Refractive Error / Astigmatism

Astigmatism

Astigmatism is a common focusing difference caused by the shape of the cornia - or sometimes the lens inside the eye. Instead of focusing light at one precise point, the eye focuses it unevenly, which can make vision look blurred, stretched or slightly smeared at both near and distance.

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What is Astigmatism

Why vision becomes distorted?

A normally shaped cornea and lens focus light evenly onto the retina. With astigmatism, the curvature differs between directions, so light does not come to one sharp focus.

The result can be blurred or distorted vision at both near and distance. Some people notice only mild blur, while others experience eye strain, headaches, glare or difficulty driving at night. Astigmatism is very common and often occurs together with myopia or hyperopia. Mild astigmatism may cause few or no symptoms.

VISION DISTORTION

Common symptoms of astigmatism

If blurred vision, eye strain or difficulty seeing at night is affecting daily life, an eye examination can determine whether astigmatism — or another eye condition — is responsible.

Blurred vision at all distances

Distorted or stretched-looking images

Difficulty seeing fine detail clearly

Eye strain during reading or screens

Glare and halos around lights at night

Trouble driving after dark

Map the cornea first — then talk about correction.

Topography and biometry show what a refraction can't. Once the shape is clear, the options for glasses, contacts or surgery are straightforward.

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Corneal topography map showing astigmatism pattern with colour-coded regions
WHY IT MATTERS

Why the shape matters, not just the number

The prescription tells us how much astigmatism you have. The corneal map tells us its shape.

Two people can have similar astigmatism measurements but very different corneal patterns. Most astigmatism is regular and straightforward to correct, while an irregular or changing pattern can sometimes suggest an underlying corneal condition such as keratoconus.

Corneal topography maps the shape of the cornea in detail, helping us distinguish regular astigmatism from patterns that may need closer assessment. It is also useful when planning laser vision correction or cataract surgery.

when a closer assessment is worthwhile

  • Your prescription is changing noticeably
  • Vision remains distorted despite an updated prescription
  • Astigmatism is high or irregular
  • You are considering laser vision correction
  • Keratoconus is suspected
  • You are planning cataract surgery and accurate astigmatism measurement is important
Approach and correction

Glasses, contacts or surgery — the right option depends on your eyes

Most regular astigmatism can be corrected very effectively with glasses or toric contact lenses.
Some suitable patients can also have refractive surgery. When astigmatism is high or irregular, or when the cornea is thin or abnormal, additional testing may change which options are appropriate. Patients undergoing cataract surgery may also be candidates for a toric intraocular lens to reduce astigmatism. 

If corneal mapping suggests keratoconus, the priority shifts from simply correcting the prescription Toric intraocular lens (usually for cataract surgery) to assessing and protecting the corned.
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Glasses

Toric contact lenses

Laser vision correction (when suitable)

Toric intraocular lens (usually for cataract surgery)

TREATMENT AND APPROACH

How our doctors assess astigmatism

We use precise measurements and detailed corneal mapping to understand both the amount and the shape of your astigmatism. This guides the best correction for your vision and helps us plan surgery when needed.

Accurate refraction

We measure your prescription carefully to determine how much astigmatism is affecting your vision.

Corneal shape & thickness mapping when indicated

Topography shows the surface shape; pachymetry measures the thickness — together they inform correction and planning.

Keratoconus assessment

When the pattern suggests risk or change, we rule out or detect keratoconus early.

Planning for surgery

Detailed mapping supports the best approach for laser correction or cataract lens selection.

If your vision has never felt fully sharp, come in.

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Meet your specialist

Care led by specialists you'll meet in person.

Dr. JD Ferwerda
Lead Ophthalmologist · Cataract and Retina Surgeon

Dr. JD Ferwerda, MD

Dr. JD Ferwerda, MD: Dutch-trained ophthalmologist specialising in cataracts, lens exchange, retinal disease, glaucoma, and AMD.

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Dr. Artem Kozhechenkov
Refractive Surgeon

Dr. Artem Kozhechenkov, MD

Russian-trained refractive and general ophthalmologist, leads lasik/ laser vision correction at EEC

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