Astigmatism: Real-Life Challenges and Treatment Options

In previous episodes, we’ve talked about the daily struggles faced by those who suffer from astigmatism. These challenges range from the blurring of letters and numbers when reading to the streaking of lights at nighttime, which can be particularly bothersome for driving or walking around at night. Today, I want to expand on that discussion by providing some real-life examples of when people with astigmatism face real difficulties. Later, we'll also explore some ways to manage and treat this condition.

But first, let’s do a quick recap: what exactly is astigmatism?

Astigmatism is a common vision condition that occurs when the shape of the cornea (the clear front cover of the eye) is not perfectly round, but instead, is elongated in one direction. Think of it like a soccer ball versus a football—whereas a normal cornea is shaped more like a soccer ball, an astigmatic cornea resembles a football. This irregular shape causes light to focus on multiple points on the retina rather than just one, leading to blurred or distorted vision.

Astigmatism can be caused by a combination of factors. Genetics play a significant role—if your parents have astigmatism, you’re more likely to have it too. However, environmental factors can also contribute. Long-term irritation to the cornea, such as from a misdirected eyelash or excessive eye rubbing, can lead to the gradual development of astigmatism over time.

There are different types of astigmatism that affect vision in unique ways. "With the rule" astigmatism is the most common type, particularly in younger individuals. This type typically causes vertical stretching of images. On the other hand, "against the rule" astigmatism causes horizontal stretching and is more common in older adults. Then, there’s oblique astigmatism, where the stretching occurs diagonally. Each type affects vision differently, and each person may experience a unique set of challenges.

Now, let’s dive into some real-life scenarios.

We’ll start with a mild case of astigmatism at minus 1 diopter and progressively move up to 4 diopters. Diopters are the units used to measure the optical power of a lens, and in this context, they represent the severity of astigmatism. For reference, 1 to 2 diopters is considered mild to moderate astigmatism, while 3 to 4 diopters are generally considered severe. For each example, I’ll show you how different types of astigmatism change our perception of everyday scenes.

Example 1: Browsing a Web Page

Imagine you’re browsing a simple web page, like Google. On the left side, you see the world through the eyes of someone with no astigmatism—everything is clear and sharp. Now, imagine that same page through the eyes of someone with 4 diopters of astigmatism. The text becomes blurry and distorted, making it difficult to read or navigate the page.

With "with the rule" astigmatism, which causes vertical stretching, the text may appear stretched out from top to bottom. On the other hand, "against the rule" astigmatism, which causes horizontal stretching, would make the text appear wider or compressed horizontally. This difference in stretching is why some people with astigmatism find reading more challenging than others, depending on their specific type. I personally find "against the rule" astigmatism the most difficult to deal with when reading, but many of you have shared different experiences in the comments. I’m curious to know which type you find most challenging—just type "WTR" (with the rule), "ATR" (against the rule), or "oblique" in the comments to share your thoughts!

Example 2: Reading a Car’s Dashboard

Let’s move to another scenario: driving. Reading the speedometer or other dashboard instruments is a straightforward task for most people. However, for those with astigmatism, particularly in severe cases, the numbers can appear doubled or shadowed. This doubling effect happens because the vertical and horizontal curvatures of the cornea do not align properly, causing two different focal points to be projected onto the retina. This results in the perception of two images instead of one.

Driving at night can be especially problematic. Lights from oncoming traffic, streetlights, and even reflections can streak or flare, making it hard to focus. This can create a "halo" effect around lights, which can be distracting and even dangerous if it affects your ability to see the road clearly.

Example 3: Reading Fine Print on a Cereal Box

Now, let’s consider a more everyday example: reading the back of a cereal box. The important nutritional information or promotional details are often written in small, fine print. For someone without astigmatism, this might be no big deal. But for someone with astigmatism, especially severe astigmatism, the fine print can be nearly impossible to read without squinting or straining their eyes. This can lead to eye fatigue and discomfort, especially if they are trying to read small text for extended periods.

Example 4: A Golf Scorecard or Spreadsheet

Lastly, let’s look at a scenario involving numbers and columns, like a golf scorecard or a spreadsheet at work. These grids can become quite challenging to interpret correctly for someone with astigmatism. I remember when I was younger and didn't know I had astigmatism; I often confused similar-looking numbers. For instance, eights looked like nines, and fives looked like sixes. This led to mistakes on math exams or even simple tasks like reading a scorecard. Now, with proper glasses, I can clearly differentiate these numbers, but it just goes to show how even minor cases of astigmatism can impact daily life.

So, what can you do if you have astigmatism?

The first step in managing astigmatism is to prevent further deterioration. Protect your eyes from irritants like dust, smoke, and pollen, and try to avoid excessive eye rubbing. This might seem simple, but it's a crucial first step in maintaining your eye health.

If you're looking for a more permanent solution, laser refractive surgery, such as LASIK or SMILE, can be a great option. These surgeries reshape the cornea, correcting its irregular curvature and improving vision. People with larger amounts of astigmatism may consider lens insertion surgery or even lens replacement surgery. These procedures can correct vision more permanently but come with their own risks and recovery processes.

For those who prefer non-surgical options, glasses and contact lenses are also highly effective. They provide clear vision with minimal side effects and can be easily updated as your prescription changes over time. Glasses specifically designed to correct astigmatism, called toric lenses, can help balance the irregular curvature of the cornea, improving vision quality.

I’m planning a future video where I’ll dive into the different types of eye surgeries available to improve vision, so make sure to subscribe if you want to learn more about those options.

Wrapping Up

That’s all for today’s video! I hope this gave you a clearer understanding of what it’s like to live with astigmatism and the various ways it can affect daily life. If you found this video helpful or learned something new, please give it a thumbs up. And if you haven’t subscribed yet, make sure to do so you don’t miss out on future content.