What is astigmatism: causes, classification, diagnosis and treatment

Good vision and eye health is the dream of any of us. However, today, unfortunately, not every person can boast of clear and precise vision. Almost all of us suffer from one or another ophthalmological pathology. Not least important is astigmatism, which we will discuss in detail in this article.

In this article

• What is astigmatism?
• Does astigmatism occur in one eye?
• Causes of astigmatism
• What types of astigmatism are there?
• How is the disease diagnosed?
• Tabo scale and home diagnostics
• Glasses as a type of astigmatism correction
• Contact lenses and astigmatism
• Lens replacement due to pathology
• Gymnastics for the eyes for astigmatism
• Does astigmatism occur in children?
• Can people with astigmatism join the army?

According to rough estimates, every fourth inhabitant of our planet suffers from astigmatism to varying degrees. As ophthalmologists themselves admit, it is quite difficult to maintain any statistics regarding this visual impairment.

Firstly, in the early stages of the disease, the patient does not notice any special changes, and therefore is in no hurry to make an appointment with a specialist. Secondly, even having paid attention to certain difficulties arising with vision, not everyone thinks that it is astigmatism, but, as a rule, blames long-term work at the computer, improper daily routine, headaches and, as a result, general fatigue of the body for impaired visibility . However, the forecasts of experts from the World Health Organization are very disappointing. In their opinion, more than 45% of the population of our planet today suffer from such refractive errors of the eye as myopia, farsightedness and astigmatism, which, in the absence of proper treatment, can lead to a rapid decline in vision.

What is astigmatism?

Astigmatism is a specific refractive error that occurs when the natural shape of the lens or cornea is disrupted. This is fraught with the fact that it entails improper dispersion of light rays and forms a distorted image on the retina of the eye. People suffering from astigmatism to varying degrees see objects around them, located at any distance, a little blurry. For example, they can be stretched in a vertical or horizontal position. Doctors explain such cases by the fact that light rays passing through the eyeball are unable to focus at one specific point.

To fully understand what astigmatism is and its classification, which we will talk about a little later, let's delve a little deeper into the theory of ophthalmology. A spherical surface of ideally regular shape practically does not exist in nature. Some of us have a more rounded cornea, while others have an oval one. The more it resembles an oval visually, the more pronounced the signs of astigmatism are.

To get a better idea of ​​how people with astigmatism see, imagine an image that contains both clear areas and blurry areas. Vagueness is the main symptom of this pathology. That is, this is not a “plus” or “minus”, which are well known to many people suffering from myopia or farsightedness, but rather a distortion of the picture.

Due to the fact that our visual organs are under constant tension, they get tired much faster. If you work at a computer for more than 8 hours a day, you may experience burning sensations, pressure, itching in your eyes, and you may also experience headaches or pressure in the temporal region. The problem is that most people do not consider these to be symptoms of astigmatism, and therefore prefer to take painkillers, hoping that the discomfort will go away by morning. Quite often, people suffering from a disorder such as astigmatism complain to their ophthalmologists that their vision has become much worse at dusk. They may also lose the ability to see colors correctly in low light levels. Drivers should pay special attention to this, since driving a car in this condition can be fraught with dire consequences.

Many people believe that eye disease is astigmatism, and that nearsightedness and farsightedness, which are even more common these days, are refractive errors. However, this conclusion is fundamentally incorrect. All three of the above visual changes represent a group of ametropia, that is, conditions characterized by a violation of the refractive power of optical functions, and, as a result, distortion of the rear focus of the eye. By the way, translated from Latin, astigmatism sounds like “lack of a focal point.” Perhaps this is one of the best definitions of this visual disorder, allowing even a person far from the world of ophthalmology to form a primary idea of ​​​​this pathology.

Development of pathology

In a healthy person, the cornea has a slightly convex shape. The light beam passes through it and through the lens, after which it converges at one point on the retina. At the slightest disturbance in the shape of the cornea, the light stream is refracted in different directions, which is why the retina hits not one point, but several, or the light is focused behind or in front of the retina. As a result, the image becomes distorted and blurry. The greater the convexity of the cornea, the more pronounced the pathology.

A similar picture is observed with lens deformation.

Does astigmatism occur in one eye?

“Could it be that astigmatism occurs in only one eye?” is a question patients often ask their doctors. Ophthalmologists admit that such visual deviation is not uncommon these days and can occur for a variety of reasons. However, whatever they are, correction of this condition is still necessary. The occurrence of astigmatism in one eye can occur due to a number of very diverse circumstances, among the reasons:

• the presence of inflammatory processes on the cornea, the most common of which are conjunctivitis, keratitis, blepharitis and other infectious ophthalmological pathologies;
• violation of the structure of the retina of the eye. In most cases, such a defect is congenital and, as a rule, is hereditary. Diagnosis is carried out at an early age, for the very first time in the maternity hospital. Basically, when a child undergoes an examination before going to kindergarten;
• consequences of previous surgical interventions on one of the eyeballs, as well as all kinds of traumatic injuries leading to the formation of scars on the cornea of ​​the eye;
• the last reason is a violation of the structure of the jaw or teeth, but it is quite rare. For example, deterioration of vision can be observed with an open bite, when the upper and lower teeth cannot connect when the jaws are closed.

For the above reasons, in order to clearly examine this or that object, a person is forced to squint his eyes or tilt his head to the side. Of course, this causes some inconvenience. That is why, if you notice the first signs of astigmatism, you should consult your doctor as soon as possible.

Symptoms of astigmatism

The first signs of astigmatism
appear in childhood. Unfortunately, kids can rarely formulate problems and explain that they are experiencing discomfort. That is why children are required to undergo examinations from the first months of life.

The main manifestation of eye astigmatism is blurred vision and blurred vision. In addition, the following symptoms may indicate pathology:

• increased eye fatigue;
• headache with visual stress;
• sensation of a foreign object in the eye;
• doubling of objects;
• burning, painful sensations in the eyes;
• difficulty maintaining attention;
• problems with visually determining the distance to objects.

Children's performance is falling.
They have difficulty reading and writing, confusing letters and numbers that are similar in spelling. It is especially important to identify astigmatism in time in children. If vision is not corrected promptly, amblyopia, or “lazy eye,” may develop. Due to the fact that during the early development of vision there is inadequate stimulation of the visual system (a constantly “blurred” picture), unequal refraction is formed, structural changes occur in the parts of the eyes and a significant decrease in vision that cannot be corrected is observed.

Causes of astigmatism

The reasons for the development of astigmatism are either congenital or acquired. If we talk about congenital ones - those that, as a rule, can be inherited, then a violation of the refractive system of the eye is explained by certain disorders of the lens or cornea of ​​the fetus during the mother's pregnancy. This usually happens from 3 to 7 weeks of gestation, when many women are often not even aware of their situation. A type such as congenital astigmatism occurs most often in modern medical practice. The cause of this phenomenon is certain defects in the genetic apparatus of the unborn baby, which he inherited from one of the parents. How the visual organs of the unborn child will develop depends on the activity of thousands of genes that influence not only the color of the eyes, but also the shape of the lens and cornea. At the moment of conception, the genes of the future parents are connected with each other, and as a result, the baby inherits genetic information from both parents. If in one of them the genes responsible for the development of the visual organs were damaged, then there is a high probability that this will also affect the condition of the baby’s eyes. And astigmatism can become one of the forms of the disorder.

As for the acquired form, it occurs under the influence of external factors. The most common causes of astigmatism are injuries to the cornea or lens. For example, if they were damaged by sharp objects. This often happens with penetrating ocular wounds, as well as with subluxation of the lens, leading to rupture of the ligamentous apparatus. Another very common cause can be inflammatory pathologies of the cornea, for example, keratitis or blepharitis. They can develop for a variety of reasons. For example, due to infection on the mucous membrane of the eye, when exposed to various chemicals or reagents, if, for example, a person works in a hazardous industry. Often, astigmatism accompanies a disease such as keratoconus - a pathology of the cornea that causes its thinning, due to which it gradually begins to acquire a pointed shape, resembling a cone.

If the patient previously had to be observed in a hospital and had surgery on the eyeball, then this can also become one of the reasons for the development of astigmatism. In most cases, this concerns improper suturing by medical personnel or the patient’s failure to comply with recommendations for care in the postoperative period. The shape of the cornea, in this case, changes due to excessively strong suturing, that is, tightening of the edges of the wound or, conversely, their divergence.

How does astigmatism appear?

If a person has healthy eyes, the cornea and lens have a smooth, spherical surface. When astigmatism appears in the eyes, the sphericity is disrupted and curvature appears in different directions. Because of this, some of the light rays are focused on the retina, and some are focused behind the retina or in front of it, i.e. at several points. Therefore, the overall image will be unclear and blurry. The same image will appear if you look at the lower, rounded part of the spoon.

The causes of astigmatism vary depending on whether congenital or acquired .

Most often, the irregular (non-spherical) shape of the cornea is inherited.

The cause of acquired astigmatism can be degenerative processes in the cornea, herpetic keratitis and other inflammatory processes that cause clouding of the cornea, various eye injuries and ophthalmological operations.

In addition to corneal astigmatism , there is also lenticular astigmatism , caused by an irregularly shaped lens.

There are two main meridians in the eye. One has the lowest refractive power, the other has the greatest. And the difference between these meridians is the degree of astigmatism.

If the meridians are located at an angle of 90 degrees to each other and there is a constant refraction between them, then this is correct astigmatism .

With irregular astigmatism, the meridians are not located at right angles and the refraction between them is different.

1 Diagnosis and treatment of astigmatism

2 Diagnosis and treatment of astigmatism

3 Diagnosis and treatment of astigmatism

What types of astigmatism are there?

Today, experts in the field of optometry distinguish five types of astigmatism. Dealing with them is quite simple. Many people today know that the human eye can differ:

• normal visual functions. This phenomenon is called emmetropia;
• myopia, in which a person cannot clearly see objects located in the distance;
• farsightedness - the opposite of the above condition, in which a person has trouble seeing objects close up.

Astigmatism can be either a separate disorder or combined with myopia or farsightedness. Depending on this, they distinguish:

• simple, in which one of the meridians is characterized by myopia or farsightedness, and the other has normal vision;
• complex, occurring in two meridians simultaneously, with the preliminary diagnosis of one of the refractive errors: myopia or farsightedness;
• mixed, in which myopia is recorded in one meridian, and farsightedness in the other.

Based on these data, five types of this pathology are distinguished, namely:

• Simple hyperopic astigmatism, designated by doctors as the letter H and representing a combination of farsightedness in the main meridian and emmetropia in the other;
• Simple myopic astigmatism, designated by ophthalmologists with the letter M and consisting of a combination of myopia in one main meridian with emmetropia in the other;
• Complex hypermetropic astigmatism, designated by the letters НН, is a combination of farsightedness, usually of high degrees, in the main meridians;
• Complex myopic astigmatism, designated by the letters MM, consists of a combination of high or varying degrees of myopia in two main meridians;
• Mixed astigmatism, designated by the letters NM or MN, is a combination of farsightedness in one main meridian with myopia in another.

Prevention methods

There are no special ways to prevent hypermetropic astigmatism. It is necessary to protect the eyes from injury and promptly treat diseases of the anterior part of the eye and lens. Regular eye exercises and courses of vitamins to strengthen vision will also be useful. Source: E.P. Tarutta, O.V. Proskurina, N.A. Tarasova, G.A. Markosyan Analysis of risk factors for the development of myopia in preschool and early school age // Health Risk Analysis, 2021, No. 3, pp. 26-31

Sources:

1. https://www.ncbi.nlm.nih.gov/pubmed/24637486 Kulp MT, Ying GS, Huang J, Maguire M, Quinn G, Ciner EB, Cyert LA, Orel-Bixler DA, Moore BD; VIP Study Group. Associations between hyperopia and other vision and refractive error characteristics // Optom Vis Sci. 2014 Apr;91(4):383-9. doi: 10.1097/OPX.0000000000000223.
2. E.P. Tarutta, O.V. Proskurina, N.A. Tarasova, G.A. Markosyan. Analysis of risk factors for the development of myopia in preschool and early school age // Health Risk Analysis, 2021, No. 3, pp. 26-31.

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

What are the degrees of astigmatism?

To make it easier for ophthalmologists not only to identify signs of a disorder, there is a certain classification. It depends on how strongly light rays are refracted in the main meridians of the eye of a patient with astigmatism. It is customary to distinguish the following degrees of ocular astigmatism:

• weak, not exceeding 3 diopters;
• medium - from 3 to 6 diopters;
• high - more than 6 diopters;

As it becomes clear, the higher the degree of impairment, the more difficult it is to correct it, and the more labor-intensive the process of creating optical products used for vision correction will be.

Doctors at the Excimer Clinic will help you cope with astigmatism

All doctors
Pershin Kirill Borisovich

Leading ophthalmic surgeon and medical director of the Excimer clinics, doctor of the highest category, Doctor of Medical Sciences, professor, academician of the Russian Academy of Natural Sciences

Work experience 36 years

Pashinova Nadezhda Fedorovna

Chief physician of the Moscow ophthalmological clinic "Excimer", ophthalmic surgeon of the highest category, Doctor of Medical Sciences, Associate Professor, Academician of the Russian Academy of Natural Sciences

Work experience 45 years

Georgiev Nebojsa

Ophthalmic surgeon, Candidate of Medical Sciences

Work experience 28 years

How is the disease diagnosed?

If you notice any signs of astigmatism, you should make an appointment with an ophthalmologist as soon as possible, since the disorder will actively progress. The first thing a specialist should do is collect an anamnesis: clarify where and who you work for, how much time on average you spend at the computer or other gadgets, what diseases you suffer from. If your answers “lead” the ophthalmologist to a diagnosis such as ocular astigmatism, then the doctor will perform the following procedures:

• refractometry is one of the most well-known methods for analyzing the refractive power of the eye, in other words, checking whether the patient has one or another refractive error
• visometry - testing visual acuity. If this violation is suspected, the procedure is carried out both without correction and with correction. The patient is put on a frame in which one eye is completely closed, and cylindrical lenses are placed in front of the other, differing in their refractive power;
• skiascopy, or as this research method is also called, the shadow test method. It is performed using spherical and cylindrical lenses. While the patient is “trying on” them, the doctor carefully observes the movements of the shadows in the pupillary area, illuminating this area with a beam of light reflected from the mirror.

Having received the results of these examination methods, the ophthalmologist will need to determine what exactly caused the astigmatism. For this purpose, biomicroscopy of the eye is performed - a thorough examination of the eyeball using a special device - a slit lamp, which is a combination of a light source and a diaphragm. This study is carried out in a dark room, which allows for a certain contrast between the illuminated and unlit areas of the eye.

Another examination method is ophthalmometry, which is performed using an ophthalmometer. It allows you to determine the refractive ability of the cornea and identify the corneal form of astigmatism. The most modern and reliable method of examination is computer keratotopography. It is carried out using a laser and a computer. The laser scans the cornea, and upon completion of the processing, using a computer, the specialist receives detailed information about the shape of the cornea, its refractive abilities, as well as all defects present in the main meridians.

Diagnostic methods

During the examination, the ophthalmologist takes measurements of the surface of the eye in three dimensions - the highest and lowest points of the cornea. There are several meridians on the surface of the eye, thanks to which it becomes possible to determine the unevenness of the surface, which causes astigmatism. Measurements are made in units called diopters, which show the degree of refraction in each meridian.

To imagine the meridians of the eye, remember what a round dial on a watch looks like. One meridian connects the numbers 6 and 12, the other 3 and 9.

The doctor compares the differences between the meridians, based on which he writes a prescription. To determine refraction, skiascopy or a shadow test is used - a beam of light is directed into the eye and how the shadows move in the pupil area is observed. The doctor uses different lenses to choose the one that most effectively improves vision.

Tabo scale and home diagnostics

In modern ophthalmology, there is a scale called Tabo. It is used by specialists to accurately determine the axis of astigmatism, more specifically, its main meridians. It is a circle around the perimeter of which there is a certain scale, divided into degrees, and the countdown begins counterclockwise. If the main meridians are located with a stronger vertical angle, then such astigmatism is considered straight. If the patient’s main meridian, characterized by stronger refraction, is located horizontally along the axis, then it is customary to talk about reverse astigmatism. The location of the main meridians on the Tabo scale at a distance from 30 to 50 or from 120 to 150 degrees is called astigmatism with oblique axes. If the patient suspects progressive astigmatism, the middle of the school circle will seem too blurry to him, and the circle itself will appear elliptical. Objectively speaking, the Tabo scale is practically not used in ophthalmology today, but it is an excellent tool for checking vision at home.

Home tests

To determine the disease, there are many schematic tests that can be found on the Internet. Some you can do yourself:

• Siemens Star test - a circle with a diameter of 10 cm is displayed on a computer monitor, which is formed from 54 black rays, the background is white, the rays are the same in size and color. The test is carried out in the morning, the brightness of the monitor should be medium. The child takes off his glasses or contacts and moves 5 m away from the screen. First, he closes one eye and looks at the picture for 2-3 seconds, then closes the second eye and looks again for 2-3 seconds. Then you need to look at the picture with both eyes. With astigmatism, the lines visually thicken, bend, their contrast changes, and an oval or shapeless image appears in the center of the circle.
• “Straight Lines” test - with astigmatism, the child sees straight lines drawn or created on a computer as curved.
• Test “Dark lines” - on the monitor you need to draw a circle consisting of straight dark lines, like rays. The child takes the test without taking off his glasses. You need to sit in front of the drawing at a distance of 35 cm, look, closing one eye. All lines should normally be sharp and distinct, equally dark. With astigmatism, some lines are normal, while others are lighter and blurred.

Is astigmatism treatable?

Many people mistakenly believe that it is impossible to get rid of astigmatism. That it is equivalent to a chronic disease and can only progress. However, this is not true - astigmatism is treatable. To correct this visual impairment, ophthalmologists use methods such as:

• wearing special glasses;
• use of toric lenses;
• laser vision correction;
• microsurgical eye surgery.

Which of the above methods will be used in a particular case will be decided only by an ophthalmologist, based on the results of a previous examination. In most cases, with low degrees of impairment, correction of visual functions with glasses or contact lenses is prescribed. If the changes in the visual system are quite serious, then most likely the doctor will recommend surgery or laser vision correction.

Why is astigmatism dangerous?

If astigmatism is left untreated, it can lead to squinting and a sharp decrease in vision. Without correction, astigmatism can cause headaches and eye pain. Therefore, it is very important to visit an ophthalmologist regularly.

What should you not do if you have astigmatism?

If you have astigmatism, you can play sports, but you should not lift weights, avoid sharp bends and strong muscle tension (for example, when doing weightlifting, in the gym). This may negatively affect intraocular pressure. With high degrees of astigmatism, it is not recommended to engage in sports that require teamwork due to problems with orientation in space.

Glasses as a type of astigmatism correction

For many years, glasses remained the simplest and most accessible way for users to correct astigmatism. Such models were called cylindrical. Of course, they did not have any therapeutic effect, that is, they did not inhibit the development of astigmatism, but only provided bright and contrasting vision to their owner. Only an ophthalmologist should select these optical products, since without his examination it is almost impossible to correctly select corrective lenses. Before writing you a prescription for a particular model, the doctor must:

• determine the accompanying refraction: myopia or farsightedness;
• clarify the exact direction of the eye meridians;
• determine which type of astigmatism you have and its degree.

What is the difference between the operating principle of cylindrical spectacle lenses and conventional ones? The fact is that they are distinguished by their ability to refract light rays that travel in a direction perpendicular to the cylinder axis. This allows rays passing parallel to the cylindrical axis not to be refracted. Ophthalmologists prescribe similar models for simple myopic or hypermetropic astigmatism. This is due to the fact that the effect provided by the glasses allows you to correct the defect in the affected meridian, without affecting the second one.

Another type is spherical lenses. Their main difference is that they have equal refractive power in all meridians. In modern practice, such means of contact correction are used quite rarely. This is due to the fact that they are able to have an effect only in the initial stages of astigmatism. There are cases when ophthalmologists prescribe them in addition to cylindrical lenses. This usually happens when we are talking about complex forms of the disorder, for example, mixed astigmatism. It is very important that the refractive power of the spectacle lenses used corresponds as closely as possible to the diagnosed degree of astigmatism.

Causes of pathology

There are two types of astigmatism - lenticular and corneal. The first occurs due to a defective shape of the lens, its partial or complete ectopia. The reason for the second pathology lies in the irregular shape of the cornea, which does not allow the rays to be focused at a certain point on the retina. In this case, a person sees blurry images of objects.

If the refractive power of the cornea is about 43 diopters, then the lens has only 19 diopters. Since the cornea is more important in the refraction (refraction) of rays, distortion of its configuration usually causes astigmatism.

Common causes of the disease are:

1. Heavy heredity . A congenital disease is usually formed at the gene level if parents have the same problem. Astigmatism, caused by a defect in the genetic code, is diagnosed in early childhood.
2. Inflammation of the eyes . Most often, curvature of the cornea occurs due to keratitis, which disrupts the structure of the membrane, causing deformations and opacities. This impairs the refractive power of the eyes.
3. Injuries . Superficial and penetrating injuries to the apple often cause dislocation (subluxation) of the lens, scratches and ruptures of the cornea. Scars form on the shell, changing its shape. A person develops unilateral, usually irregular, astigmatism.
4. Degeneration and dystrophy of the cornea . Such diseases distort the standard shape of the sclera. In its normal form it should be a clear hemisphere, but with defects (keratoconus, keratoglobus, etc.) it becomes curved or uneven.
5. Surgical interventions . Treatment accompanied by an incision of the cornea often causes deformation of the latter. The reason for this is incorrectly applied, frayed sutures, and their removal ahead of time.

Contact lenses and astigmatism

According to the majority of ophthalmologists and patients themselves, contact lenses are the most practical and effective in correcting astigmatism. Despite the fact that they are selected using almost the same system as cylindrical ones, the presented models have a number of significant advantages over glasses.

• Firstly, they provide more effective vision correction, since there is no distance between the cornea itself and the lens, while when wearing glasses it is about 10 mm.
• Secondly, the lenses provide not only central, but also peripheral vision, which allows you to clearly see objects located on the sides;
• Thirdly, the lenses can be worn in any weather, they do not fog up during rain or snow, and also do not draw attention to your visual impairments.

To correct this disorder, both lenses developed on the basis of soft polymers and those based on hard ones can be used. As a rule, the latter types are made exclusively to order. Finding them in the public domain is almost impossible. Among soft contact lenses today, the following models are especially popular:

• Air Optix for Astigmatism;
• 1-Day Acuvue Moist for Astigmatism;
• Acuvue Oasys for Astigmatism with Hydraclear Plus;
• Biomedics Toric;
• Biofinity Toric;
• PremiO Toric.

When creating toric lenses, manufacturers pay great attention to the method of fixing them on the cornea. The most common is the use of ballast, the essence of which is that a certain seal is formed in a certain area of ​​the optical product. When gravity is applied, it will pull this edge down, causing the lens to remain in the same position all the time.

Another, no less popular method is cutting off the edge of the lens. As a rule - the lower one. However, this method is far from ideal and is practically not used by modern manufacturing companies. This is due to the fact that the lens itself can easily become detached during blinking and get lost, both in the eye itself and outside it. The most reliable method is periballast, a more advanced technology of conventional ballast. In this case, small bulges are created simultaneously in the upper and lower edges of the contact lens, thereby increasing its level of stability on the eye. Remember that optical products should only be selected by a qualified specialist, and therefore do not self-medicate by buying lenses on the advice of friends or acquaintances.

Review of the treatment of astigmatism at the Excimer Clinic

E. Rimma, Moscow

I express my deep gratitude to Kuznetsov Yu.E. He is a professional in his field and simply a magician. I began to see perfectly, it’s just magic... Many thanks to all the staff for their attentiveness, sensitivity and wonderful attitude... Health and great success to everyone!!!

K. Irina Konstantinovna, Moscow

I would like to express my deep gratitude to Larisa Vladimirovna Batalina and all the clinic staff! My vision decreased from the 3rd grade, and I wore contact lenses from the 10th grade. How glad I was that all the mockery was over! But how scary it was when you take off your lenses and see only vague spots around you! And finally, at almost 19, I had surgery with Larisa Vladimirovna and I SEE!!! Thank you very much to all the staff for your sensitivity and prompt work!

K. Sergey Sergeevich, Moscow

I would like to express my gratitude to Batalina Larisa Vladimirovna and all the staff of the clinic, I had mixed astigmatism, they performed laser surgery, now my vision is good, in general the clinic is good, clean, beautiful, the staff is kind and smiling, the nurses are beautiful, the doctors are specialists in their field, they gave a family discount, Overall everything is great, thank you again!!!

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See also:

• Treatment of astigmatism
• Laser correction of astigmatism
• Online tests for self-examination of vision
• Checking a child's vision online
• Questions and answers on astigmatism

Lens replacement due to pathology

This method of surgical intervention is considered, today, the most practical and optimal way to treat astigmatism in situations where the cause of the development of pathology in the future was injury, deformation or disruption of the development of the lens itself. However, according to some ophthalmologists, this correction method can be used, in rare cases, to correct the corneal form of ametropia. What is the essence of this process? After a detailed examination of the patient and determination of the type and degree of astigmatism, specialists make intraocular, or intraocular, contact lenses. They can have either a spherical or toric shape. After careful checks, these optical products are implanted directly inside the eyeball, replacing the damaged lens. The operation is performed under local anesthesia.

After surgery, the incision above the cornea is carefully sutured, and after just a couple of hours the patient can go home. It is important to remember that after replacing the lens, you must follow a gentle regime for the eyes: try to avoid working at the computer, watch less TV, use sunglasses with polarized lenses, etc. Despite the many advantages of this method, some patients outright refuse to undergo it. The risk of complications is quite rare, but still cannot be completely excluded. It can manifest itself either in redness of the eyes or increased lacrimation, or in more serious consequences, for example, suture dehiscence, eye infection, intraocular bleeding, etc.

Diagnosis of astigmatism

If alarming symptoms appear, it is recommended to immediately consult an ophthalmologist. To confirm the type and stage of the disease, a number of studies are carried out:

• refractometry (drops are instilled into the eye to dilate the pupil, then refraction is determined);
• visometry - determination of refraction in both meridians: for this, one eye is closed, and lenses with different refractions are selected for the second;
• computer keratotopography (necessary to exclude keratoconus - thinning of the cornea in the center);
• skiascopy - determination of the refraction of the eye using an indirect ophthalmoscope;
• ophthalmometry, along with ultrasound of the eye, is used to measure the eyeball;
• biomicroscopy - search for inflammatory processes in the lens and cornea of ​​the eye;
• ophthalmoscopy - examination of the vitreous body and fundus of the eye.

1 Diagnosis and treatment of astigmatism

2 Diagnosis and treatment of astigmatism

3 Diagnosis and treatment of astigmatism

Is laser correction possible?

The “gold standard” in the treatment of astigmatism today is laser vision correction. It allows you to carry out the necessary manipulations with the eyes with maximum accuracy and, most importantly, safety for the patient. The essence of this method is that, using a special laser, ophthalmologists perform a keratotomy - removing the affected part of the cornea and reducing its refractive power. In cases where correction of myopic astigmatism is necessary, the doctor may prescribe thermokeratoplasty - cauterization of the corneal edges and increasing its refractive power.

Both types of procedures are performed under local anesthesia, and therefore the patient does not experience any discomfort. During the postoperative period, a burning sensation in the eyes is possible, which is directly related to the healing process of the damaged cornea. There are also certain contraindications for laser vision correction. These include: pregnancy and lactation, severe forms of diabetes mellitus, retinal lesions, etc.

Treatment

How to treat astigmatism in adults? Treatment of astigmatism depends on the cause and location of the pathology, severity, and the presence of concomitant diseases.

This may include:

• vision correction with glasses and contact lenses;
• drug therapy - used to eliminate negative processes (relieving inflammation, pain and aching, relieving fatigue and discomfort, improving nutrition and microcirculation);
• physiotherapy (hardware effects);
• diet therapy - foods rich in vitamins A, C, group B and fatty acids help improve vision;
• surgical intervention: laser correction;
• thermokeratoplasty – correct the shape and convexity of the cornea using a laser;
• phacoemulsification - replacing the lens with an intraocular lens;
• Implantation of phakic lenses – a lens is installed into the eye chamber to correct refraction.

Laser correction

Conducting modern refractive laser surgeries to correct refractive errors.

Hardware treatment (physiotherapy)

Physiotherapeutic procedures activate blood microcirculation in the eye area and relieve fatigue.

The most effective and safe method of restoring vision for astigmatism is treatment with the MAKDEL-08 device. Thanks to laser radiation, the device creates a speckle structure on the retina of the eye. It is characterized by appropriate speckle sizes and contrast suitable for visual systems with reduced function. Long-term observation of the speckle structure relieves visual fatigue, improves tissue nutrition and helps restore accommodation.

Glasses and contact lenses

Optical systems level the light flux using special lenses (cylindrical in glasses, spherical, cylindrical or toric in contact lenses). The ophthalmologist selects glasses and contact lenses individually for each patient, taking into account the stage of the pathology and specific image distortions.

The main advantage of spectacle correction is ease of use. The main disadvantages are the presence of a gap between the lens and the eye, which distorts the picture at the slightest shift of the glasses, and the appearance of pain in the eyes, headaches, and increased fatigue when worn for a long time.

Contact lenses fit tightly to the cornea, eliminating the possibility of distortion. In addition, modern lenses, unlike their predecessors, are soft and do not cause discomfort.

Important! Glasses and contact lenses cannot cure astigmatism. They only temporarily correct visual defects. In addition, they require periodic replacement, which is explained by age-related changes in the structure of the eye.

Eye exercises

Eye gymnastics is important in the treatment of astigmatism in adults. It reduces eye strain, relieves fatigue, tones the eye muscles, and stimulates the functioning of the visual organs.

The most effective exercises:

• alternately focusing vision on a distant and nearby object;
• circular rotation of the eyes in different directions;
• moving the gaze up and down, left and right;
• “drawing” with the eyes of lines, letters, numbers, geometric shapes;
• focusing your gaze on the tip of your nose;
• alternately closing and opening the eyes;
• frequent blinking;
• massaging the eyelids.

Gymnastics for the eyes for astigmatism

Gymnastics for the eyes with astigmatism is also very important. Of course, it is impossible to perceive a set of certain physical exercises as an ideal panacea, since it is not possible to cure this pathology in this way. However, regular exercise can help relieve astigmatism. This is explained by the fact that with this visual impairment, a strain on the accommodation of the eye occurs, in other words, the refractive ability of the lens changes, depriving a person of the ability to clearly see the objects around him. In this regard, fatigue of the visual organs increases, especially if you are forced to spend a lot of time at the computer, pain occurs in the area of ​​​​the eyes or temples.

Experts have developed special training programs that help reduce visual stress. Their effectiveness lies in the fact that when performing these exercises, the eye muscles rest and relax, providing the necessary level of accommodation of the lens. In addition, blood circulation improves and metabolic processes are normalized. Ophthalmologists recommend their patients to perform eye exercises at least three times during the day, and if your work involves a computer, then at least every hour.

What exercises do experts recommend doing in this situation?

• Close your eyes as tightly as possible for at least five seconds. This improves blood flow to the eyes and thereby speeds up metabolism in the involved muscles of the visual organs.
• Go to the window and focus your vision on the glass, then find a point that is at the maximum distance and try to look at it for about 30 seconds. This will relax the ciliary muscles.
• Rotate your eyes clockwise and in the opposite direction at a slow pace for about 20 seconds. This helps activate the extraocular muscles.

Prevention methods

Now that we have figured out how to cure astigmatism

, let's talk about how to prevent the development of pathology. It is necessary to visit an ophthalmologist regularly and have your vision tested to notice changes in the early stages. Gymnastics for the eyes will be useful: exercises will help relax the eye muscles, improve blood circulation and normalize metabolic processes.

To prevent astigmatism in children, it is worth making sure that the eyes are not overstrained: limit time with gadgets and monitor the correct position and light level during classes. Ophthalmologists also recommend regularly taking courses of multivitamins intended for the eyes.

Does astigmatism occur in children?

Unfortunately, astigmatism occurs not only in adults, but also in children. In most cases, it is genetically determined, but it can also be acquired. If we are talking about high degrees of impairment, they are often accompanied by albinism, congenital retinitis pigmentosa, as well as fetal alcohol syndrome - damage to the organs of vision, due to the mother’s regular consumption of alcoholic beverages during pregnancy. If we are talking about an acquired form of astigmatism, then it usually occurs in connection with eye injuries, subluxations of the lens, which are often accompanied by rupture of the ligament of Zinn. Often it can develop in connection with pathologies of the jaw system, which provokes deformation of the walls of the orbit. In such situations, astigmatism is often accompanied by keratoconus, congenital nystagmus, eyelid ptosis, and optic nerve hypoplasia.

Typically, this pathology is diagnosed in children in the second year of life. If it was not detected during this period of time, then it can be identified by an ophthalmologist during a medical examination before going to kindergarten. Diagnosis of childhood astigmatism is not much different from examination of an adult and includes

• visometry;
• biomicroscopy;
• ophthalmoscopy,
• skiascopy.

In some cases, an ultrasound of the eyeballs may be required. It is very important to check children's vision for the development of astigmatism, as its consequences can be very dire. If the disorder is not detected in time, it can lead to amblyopia, the so-called lazy eye syndrome, in which one of the visual organs ceases to participate in the vision process, as a result of which binocular vision is lost and strabismus may develop.

Astigmatism: degrees of pathology and first symptoms

Astigmatism, being a congenital pathology, can make itself felt at absolutely any age. However, according to statistics, most often the disease is detected in children under two years of age. After conducting a detailed diagnosis, the doctor can give a prognosis even for such a young patient.

The primary task is to identify the extent of the disease. If the indicator is up to 0.75 diopters, then this is not a violation. And here are the degrees that are usually distinguished:

• Weak. Up to 2 diopters.
• Average. Up to 3 diopters.
• High. Up to 4 or more diopters.

If the degree is low, then the person will not even notice any violations. It is normal for him to see the picture around him slightly blurred or stretched, since he has no other idea of ​​the world due to his physiology. Therefore, he cannot guess about astigmatism.

But there are some alarming symptoms that indicate the development of this pathology. Frequent headaches, double vision from overwork, rapid fatigue, difficulty reading small print - these are clear signs of astigmatism.

Unfortunately, people often delay visiting an ophthalmologist. But even in a dire situation, the patient can be given good glasses. Nowadays this is not a problem.

True, the recipe will not be quite ordinary - it will contain the designations of sphere (sph), axis (ax), cylinder (cyl). The sphere indicates the amount of astigmatism correction. And the axis and cylinder indicate its orientation and size. Doctors call such glasses cylindrical.

Can people with astigmatism join the army?

Young people, whose turn has come to repay their debt to their homeland, are very often concerned with the question of whether eye astigmatism is an obstacle to serving in the army. It is impossible to answer this question unequivocally, since everything depends on the exact degree of impairment diagnosed in a particular conscript. As a rule, young people with a mild form of astigmatism fall under category B. However, there are some nuances here. Only vision from 2 to 4 diopters is taken into account. With such vision, a conscript is obliged to serve, but in certain troops.

If the degree of violation is weak, then such a young man is fit to serve in the army, but they have the right to call him fit only during military operations. But even here, not everything is so simple. A medical examination must be completed every three years. If during this time the medical board finds that the conscript’s visual functions have improved, he will receive category B and go to serve. Those young people whose vision is plus or minus 6 diopters and above will not be accepted into the army.

Prevention of astigmatism

To prevent astigmatism, it is necessary to follow a number of rules that will help avoid worsening the condition:

• Alternate mental and physical activity with active recreation.
• When choosing a lighting device, give preference to such lamps that the light output in the living room is at least 200 Lm/m2. More for office space. In this case, the light should not be too bright so as not to tire the eyes. The table lamp should be positioned on the left, slightly forward to avoid shadows.
• After 45-50 minutes of load in the form of reading or writing, you need to perform eye exercises for 5-10 minutes. This helps to avoid overstrain of the visual organs.
• Eat right. A balanced diet rich in vitamins and microelements increases visual activity and prevents the occurrence of many eye diseases.
• For people who have been diagnosed with astigmatism, it is important to carry out general strengthening activities: sports, walks in the fresh air, massage, hardening.
• If the cause of astigmatism was keratoconus, then you should be careful about external factors that can irritate the mucous membrane of the eye. Avoid prolonged stays outside in frosty and windy weather, or rooms with dry air and dust.
• If the disease worsens, the doctor may prohibit the person suffering from astigmatism from driving a vehicle and exempt him from military service.

For preventive purposes, it is necessary to visit an ophthalmologist 1-2 times a year to avoid serious consequences.

Vision correction

To correct simple types of myopia and farsightedness, cylindrical lenses are used that refract the light beam perpendicular to the axis of the cylinder. Complex and mixed vision defects require a combination of two lenses - spherical and cylindrical.

Glasses and contact optics cannot solve the problem; they only correct the refraction of the beam. Therefore, along with correction, you need to find the source of the pathology in order to eliminate it to the best of your ability. This is how the doctor stops the further development of the disease.

For astigmatists, optical lenses are more comfortable and more effective than glasses. It is important to give them the correct position using the latest techniques (ballast, periballast, etc.)

Laser therapy

For irregular astigmatism, these procedures are prescribed for those who do not want to wear optics. Laser correction is carried out at the request of the patient and is the most popular method of surgical treatment of vision defects.

Contraindications for refractive surgery:

1. Serious retinal damage;
2. Decompensated diabetes mellitus;
3. Eye inflammation, glaucoma or cataracts;
4. Pregnancy and breastfeeding.

Laser therapy is very effective for patients with irregular astigmatism that cannot be corrected optically. The method will eliminate corneal defects and restore its standard configuration. After the operation, people begin to clearly see surrounding objects.