Astigmatism is a common and generally imperfection in the curvature of the eye that causes blurred distance and near vision.
Astigmatism occurs when either the cornea (front surface of the eye) or the lens inside the eye has mismatched curves. Instead of having one curve like a round ball, the surface is oval shaped/egg-shaped. This causes blurred vision at all distances.
Astigmatism is often present at birth and may occur in combination with nearsightedness or farsightedness. Often, it’s not pronounced enough to require corrective action. One can develop it at any point in his/her life. It can get better or worse over time.
What does astigmatism do to our vision?
The parts of our eyes work together like a relay team to pass light that enters our eye along a pathway to our brain. Light passes through our cornea — the clear part at the front of our eye. Our cornea focuses that light through our lens into retina (the layer at the very back of your eyeball). Our retina converts that light into electrical signals that our optic nerve sends to our brain. Our brain then uses those signals to create the images we see.
In astigmatism, light that enters our eye is bent more than it should be. The light can’t properly focus on our retina. This means only parts of an object we are looking at are in focus. That uneven focus makes objects look blurry or wavy. Astigmatism can affect our vision at any distance — both up close and farther away.
We might experience eye strain — like our eyes are constantly working too hard to see.
Types of astigmatism
Cornea having an irregular shape is called corneal astigmatism.
Lenticular astigmatism, where the lens in our eye has an irregular shape. Lenticular astigmatism is often caused by cataracts.
Some people have both corneal and lenticular astigmatism.
Symptoms
Blurred vision is the most common astigmatism symptom. It also makes it hard to see details on objects, like the words printed on a menu in front of you, or letters on a road sign in the distance.
Other astigmatism symptoms include:
- Eyestrain or discomfort.
- Headaches.
- Difficulty with night vision.
- Seeing a glare or halos around lights.
- Squinting to see clearly.
- Fatigue.
- Eye strain.
Some young children don’t know there’s anything wrong with their vision, even if they’re experiencing symptoms. Visit an eye care specialist if you notice your child squinting, rubbing their eyes or having frequent headaches.
Causes
The eye has two structures with curved surfaces that bend (refract) light onto the retina, which makes the images:
- The cornea, the clear front surface of the eye along with the tear film.
- The lens, a clear structure inside the eye that changes shape to help the eye focus on near objects.
In a perfectly shaped eye, each of these elements has a round curvature, like the surface of a smooth ball. A cornea or lens with such curvature bends (refracts) all incoming light equally to make a sharply focused image directly on the retina (the back of the eye).
Simplified anatomy of the eye
A refractive error
If either the cornea or the lens is egg-shaped with two mismatched curves, light rays aren’t bent the same, which means that two different images form. These two images overlap or combine and result in blurred vision. Astigmatism is a type of refractive error.
Astigmatism occurs when the cornea or lens is curved more steeply in one direction than in another. You have corneal astigmatism if your cornea has mismatched curves. You have lenticular astigmatism if your lens has mismatched curves.
Either type of astigmatism can cause blurred vision. Blurred vision may occur more in one direction: horizontally, vertically or diagonally.
Astigmatism may be present from birth, or it may develop after an eye injury, disease or surgery. Astigmatism isn’t caused or made worse by reading in poor light, sitting too close to the television or squinting.
Other refractive errors
Astigmatism may occur in combination with other refractive errors, which include:
- Nearsightedness (myopia). This occurs when the cornea is curved too much, or the eye is longer than usual. Instead of being focused precisely on the retina, light is focused in front of the retina, making distant objects seem blurry.
- Farsightedness (hyperopia). This occurs when the cornea is curved too little, or the eye is shorter than usual. The effect is the opposite of nearsightedness. When the eye is in a relaxed state, light never comes to a focus at the back of the eye, making nearby objects seem blurry.
Astigmatism is usually hereditary, which means it’s a condition biological parents pass down to their children. It can also be caused by your eyelids putting too much pressure on your cornea.
Astigmatism usually isn’t caused by health conditions. Some conditions and issues that can cause astigmatism include:
- Eye injuries.
- Keratoconus.
- Complications after eye surgery.
Diagnose
Astigmatism is diagnosed with an eye exam. A complete eye exam involves both a series of tests to check eye health and a refraction, which determines how the eyes bend light. Doctor may use various instruments, aim bright lights directly at patient’s eyes and ask him to look through several lenses, uses these tests to examine different aspects of patient’s eyes and vision and to determine the prescription needed to provide clear vision.
Some other tests to diagnose astigmatism includes:
- Visual acuity test: A chart of letters or symbols.
- Refraction test: To measure how much light focuses and is bent as it enters patient’s eye.
- Keratometry: Keratometry measures cornea’s curve.
- Slit lamp exam: A slit lamp (a special microscope with a bright light). by adjusting the brightness and thickness of the light’s beam we can see the different layers and parts of patient’s eye.
Allopathic management and treatment for astigmatism
In allopathic treatment most patients with astigmatism are prescribed corrective lenses (eyeglasses or contact lenses).
If the astigmatism is very mild (and doesn’t affect vision), patient might not need glasses or contacts. Astigmatism can change over time and get worse, so a patient might need glasses or contacts eventually, even if he/she doesn’t at first checkup.
The allopathic goal of treating astigmatism is to improve vision clarity and eye comfort. Treatments are corrective lenses or refractive surgery.
Corrective lenses
Wearing corrective lenses treats astigmatism by counteracting uneven curvatures of our cornea or lens.
Types of corrective lenses include:
- Eyeglasses. Eyeglasses are made with lenses that help compensate for the uneven shape of the eye. The lenses make the light bend into the eye properly. Eyeglasses can also correct for other refractive errors, such as nearsightedness or farsightedness.
- Contact lenses. Like eyeglasses, contact lenses can correct most astigmatism. Contact lenses are also used in a procedure called orthokeratology. In orthokeratology, rigid contact lenses are worn during the night while sleeping until the curvature of the eye evens out. Then the lenses are worn less frequently to maintain the new shape.
If treatment is discontinued, the eye returns to its former shape and refractive error.
Wearing contact lenses for extended periods of time increases the risk of infection in the eye.
Refractive surgery
Refractive surgery improves vision and reduces the need for eyeglasses or contact lenses. An eye surgeon uses a laser beam to reshape the curves of the cornea, which corrects the refractive error.
Patients who have cataracts and astigmatism can have both treated at the same time during cataract surgery.
Types of refractive surgery for astigmatism include:
- Laser-assisted in-situ keratomileusis (LASIK)
With this procedure, an eye surgeon makes a thin, hinged flap in the cornea. Uses an excimer laser to sculpt the shape of the cornea and then repositions the flap.
- Laser-assisted subepithelial keratectomy (LASEK)
Instead of creating a flap in the cornea, the surgeon loosens the cornea’s thin protective cover (epithelium) with a special alcohol. Uses an excimer laser to change the curvature of the cornea and then repositions the loosened epithelium.
This procedure is similar to laser-assisted subepithelial keratectomy (LASEK), except the surgeon removes the epithelium. It will grow back naturally, conforming to the cornea’s new shape. Patient may need to wear a bandage contact lens for a few days after surgery.
- Epi-laser-assisted in situ keratomileusis (LASIK)
This is a variation of . The surgeon uses a special mechanized blunt blade — instead of the alcohol — to separate a very thin sheet of epithelium. Doctor uses an excimer laser to reshape the cornea and repositions the epithelium.
- Small incision lenticule extraction (SMILE)
This type of refractive surgery reshapes the cornea by using a laser to make a lens-shaped bit of tissue (lenticule) below the cornea’s surface. The lenticule is then removed through a very small incision. For now, the small incision lenticule extraction (SMILE) procedure is only approved for treating mild nearsightedness (still under experiments).
Other types of refractive surgeries include clear lens extraction and implantable contact lenses.
There is no one best method for refractive surgery, and patient should make a decision only after a complete evaluation and thorough discussion with his/her surgeon.
Some of the complications that can occur after refractive surgery include:
- Under correction or overcorrection of your initial problem.
- Visual side effects, such as a halo or starburst appearing around lights.
- Dry eye.
- Infection.
- Corneal scarring.
- Vision loss.
Homeopathic treatment for astigmatism
Gelsemium Sempervirens
Paralysis of various groups of muscles off the eyes, throat, chest etc. Muscular weakness. Complete relaxation and prostration. Lack of muscular co-ordination. Double vision. Disturbed muscular apparatus. Blurring and discomfort in eyes even after accurately adjusted glasses. Vision blurred, smoky. Dim-sighted; pupils dilated and insensible to light. Orbital neuralgia, with contraction and twitching of muscles. Bruised pain back of the orbits. Astigmatism – one pupil dilated, the other contracted. Deep inflammations, with haziness of vitreous. Serous inflammations. Albuminuria and retinitis. Detached retina, glaucoma and descemetitis. Hysterical amblyopia.
Magnesium Phosphoricum
Supraorbital pains. Increased lachrymation. Twitching of lids. Nystagmus strabismus, ptosis. Eyes hot, tired, vision blurred, colored lights before eyes. Astigmatism.
Ipecacuanha
Eyes inflamed, red. Pain through eyeballs. Profuse lachrymation. Cornea dim. Eyes tire from near vision. State of vision constantly changing. Astigmatism. Spasm of accommodation from irritable weakness of the ciliary muscle. Nausea from looking on moving objects.
Cyclamen Europaem
Dim vision, worse on waking, with spots before eyes. Flickering of various colors. Convergent strabismus. Sees countless stars. Diplopia. Disturbance of vision, associated with gastric disturbances.
Lilium Tigrinum
Hyperesthesia of retina. Pain, extending back into head; lachrymation; and impaired vision. Myopic astigmia. Useful in restoring power to the weakened ciliary muscle. Astigmatism.
Argentum Nitricum
Inner canthi swollen and red. Spots before the vision. Blurred vision. Photophobia in warm. Purulent ophthalmia. Astigmatism. Chronic ulceration of margin of lids; sore, thick, swollen. Unable to keep eyes fixed steadily. Eyestrain. Aching, tired feeling in eyes, better closing or pressing upon them. Useful in restoring power to the weakened ciliary muscles. Paretic condition of ciliary muscle. Acute granular conjunctivitis. Cornea opaque. Ulcer in cornea.
Natrium Muriaticum
Feels bruised, with headache. Eyelids heavy. Muscles weak and stiff. Letters run together. Sees sparks. Astigmatism. Fiery, zigzag appearance around objects. Burning in eyes. Tiredness – give out on reading or writing. Stricture of lachrymal duct with suppuration. Escape of muco-pus when pressing upon sac. Lachrymation, burning and acrid. Lids swollen. Eyes appear wet with tears. Tears stream down face on coughing. Asthenopia due to insufficiency of internal recti muscles. Pain in eyes when looking down. Cataract incipient.
Jaborandi
Eye strain. Astigmatism. Irritability of the ciliary muscle. Eyes easily tire from slightest use. Heat and burning in eyes. Headache; smarting and pain in globe on use. Everything at a distance appears hazy; vision becomes indistinct every few moments. Retinal images retained long after using eyes. Irritation from any light. Pupils contracted; do not react to light. Staring eyes. Myopia (Near-sightedness). Vertigo and nausea after using eyes. White spots before eyes. Smarting pain in eyes. Lids twitch. Atrophic choroiditis. Spasm of the accommodation while reading.
Ruta Greolens
Eyes-strain followed by headache. Eyes red, hot, and painful from sewing or reading fine print. Disturbances of accommodation. Weary pain while reading. Pressure deep in orbits. Tarsal cartilage feels bruised. Astigmatism. Asthenopia.
Silicea Tera
Swelling of lachrymal duct. Aversion to light, especially daylight; it produces dazzling, sharp pain through eyes; eyes tender to touch. Astigmatism – vision confused; letters run together on reading. Styes. Iritis and irido-choroiditis, with pus in anterior chamber. Perforating or sloughing ulcer of cornea. Abscess in cornea after traumatic injury. Cataract in office workers. After-effects of keratitis and ulcus cornea, clearing the opacity.
Sepia Oficianalis
Muscular asthenopia; black spots in the field of vision; asthenic inflammations. Astigmatism. Tarsal tumors. Ptosis, ciliary irritation. Venous congestion of the fundus.
Zincum Metallicum
Pterygium; smarting, lachrymation, itching. Pressure. Itching and soreness of lids and inner angles. Ptosis. Rolling of eyes. Blurring of one-half of vision; worse, stimulants. Squinting. Amaurosis, with severe headache. Red and inflamed conjunctiva; worse, inner canthus. Astigmatism.
Heloderma Suspectum
Itching of eyelids; lachrymation. Weight of eyelids. Weak eyesight. Astigmatism. Locomotor ataxia. Muscular weakness. Paralysis though nervous system is normal.
Agaricus Muscarious
Agaricus is another effective medicine for Myopia. Reading difficult, as type seems to move, to swim. Vibrating specters. Double vision, dim and flickering. Astigmatism. Asthenopia from prolonged strain, spasm of accommodation. Twitching of lids and eyeballs.
Viola Odorata
Myopia with accompanied by severe pain in the eyes. Astigmatism. Flames/sparks before eyes. Illusions of vision; fiery, serpentine circles.
Oleum Animale
Myopia. Pain in eyes. Pressure and drawing in eyes. Burning pain in eyes, especially by bulb/light. Lachrymation, lachrymation when eats meals. Quivering and starting in eyelids. Frequent twitching. Confused sight especially in the afternoon and when writing. Astigmatism. Myopia. Dark clouds before eyes. Sight and hearing vanish for a moment.
Phosphorus
Cataract. Veil, or dust before eyes. Floaters – black points seem to float before the eyes. Astigmatism. Patient sees better by shading eyes with hand. Fatigue of eyes and head even without much use of eyes. Green halo about the bulb/source of light. Letters appear red. Atrophy of optic nerve. Pearly white conjunctiva and long curved lashes. Partial loss of vision. Pain in orbital bones. Paresis of extrinsic muscles. Diplopia, due to deviation of the visual axis. Amaurosis from sexual excess. Glaucoma. Thrombosis of retinal vessels and degenerative changes in retinal cells. Degenerative changes where soreness and curved lines are seen. Retinal trouble with lights and hallucination of vision.
Osimium
Glaucoma; with iridescent vision. Violent supra and infra-orbital neuralgia; violent pains and lachrymation. Astigmatism. Green colors surround light/bulb. Conjunctivitis. Increase in intra-ocular tension, dim sight, photophobia.
Physostigma Venenosum
Contraction of the pupil and of the ciliary muscles. Astigmatism. Myopia. Rigidity of muscles; paralysis. Depressed motoneuron reflexes. Loss of sensibility to pain, muscular weakness, followed by complete paralysis. Night blindness, photophobia; contraction of pupils; twitching of ocular muscles. Lagophthalmos. Muscae volitantes; flashes of light; partial blindness. Glaucoma; paresis of accommodation. Profuse lachrymation. Spasm of ciliary muscles, with irritability after using eyes. Increasing myopia. Post-diphtheritic paralysis of eye and accommodation muscles.
Tuberculinum
Swollen lids; headache with swollen lids in morning. Conjunctiva inflamed. Dullness and heaviness of eyes; darkness before eyes. Obscuration of vision. Astigmatism. Breaking down of cicatrices of old corneal ulcers. Phlyctenule appeared where none existed before. Conjunctivitis; herpes on lids. Amblyopia with irregularity and complete paralysis of pupils.
P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).
For proper consultation and treatment, please visit our clinic.
None of above-mentioned medicine(s) is/are the full/complete treatment, but just hints for treatment; every patient has his/her own constitutional medicine.
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Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS), Abdominal Surgeries, Oncological surgeries, Gastroenterologist, Specialist Homeopathic Medicines.
Senior research officer at Dnepropetrovsk state medical academy Ukraine.
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