A complication of keratoconus is acute corneal hydrops, a sudden tear in Descemet’s membrane. This allows fluid from inside the eye to leak into the cornea, causing acute swelling, pain, and sudden vision deterioration. While acute corneal hydrops often resolves over several months, it can leave residual scarring that further impacts vision.
Eye Injury or Trauma
Direct impact or penetrating injuries to the eye can immediately alter the cornea’s shape, leading to sudden astigmatism. Trauma can cause scarring or changes in the cornea’s curvature, directly affecting how light enters the eye. Even blunt force can induce astigmatism.
The healing process following an injury might also lead to irregular corneal surfaces, contributing to astigmatism. Such changes can result from physical damage to the eye’s structure. Prompt medical attention is needed to manage these concerns and preserve vision.
Post-Surgical Complications
While eye surgeries aim to improve vision, complications can sometimes induce or worsen astigmatism. Procedures such as cataract surgery, corneal transplants, or refractive surgeries like LASIK or PRK can lead to changes in corneal shape. Incision placement, healing, or scarring can influence the cornea’s curvature.
After cataract surgery, residual astigmatism can become more noticeable if pre-existing astigmatism was not fully addressed or if healing leads to irregular corneal remodeling. The location and size of surgical incisions play a role in how the cornea heals and whether new astigmatism is induced or existing astigmatism is exacerbated.
Acute Corneal Conditions
Acute conditions affecting the cornea can also cause rapid changes in its curvature, leading to sudden astigmatism. Severe corneal infections can cause significant inflammation and scarring. This scarring can result in irregular astigmatism that impairs visual function.
Corneal ulcers, often stemming from infections, can also lead to an irregular corneal surface as they heal. These conditions disrupt the smooth, symmetrical curve of the cornea, causing light to refract unevenly and vision to blur. Early and appropriate treatment of these conditions helps minimize permanent changes to the corneal shape.
When to Seek Medical Attention
Any sudden, noticeable change in vision, especially blurring or distortion, warrants immediate attention from an eye care professional. This includes instances where previously stable vision suddenly worsens, making daily tasks difficult. Such abrupt changes require prompt evaluation.
Symptoms like eye pain accompanying vision changes, persistent redness, discharge, or extreme light sensitivity signal urgent medical consultation. If vision changes occur following an eye injury or any eye surgery, seeking prompt care is also important. Rapid vision changes that cause concern or interfere with daily activities should be assessed by an eye doctor.
Diagnosis and Treatment Approaches
When astigmatism suddenly worsens, an eye care professional will conduct a comprehensive eye examination to identify the underlying cause. This includes a visual acuity test to measure sharpness of vision and a refraction test to determine the precise lens prescription needed.
Diagnostic tools like keratometry and corneal topography map the cornea’s curvature and detect irregularities. A slit-lamp examination allows the doctor to inspect the eye’s structures for signs of disease, injury, or post-surgical complications. Treatment depends on the identified cause.
For conditions like keratoconus, treatment may involve specialized contact lenses, such as scleral lenses, to improve vision, or corneal cross-linking to stabilize the cornea and halt disease progression. Infections or inflammation may require medication, while severe trauma or surgical complications might necessitate further surgical interventions. The goal of treatment is to address the root cause, aiming to restore or preserve vision.