Can Astigmatism Get Worse Over Time? Causes and Treatment

What Is Astigmatism?

With normal vision, light focuses directly onto the retina, allowing for clear vision. With astigmatism, light focuses in front of or behind the retina due to the irregularly shaped cornea. This leads to blurred vision at all distances.

There are two main types of astigmatism:

• Myopic Astigmatism - Light focuses in front of the retina. This causes nearsighted vision.
• Hyperopic Astigmatism - Light focuses behind the retina. This leads to farsighted vision.

Astigmatism often occurs together with nearsightedness or farsightedness. The faulty curvature causes images to appear stretched or distorted. Straight lines may appear wavy, blurry or overlapping.

Symptoms of Astigmatism

Common symptoms of astigmatism include:

• Blurry vision at all distances
• Difficulty seeing details
• Eyestrain and headaches
• Squinting or blinking excessively
• Vision that varies by the day or hour
• Images appear warped or distorted
• Difficulty reading or doing detail-oriented tasks
• Fatigue, dizziness or nausea when doing visual tasks

Symptoms are usually present in both eyes but may be worse in one eye. Severity can range from mild blurriness to significant vision impairment.

Causes and Risk Factors

Astigmatism is generally caused by an irregularly shaped cornea. Common causes include:

• Genetics - Astigmatism may be hereditary and passed down through families.
• Birth Defect - The cornea can become misshapen during fetal development.
• Aging - The cornea can change shape as it ages.
• Eye Injury - Scarring or trauma to the cornea can distort its shape.
• Eye Surgery - Complications from refractive eye surgery or cataract surgery could induce astigmatism.
• Other Eye Conditions - Some conditions like keratoconus involve progressive corneal distortion.

Risk factors for developing astigmatism include:

• Advanced age
• Nearsightedness
• Eye injury or surgery
• Genetic predisposition
• Other eye diseases like keratoconus

Can Astigmatism Progress Over Time?

For many people, astigmatism is a stable condition present from childhood that does not significantly worsen over time. However, astigmatism can progress in some cases due to factors like:

• Aging - The cornea may weaken or change shape with advanced age.
• Keratoconus - This disorder causes progressive thinning and distortion of the cornea.
• Injury - Trauma, scarring or surgery could worsen astigmatism.
• Eye Rubbing - Chronic eye rubbing may deform the cornea over time.

Additionally, cataract surgery has been linked to potential worsening of pre-existing astigmatism. The factors involved include the surgical technique, the type of incision and post-surgical healing.

For individuals with progressive astigmatism, vision correction prescriptions generally need to be updated on a regular basis to keep up with the changes.

Diagnosing Astigmatism

Astigmatism is easily diagnosed through a comprehensive eye exam by an optometrist or ophthalmologist. Diagnostic tests typically include:

• Visual Acuity Test - Assesses sharpness of vision using a Snellen chart.
• Refraction Test - Measures how your eye focuses light. Determines need for vision correction.
• Slit Lamp Exam - Allows close inspection of the front structures of the eye.
• Keratometry - Measures the curvature of the cornea.
• Retinoscopy - Evaluates focusing ability by shining light into the eye.

These tests help identify irregular corneal curvature and determine the amount and axis of astigmatism correction needed.

Treatment Options for Astigmatism

Astigmatism can be effectively corrected through various treatment options:

Glasses or Contact Lenses

Prescription eyeglasses or contact lenses with cylindrical lenses can compensate for irregular corneal curvature. Strength depends on amount of astigmatism.

Refractive Surgery

Refractive surgery reshapes the cornea for clear vision without glasses or contacts. LASIK, PRK or corneal implants may be options for some individuals.

Cataract Surgery

Astigmatism-correcting intraocular lenses (IOLs) implanted during cataract surgery can treat astigmatism and cataracts together. Specialized surgical techniques can also address astigmatism.

Contact Lens Inserts

Contact lens inserts worn overnight can gently reshape the front of the eye to reduce astigmatism and nearsightedness in some cases.

Living with Astigmatism

Though there is no cure for astigmatism, it can be well controlled with appropriate vision correction. To optimize eye health:

• Avoid eye rubbing, which could worsen astigmatism
• Use proper lighting for reading and computer work
• Take eye breaks when doing visually intensive tasks
• Wear protective eyewear with sports or risky activities
• Eat a diet rich in eye-healthy nutrients like vitamins C and E
• Don't smoke, as this elevates risks of eye disease
• Get regular eye exams to monitor for changes

See an optometrist promptly if your vision changes or astigmatism symptoms worsen. Progressive astigmatism may require more frequent prescription updates or specialized contact lenses to maintain sharp vision.

The Bottom Line

For most people, astigmatism is a stable condition. However, aging, eye disease or trauma can sometimes cause gradual worsening. Detecting progression early is key to preserving vision clarity through updated prescriptions or opting for corrective surgery when appropriate.

With the right vision correction and eye care, astigmatism can typically be well managed. But progressive worsening should never be ignored, as it could indicate a more serious underlying eye condition requiring specialized treatment.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.