Astigmatism treatment

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Correcting astigmatism with LASIK is the treatment of choice and can make a
dramatic improvement to the quality of vision

Astigmatism laser eye surgery

Astigmatism is a refractive error where the cornea (this is the clear window at the front of your eye) is not completely round but instead shaped more like a rugby ball. This creates distortion, double images or shadowing in the vision at all distances.

correcting astigmatism with LASIK is the treatment of choice and can make a dramatic improvement to the quality of vision

Occasionally astigmatism can be found by itself, but much more commonly together with short-sight (myopia) or long-sight (hyperopia). When it is combined with these other refractive errors, it will increase the blur and distortion that the patient sees. When someone suffers from significant astigmatism (usually anything more than 0.5 of a dioptre) they will require corrective lenses, usually glasses. Contact lenses are available for this condition, known as toric lenses, but are not well tolerated by some patients due to the lens rotating on the cornea, blurring vision.

LASIK is the treatment of choice for astigmatism and highly effective. PRK or LASEK is used far less frequently because the technique has significant restriction for this refractive error.

laser surgery can cure astigmatism once the condition is no longer progressing

The laser part of the procedure takes 5-10 seconds to evaporate a very thin layer of tissue within the cornea, reshaping its curvature to produce a more spherical cornea. This eliminates the double focus that is characteristic of astigmatism, allowing all rays of light to come to a single focus.

The whole procedure is complete in approximately 4 minutes per eye.

The cause of astigmatic blur

In a normal eye, light enters through the clear cornea, passes through the pupil (the central opening in the iris) and continues through the lens located just behind the iris.

If there is no prescription (refractive error), the cornea and lens focus parallel rays of light to converge together to make a clear image on the retina. This light-sensitive layer converts the light into information that passes along the optic nerve at the back of the eye, taking visual data to the occipital lobe within the rear part of the brain. Neural processes then interpret this information so that you get a visual perception and understanding of the world around you.

Astigmatism is most commonly caused by an asymmetric curvature across the cornea. Imagine the shape of a rugby ball instead of a football. Commonly, horizontal rays of light are focused at one point, and vertical rays at a separate point, rather than all rays arriving at a single focal point.

Indeed, the word ‘astigmatism’ is derived from ‘a-stigma’, where ‘a’ means without and ‘stigma’ means point – hence there is no single point of focus of light.

astigmatism is commonly present together with myopia (near-sight, short-sight) or hyperopia (long-sight, far-sight)

Astigmatism is a common refractive error, accounting for as much as 13% of all refractive problems.

Astigmatism: natural progression

Childhood astigmatism

It is common in the first months of life when the curvature of the cornea is very steep. As infants grow older, the cornea flattens and the prevalence of high degrees of astigmatism (>1.00 dioptre) decreases, reaching a level of just 4.8% of preschool children.

The steady reduction of the astigmatism to lower values with age is apparently part of normal eye maturation. By the ages of 1-3 years, the vertical and horizontal diameters of the cornea and its elasticity attain adult levels.

Risk Factors

Factors that may increase your chance of astigmatism include:

1. Heredity—a family history of astigmatism, eye disease, or disorders such as keratoconus
2. Eye surgery—certain types of eye surgery, such as cataract extraction and lens replacement
3. A history of corneal scarring or thinning
4. A history of higher degrees of nearsightedness or farsightedness (myopic astigmatism and hyperopic astigmatism)

Further details on laser eye surgery risks and safety can be found here.

Astigmatism: prevalence

Adult astigmatism

Astigmatism is a common refractive error, accounting for as much as 13% of all refractive problems.

Around 63% of young adults aged 20 to 30 years exhibit 0.25 dioptre or more of astigmatism, although only a few have an astigmatism >1 dioptre.

In a research study, only 4.7% of the total population exhibited astigmatism of more than 1.50 dioptre.

Focus has a 100% 20/20 success rate for short-sight including up to 2.00 dioptres of astigmatism, i.e. almost all astigmatic prescriptions

Some ethnic groups show a higher prevalence of astigmatism. East Asian people show a relatively high prevalence of astigmatism (in addition to myopia), perhaps due to the greater tightness of the Asian eyelids and narrower palpebral apertures.

Most adult astigmatism occurs together with either short-sight or long-sight. Almost all of these prescriptions can be helped by laser vision treatment, excluding extreme cases.

Astigmatism treatment options

Laser surgery for astigmatism

Laser vision surgery (LASIK) for astigmatism is the treatment of choice in most cases. 97% of Focus patients receive dual-laser advanced LASIK, and 3% undergo PRK.

A-LASIK is an advanced form of LASIK utilising a high numerical aperture femtosecond laser to create the LASIK flap, creating a remarkably accurate focus for precision treatment of astigmatism.

Using the WaveLight laser, which removes less corneal tissue per dioptre than other lasers, we are able to treat most patients up to 6.00 dioptres, which represents almost all astigmatic prescriptions.

Focus have targeted the best reported outcomes for treating astigmatism in the UK – 100% of typical shortsighted patients see 20/20 or better after having LASIK eye surgery at our clinic, including up to 2.00 dioptres of astigmatism (more than 95% of all astigmatism prescriptions, and have done so for the past 3 years.

In fact, the great majority of our patients can see even better than 20/20. (What is 20/20 vision?)

We know of no other clinic that has matched our vision results. Click here to learn more about our surgery outcomes.

Treatment for long sighted hyperopia

Depending on your eye, long sight can be treated with either laser eye surgery or, especially those aged 50+, with refractive lens exchange (RLE).

 

Refractive Lens Exchange (RLE)

Lens replacement surgery can usually provide an effective cure as the results are permanent, due to the natural lens inside the eye (the cause of the condition worsening with age) being removed.

You can learn more about lens implants on our comprehensive refractive lens exchange surgery page.

Laser surgery for long-sight

Treatment has developed greatly over the past 10 years. Using an excimer laser we can now correct up to 6 dioptres of hyperopia, with or without astigmatism, although correction works best for up to 4 dioptres.

Long-sighted treatment with our LASIK procedure involves creating a very thin flap using a femtosecond laser, which at Focus is the advanced Ziemer LDV, and then using the WaveLight Allegretto excimer laser to remove tissue in the outer part of the cornea so steepening the central zone. This central steepening makes the cornea into a more powerful lens, compensating for the effects of long-sight.

At Focus Clinic, we prefer using LASIK rather than PRK for the correction of hyperopia. Because it is a progressive condition which continues to get worse with age, it is important for the patient to realise that this is not a permanent solution even though they will always retain a benefit from having had the treatment. It may be possible to improve the vision further when the patient is older and has more farsight, with a second enhancement procedure.

Hyperopic patients are often the happiest after treatment. This is because higher degrees of this refractive error is a very unpleasant condition because vision is blurred at every distance. This compares to short sight, where at least the near vision is in clear focus.

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100% 20/20 vision

100% 20/20 vision

Focus Clinic has a remarkable 100% success rate for 20/20 vision. We know of no other clinic that has matched these results. There is a big difference between, for example, 98% and 100% success, especially if you are in the 2%.

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10 year guarantee

Your 10 Year Guarantee means you can return at any time if you have additional questions on the quality of your vision. If you have distance vision correction for short-sight then any repeat laser eye treatments to correct a return of myopia in the first 10 years are included free of charge.*

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