Astigmatism (दृष्टिवैषम्य) is a type of refractive error due to rotational asymmetry in the eye’s refractive power. This results in distorted or blurred vision at any distance. Other symptoms can include eyestrain, headaches, and trouble driving at night. Astigmatism often occurs at birth and can change or develop later in life. Three treatment options are available: glasses, contact lenses, and surgery. Glasses are the simplest. Contact lenses can provide a wider field of vision and fewer artifacts than even double aspheric lenses. Refractive surgery aims to permanently change the shape of the eye and thereby cure astigmatism. In Europe and Asia, astigmatism affects between 30% and 60% of adults. Astigmatism was first reported by Thomas Young in 1801.
Astigmatism Meaning
It is a common vision condition caused by an irregular curvature of the cornea or eye lens. This irregular shape prevents light from focusing properly on the retina, resulting in blurred or distorted vision at any distance. The cornea is typically spherical, but in individuals with astigmatism, it is more oval-shaped, like a football. This distortion can lead to symptoms such as eyestrain, headaches, and difficulty seeing at night.
Types of Astigmatism
Here are the main types of astigmatism, explained in detail:
1. Regular Astigmatism
In regular astigmatism, the principal meridians (the steepest and flattest curvatures of the cornea) are perpendicular to each other.
Types of Regular Astigmatism
- With-the-Rule Astigmatism: The vertical meridian is steeper than the horizontal meridian. This type is common and often corrects naturally with age as the cornea flattens.
- Against-the-Rule Astigmatism: The horizontal meridian is steeper than the vertical meridian. This type is less common and can occur naturally or as a result of corneal surgery.
2. Irregular Astigmatism
In irregular astigmatism, the principal meridians are not perpendicular to each other. This type is often more complex and harder to correct with standard lenses.
Causes of Irregular Astigmatism
- Corneal Scarring: Scars from injury, infection, or surgery can cause irregularities in the cornea.
- Keratoconus: A progressive eye disease where the cornea thins and bulges into a cone-like shape.
- Pterygium: A benign growth on the cornea that can alter its shape.
3. Myopic Astigmatism
Myopic astigmatism occurs when one or both principal meridians are focused in front of the retina, causing a combination of astigmatism and nearsightedness (myopia).
Types of Myopic Astigmatism
- Simple Myopic Astigmatism: One meridian is focused on the retina, while the other is focused in front of it.
- Compound Myopic Astigmatism: Both principal meridians are focused in front of the retina but at different points.
4. Hyperopic Astigmatism
Hyperopic astigmatism occurs when one or both principal meridians are focused behind the retina, resulting in a combination of astigmatism and farsightedness (hyperopia).
Types of Hyperopic Astigmatism
- Simple Hyperopic Astigmatism: One meridian is focused on the retina, while the other is focused behind it.
- Compound Hyperopic Astigmatism: Both principal meridians are focused behind the retina but at different points.
5. Mixed Astigmatism
Mixed astigmatism is when one principal meridian is focused in front of the retina, and the other is focused behind it. This type results in a mixture of myopic and hyperopic astigmatism, causing blurriness and distortion.
Visual Implications and Correction
- Visual Implications: Each type of astigmatism results in different patterns of blurred or distorted vision, depending on how light is focused on the retina.
- Correction:
- Eyeglasses: Special cylindrical lenses are used to correct the specific curvatures of the cornea or lens.
- Contact Lenses: Toric contact lenses are designed to correct astigmatism by conforming to the shape of the eye.
- Refractive Surgery: Procedures like LASIK, PRK, or LASEK can reshape the cornea to correct astigmatism.
Understanding these types of astigmatism helps in diagnosing specific visual impairments and choosing the appropriate corrective measures to improve vision quality.
Astigmatism Symptoms
The symptoms of astigmatism can vary in severity and may include:
- Blurred or distorted vision: Objects at any distance can appear blurry or wavy.
- Eyestrain: Feeling of discomfort or strain in the eyes, especially after prolonged visual tasks like reading or using a computer.
- Headaches: Frequent headaches, particularly after activities that require focusing the eyes.
- Difficulty seeing at night: Poor vision in low light conditions, making activities like driving at night challenging.
- Squinting: Frequent squinting in an attempt to see more clearly.
- Double vision: Seeing double images, especially when the astigmatism is severe.
- Eye irritation: Feeling of discomfort or dryness in the eyes.
These symptoms can occur in one or both eyes and might be mild to severe. If you experience any of these symptoms, seeing an eye care professional for a comprehensive eye exam is advisable.
Astigmatism Causes
The exact causes of astigmatism include:
- Genetics: Astigmatism often runs in families, indicating a genetic predisposition.
- Congenital factors: Many people are born with astigmatism. It can be present from birth and detected during early childhood.
- Eye injury: Trauma or injury to the eye can lead to cornea scarring, which can cause astigmatism.
- Eye surgery: Certain types of eye surgery, such as cataract surgery, can alter the shape of the cornea and lead to astigmatism.
- Keratoconus: A condition where the cornea gradually becomes thinner and more cone-shaped, leading to increasing astigmatism.
- Other eye diseases: Conditions like pterygium (a growth on the cornea) can cause astigmatism by distorting the cornea.
It’s important to note that astigmatism is not caused by reading in low light, sitting too close to the television, or other common myths. Regular eye examinations can help detect astigmatism early and ensure appropriate corrective measures are taken.
Astigmatism Diagnosis
Astigmatism is diagnosed through a comprehensive eye examination conducted by an eye care professional, such as an optometrist or ophthalmologist. The diagnostic process includes several tests and procedures to assess the cornea’s shape and the eye’s overall refractive state. Here are the key methods used to diagnose astigmatism:
1. Visual Acuity Test
This test measures how well you can see at various distances. It involves reading letters on a chart (Snellen chart) placed at a standard distance (typically 20 feet). The results help determine if there is any refractive error affecting vision clarity.
2. Keratometry
Keratometry is a test that measures the curvature of the cornea. A keratometer projects a pattern of light onto the cornea and measures the reflection to determine the curvature. This helps identify irregularities in the corneal shape that indicate astigmatism.
3. Corneal Topography
Corneal topography provides a detailed map of the curvature of the cornea. This test uses a special camera to create a three-dimensional image of the cornea, highlighting areas of irregular curvature. It is particularly useful for diagnosing irregular astigmatism and conditions like keratoconus.
4. Refraction Test
A refraction test determines the exact prescription needed to correct vision. By changing lenses and asking the patient to compare which lens provides clearer vision, the doctor can determine the degree of astigmatism and other refractive errors like myopia (nearsightedness) or hyperopia (farsightedness).
5. Autorefractor and Aberrometer
An aberrometer provides a detailed analysis of how light passes through the eye, identifying both lower-order aberrations (like astigmatism) and higher-order aberrations (more complex vision problems).
6. Retinoscopy
In a retinoscopy, the eye doctor shines a light into the patient’s eye and observes the reflection (reflex) off the retina. By moving the light and changing lenses, the doctor can estimate the refractive error, including the presence and degree of astigmatism.
7. Subjective Refraction
After the objective measurements, the eye doctor will refine the prescription through subjective refraction. This involves fine-tuning the lens power while the patient provides feedback on which lenses offer the best clarity.
Diagnosing Astigmatism in Children
Diagnosing astigmatism in children involves similar tests but may require different approaches to keep the child engaged and cooperative. Pediatric eye exams often include:
- Retinoscopy: This is especially useful for young children who may not be able to provide subjective feedback.
- Visual Acuity Tests: Adapted for children using pictures or symbols instead of letters.
- Handheld Autorefractors: Portable devices to measure refractive errors in children.
Follow-up and Management
Once diagnosed, the eye care professional will discuss the best corrective options, which may include glasses, contact lenses, or, in some cases, refractive surgery. Regular follow-up exams are essential to monitor changes in astigmatism and adjust prescriptions as needed.
Diagnosing astigmatism accurately requires a combination of these tests to fully understand the nature and extent of the refractive error, ensuring the best possible correction and management strategy for the patient.
Astigmatism Treatment
Here are the best treatment options for astigmatism:
1. Eyeglasses
- Cylindrical Lenses: Eyeglasses with specially designed cylindrical lenses correct the uneven curvature of the cornea or lens, providing clear vision.
- Pros: Non-invasive, easy to use, and can be adjusted as needed.
- Cons: May not provide optimal vision for all activities (e.g. sports), and can be inconvenient for some people.
2. Contact Lenses
- Toric Contact Lenses: These lenses are specifically designed to correct astigmatism. They have different powers in different meridians to correct the uneven curvature of the cornea.
- Rigid Gas Permeable (RGP) Lenses: These lenses maintain their shape on the eye and can provide clearer vision for some types of astigmatism.
- Hybrid Lenses: These lenses have an RGP center and a soft lens outer ring, providing the clarity of RGP lenses with the comfort of soft lenses.
- Pros: Provide a wider field of vision and are suitable for active lifestyles.
- Cons: Require proper hygiene and care, and can be uncomfortable for some users.
3. Refractive Surgery
- LASIK (Laser-Assisted In Situ Keratomileusis): A laser reshapes the cornea to correct the curvature. Suitable for mild to moderate astigmatism.
- Pros: Quick recovery, high success rate, and long-lasting results.
- Cons: Potential risks and complications, such as dry eyes and glare.
- PRK (Photorefractive Keratectomy): Similar to LASIK, but the corneal surface layer is removed and then allowed to regenerate. Suitable for those with thinner corneas.
- Pros: Suitable for thin corneas, good long-term results.
- Cons: Longer recovery time compared to LASIK, initial discomfort.
- LASEK (Laser Epithelial Keratomileusis): A variation of PRK where the epithelial layer is preserved and replaced after the cornea is reshaped.
- Pros: Suitable for patients with thin corneas, less discomfort than PRK.
- Cons: Longer recovery period, potential for temporary vision issues.
- SMILE (Small Incision Lenticule Extraction): A minimally invasive procedure where a small incision is made to reshape the cornea.
- Pros: Minimally invasive, less risk of dry eyes.
- Cons: Limited availability, not suitable for all types of astigmatism.
- Astigmatic Keratotomy (AK): Incisions are made in the cornea to relax the steeper curvature, reducing astigmatism.
- Pros: Can be done in conjunction with other procedures, effective for certain types of astigmatism.
- Cons: Potential for irregular astigmatism, less precise than laser procedures.
4. Orthokeratology (Ortho-K)
- Ortho-K Lenses: Specially designed rigid contact lenses are worn overnight to temporarily reshape the cornea, providing clear vision during the day without the need for glasses or contact lenses.
- Pros: Non-surgical, reversible, suitable for active individuals.
- Cons: Requires consistent nightly use, potential discomfort, and risk of eye infections if not properly maintained.
5. Implantable Lenses
- Toric Intraocular Lenses (IOLs): These are used in cataract surgery or as a refractive procedure to replace the eye’s natural lens with a lens that corrects astigmatism.
- Pros: Permanent solution, can correct significant refractive errors.
- Cons: Surgical risks, potential for post-surgical complications.
Choosing the Best Treatment
The best treatment for astigmatism depends on various factors, including the degree of astigmatism, the patient’s age, lifestyle, and personal preferences. An eye care professional will conduct a thorough examination and discuss the most suitable options, considering the benefits and potential drawbacks of each treatment.
Regular Follow-Up
Regardless of the treatment chosen, regular follow-up visits to an eye care professional are essential to monitor vision changes and ensure the effectiveness of the correction.
Special Vitamins for Astigmatism
While no specific vitamins can cure or directly treat astigmatism, maintaining overall eye health can help manage and potentially reduce the progression of vision problems. Certain vitamins and nutrients are essential for good eye health and can support the health of the cornea and lens, potentially helping to mitigate symptoms associated with astigmatism. Here are some key vitamins and nutrients that are beneficial for eye health:
1. Vitamin A
- Role: Vitamin A is essential for maintaining healthy vision, especially in low-light conditions. It helps form a protein called rhodopsin, crucial for seeing in low light.
- Sources: Carrots, sweet potatoes, spinach, kale, and other leafy green vegetables; liver and dairy products.
2. Vitamin C (Ascorbic Acid)
- Role: Vitamin C is an antioxidant that helps protect the eyes from oxidative damage caused by free radicals. It also supports the health of blood vessels in the eyes.
- Sources: Citrus fruits (oranges, grapefruits), strawberries, bell peppers, broccoli, and Brussels sprouts.
3. Vitamin E
- Role: Vitamin E is another powerful antioxidant that helps protect eye cells from damage and supports overall eye health.
- Sources: Nuts (almonds, sunflower seeds), spinach, and broccoli.
4. Lutein and Zeaxanthin
- Role: These are carotenoids found in high concentrations in the retina. They help filter harmful blue light and protect against oxidative stress.
- Sources: Kale, spinach, turnip greens, broccoli, and eggs.
5. Omega-3 Fatty Acids
- Role: Omega-3 is essential for maintaining the health of the retinal cells and may help reduce dry eye symptoms, which can sometimes accompany astigmatism.
- Sources: Fatty fish (salmon, mackerel, sardines), flaxseeds, chia seeds, and walnuts.
6. Zinc
- Role: Zinc helps transport vitamin A from the liver to the retina to produce melanin, a protective pigment in the eyes.
- Sources: Oysters, beef, pork, chicken, beans, and nuts.
7. B Vitamins (B6, B9, B12)
- Role: These vitamins help reduce homocysteine levels, a protein that can contribute to inflammation and eye conditions.
- Sources: Whole grains, eggs, dairy products, legumes, and leafy greens.
8. Vitamin D
- Role: Vitamin D may help reduce the risk of macular degeneration and support overall eye health.
- Sources: Sunlight exposure, fatty fish, fortified dairy products, and supplements.
Comprehensive Eye Health Tips
In addition to consuming these vitamins and nutrients, adopting overall healthy lifestyle practices can support eye health and potentially alleviate some of the symptoms of astigmatism:
- Balanced Diet: Eat a diet rich in fruits, vegetables, whole grains, and lean proteins to ensure you get a wide range of nutrients.
- Regular Eye Exams: Schedule regular eye check-ups to monitor eye health and make necessary adjustments to your vision correction.
- Proper Hydration: Drink plenty of water to keep your eyes hydrated and reduce dryness.
- Avoid Smoking: Smoking can increase the risk of developing eye diseases and negatively impact overall eye health.
- Protective Eyewear: Use sunglasses that block UV rays to protect your eyes from harmful radiation.
- Limit Screen Time: Take regular breaks from screens to reduce eye strain.
While vitamins and nutrients cannot cure astigmatism, they are crucial in maintaining overall eye health, which can help manage and possibly reduce symptoms. Always consult with an eye care professional before starting any new supplement regimen.
Home remedies for Astigmatism
Astigmatism is primarily a structural issue with the cornea or lens. While home remedies can’t cure or correct the physical irregularity causing the condition, they can help manage symptoms and support overall eye health. Here are some home remedies and practices that may help improve comfort and reduce the symptoms associated with astigmatism:
1. Eye Exercises
Here are a few exercises to try:
- Focus Change Exercise: Hold a finger a few inches away from your eye and focus on it. Slowly move the finger away while maintaining focus, then focus on an object farther away. Repeat several times.
- Figure Eight Exercise: Imagine a large figure eight on the wall about 10 feet away. Trace figure eight slowly with your eyes, first in one direction, then the other.
- Eye Rolling: Roll your eyes in a circular and counterclockwise motion to help relax the eye muscles.
2. Proper Lighting
Ensure you have adequate lighting when reading or working to reduce eye strain. Poor lighting can exacerbate the symptoms of astigmatism.
3. Regular Breaks
Follow the 20-20-20 rule to reduce eye strain: every 20 minutes, take a 20-second break and look at something 20 feet away. This helps relax the eye muscles.
4. Warm Compresses
Applying a warm compress to the eyes can help relax the eye muscles and alleviate discomfort caused by eye strain.
5. Cold Water Splashes
Splashing cold water on your eyes can refresh and reduce eye fatigue, especially after prolonged periods of focusing on a screen or reading.
6. Healthy Diet
A diet rich in vitamins and nutrients that support eye health can be beneficial. Focus on foods high in:
- Vitamin A: Carrots, sweet potatoes, and leafy greens.
- Vitamin C: Citrus fruits, strawberries, and bell peppers.
- Vitamin E: Nuts, seeds, and spinach.
- Omega-3 Fatty Acids: Fatty fish, flaxseeds, and chia seeds.
- Lutein and Zeaxanthin: Kale, spinach, and other leafy greens.
- Zinc: Oysters, beef, and beans.
7. Hydration
Staying well-hydrated is crucial for overall eye health and can help prevent dry eyes, which can exacerbate discomfort in people with astigmatism.
8. Avoid Smoking
Smoking can increase the risk of developing eye diseases and can worsen symptoms of astigmatism. Avoiding smoking can help maintain overall eye health.
9. Limit Screen Time
Prolonged screen time can cause digital eye strain. Try to limit screen time and take frequent breaks to rest your eyes.
10. Protective Eyewear
Wearing sunglasses that block UV rays can protect your eyes from harmful radiation and reduce strain.
11. Good Sleep Hygiene
Ensuring adequate and quality sleep can help reduce eye strain and fatigue, promoting overall eye health.
12. Blinking Exercises
Blinking frequently can help keep your eyes moist and reduce dryness. Try to make a conscious effort to blink regularly, especially when using screens.
Conclusion
While these home remedies can’t cure astigmatism, they can help manage symptoms and support overall eye health. It’s important to have regular eye examinations and follow the advice of your eye care professional for proper diagnosis and treatment of astigmatism. If you experience significant discomfort or changes in vision, seek professional medical advice.
Ayurveda Treatments for Astigmatism
Ayurveda, the traditional system of medicine from India, focuses on holistic treatments that balance the body’s doshas (energetic forces). While Ayurveda cannot cure astigmatism, it offers several remedies and practices to support overall eye health and manage symptoms. Here are some Ayurvedic treatments that may help with astigmatism:
1. Triphala Eye Wash
- Ingredients: Triphala powder, water.
- Procedure:
- Soak one teaspoon of Triphala powder in a glass of water overnight.
- Strain the water in the morning.
- Use the strained water to wash your eyes.
- Benefits: Triphala is known for its anti-inflammatory and antioxidant properties, which can help improve eye health and reduce strain.
2. Ghee (Clarified Butter)
- Ingredients: Pure cow’s ghee.
- Procedure:
- Warm a small amount of ghee.
- Apply a drop of warm ghee to each eye before bedtime.
- Close your eyes and rest for a few minutes.
- Benefits: Ghee is believed to nourish and strengthen the eye tissues and improve vision.
3. Netra Tarpana
- Procedure:
- A dough ring is placed around the eyes and filled with warm, medicated ghee or oil.
- The eyes are bathed in this ghee for a specific period.
- Benefits: This therapy is said to soothe and rejuvenate the eyes, reduce dryness, and improve vision.
4. Ayurvedic Eye Drops
- Examples: Itone, Isotine.
- Usage: Use as directed by an Ayurvedic practitioner.
- Benefits: These herbal eye drops are formulated to reduce eye strain, dryness, and inflammation.
5. Diet and Nutrition
- Incorporate Foods Rich in Vitamin A: Carrots, spinach, sweet potatoes, and other leafy greens.
- Include Omega-3 Fatty Acids: Flaxseeds, chia seeds, and fatty fish.
- Consume Antioxidant-Rich Foods: Berries, citrus fruits, and nuts.
- Avoid Excessive Intake of Spicy, Oily, and Processed Foods: These can exacerbate eye problems according to Ayurveda.
6. Herbal Supplements
- Triphala: Taken internally, Triphala can support overall eye health.
- Bilberry: Known for its benefits to eye health and vision improvement.
- Amla (Indian Gooseberry): Rich in vitamin C and antioxidants, amla supports eye health.
7. Yoga and Eye Exercises
- Trataka (Yogic Eye Exercise):
- Sit comfortably and focus on a candle flame or a black dot on the wall.
- Concentrate without blinking for as long as possible, then close your eyes and visualize the object.
- Repeat this several times.
- Eye Rolling: Slowly roll your eyes in all directions to relieve strain.
- Palming: Rub your palms together to generate heat and place them over your closed eyes for relaxation.
8. Lifestyle Practices
- Adequate Sleep: Ensure you get enough rest to reduce eye strain.
- Regular Breaks from Screens: Follow the 20-20-20 rule to minimize digital eye strain.
- Proper Lighting: Work and read in well-lit environments to reduce eye strain.
Consultation with an Ayurvedic Practitioner
It’s essential to consult with an Ayurvedic practitioner before starting any treatments. They can provide personalized recommendations based on your specific dosha balance and health needs.
Conclusion
While Ayurvedic treatments cannot cure astigmatism, they can help manage symptoms and support overall eye health. Combining these practices with regular eye exams and conventional treatments prescribed by an eye care professional can provide a comprehensive approach to managing astigmatism.
Conclusion
Astigmatism is a common refractive error caused by an irregular curvature of the cornea or lens of the eye. It leads to blurred or distorted vision at any distance and can cause symptoms like eyestrain, headaches, and difficulty seeing at night. While it cannot be cured, astigmatism can be effectively managed through corrective lenses, refractive surgery, and lifestyle adjustments. Regular eye examinations are essential for proper diagnosis and treatment.
Frequently Asked Questions
Q1: What is astigmatism?
A1: It is a common vision condition caused by an irregular curvature of the cornea or lens of the eye, leading to blurred or distorted vision.
Q2: What are the symptoms of astigmatism?
A2: Symptoms include blurred or distorted vision, eyestrain, headaches, difficulty seeing at night, squinting, double vision, and eye irritation.
Q3: What are the treatment options for astigmatism?
A6: Treatment options include eyeglasses, contact lenses (toric lenses), refractive surgery (LASIK, PRK), orthokeratology, and implantable lenses (toric intraocular lenses).
Q4: Are there any home remedies for astigmatism?
A7: While there are no home remedies to cure, certain practices like eye exercises, proper lighting, regular breaks, and maintaining a healthy diet can help manage symptoms and support overall eye health.
Q5: Can astigmatism worsen over time?
A8: It can remain stable or worsen over time, especially during periods of eye growth (such as childhood and adolescence). Regular eye examinations are important to monitor vision changes.
Q6: Can astigmatism cause other eye problems?
A9: Untreated astigmatism can lead to eye strain, headaches, and difficulties with daily activities. It may also contribute to other eye conditions like amblyopia (lazy eye) or presbyopia (age-related near vision loss).
Q7: Can astigmatism be prevented?
Regular eye examinations are key for early detection and treatment.
Reference: https://en.wikipedia.org/wiki/Astigmatism
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