Does Astigmatism Typically Get Worse with Age? Causes, Prevention and Treatment

What is Astigmatism?

Astigmatism is a common vision condition where the cornea - the clear front surface of the eye - has an irregular or oval shape instead of being round. This causes light rays to focus incorrectly on the retina, resulting in blurred vision at all distances.

With normal vision, light focuses precisely on the retina, allowing images to be perceived clearly. With astigmatism, the irregularly shaped cornea bends light unevenly, causing light rays to focus at different points. This produces a blurred or distorted image.

Types of Astigmatism

There are several different types of astigmatism:

• Myopic (nearsighted) astigmatism - objects up close are clear while distant objects are blurry
• Hyperopic (farsighted) astigmatism - distant objects are clearer than near objects
• Mixed astigmatism - combination of myopic and hyperopic astigmatism in different parts of the cornea

Astigmatism Symptoms

Common symptoms of astigmatism include:

• Blurred vision at all distances
• Headaches and eye strain
• Squinting or screwing up the eyes to see clearly
• Difficulty seeing at night
• Words on a page appear distorted or blurred
• Vision seems better in one eye

What Causes Astigmatism?

There are several possible causes of astigmatism:

• Irregularly shaped cornea - Most astigmatism is caused by an irregular curvature of the cornea that is present from birth
• Aging - The cornea can gradually change shape with age
• Injury - Scarring or trauma to the cornea may distort its shape
• Genetics - Astigmatism has a hereditary component and often runs in families
• Eye surgery - Procedures like LASIK or corneal transplants can induce astigmatism

When Does Astigmatism Usually Start?

Astigmatism may be present from birth, or it can develop later in life:

• Congenital astigmatism - Up to 15% of astigmatism cases are present at birth
• Childhood - Astigmatism often first appears when a child begins school and starts using their eyes for reading and close work
• Adolescence - Hormonal changes and rapid growth during puberty can cause astigmatism to worsen
• Adulthood - Astigmatism may slowly progress with aging due to changes in the cornea's shape

Does Astigmatism Get Worse with Age?

For most people, astigmatism does tend to gradually worsen over time. Here's why astigmatism progresses with age:

• The cornea naturally stiffens and flattens with age, causing distortion
• EYE muscle weakness allows the eyeball to elongate into a slight football shape
• Reduced blinking from aging leads to dry eyes and corneal irregularities
• Sun exposure causes structural changes and scarring of the cornea
• Eye injuries and conditions like cataracts increase with age

These age-related factors cause the cornea to become more irregular in shape, resulting in increasing amounts of astigmatism. The rate of progression varies from person to person based on genetics, health, and lifestyle factors.

Astigmatism Progression in Children

In children, astigmatism may either improve or worsen as they grow:

• Younger children often see their astigmatism reduce during growth spurts as the cornea evens out.
• Astigmatism tends to worsen in school-age children as their eyes undergo rapid developmental changes.
• Astigmatism caused by genetics typically advances faster in childhood.
• Eye alignment issues like strabismus can exacerbate astigmatism progression in kids.

Regular eye exams are crucial to monitor astigmatism progression in children. Early detection ensures the best vision outcome.

Astigmatism Progression in Adults

In adults, astigmatism often steadily increases each year at a slow rate. On average:

• People under 40 may see their astigmatism worsen by about 0.50 diopters per decade.
• Those over 40 tend to progress at 0.75 diopters per decade.
• The rate speeds up after age 60, with astigmatism increasing 1.0 diopter or more per decade.

Rapid advancement of more than 0.50 diopters annually requires prompt medical evaluation to identify any underlying eye diseases.

Can Astigmatism Be Prevented from Progressing?

While astigmatism cannot be completely prevented from worsening with age, these methods may help slow its progression:

• Protective eyewear - Helps prevent eye injuries that distort the cornea
• Healthy diet - Nutrients like vitamins C & E support corneal health
• Quit smoking - Reduces damage from toxins and free radicals
• Control diabetes - High blood sugar accelerates astigmatism progression
• UV protection - Sunglasses and hats limit sun exposure's effects
• Lubricating drops - Can keep eyes moisturized to maintain corneal shape

While these measures are beneficial, most astigmatism advancement is unavoidable without treatment to correct the corneal irregularity.

How is Astigmatism Corrected?

The most effective treatments for astigmatism involve reshaping the cornea with:

• Glasses or contact lenses - Prescription lenses that compensate for corneal distortion
• Refractive eye surgery - LASIK, PRK, or incisional procedures reshape the cornea
• Orthokeratology - Custom rigid contact lenses worn at night reshape the cornea
• Corneal implants - Ring segments or inlays implanted in the cornea adjust its curvature

The appropriate treatment depends on factors like the severity of astigmatism, overall eye health, and patient age. Mild astigmatism can often be managed with corrective lenses.

Can Surgery Stop Astigmatism Progression?

Refractive surgeries like LASIK, PRK and cataract surgery with toric IOLs offer two benefits for astigmatism:

1. They correct existing astigmatism by reshaping the cornea.
2. They can reduce further progression in many cases by making the cornea more regular.

However, some astigmatism may still gradually return over time after surgery. Touch up enhancement procedures may be needed down the road.

The Bottom Line

While moderate amounts of astigmatism progression are normal with aging, rapid worsening or impairment in daily activities warrants an urgent eye exam. Ongoing vision correction and eye protection are key to managing age-related astigmatism changes.

Catching progression early provides the chance to adjust prescriptions or treatments to maintain clear eyesight and quality of life.

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.