Does increasing astigmatism mean keratoconus?

Not necessarily, but rapidly changing astigmatism at a young age with deteriorating glasses warrants corneal imaging to rule out keratoconus.

Does LASIK treat astigmatism?

LASIK treats regular astigmatism with a healthy stable cornea only, after a full work-up excluding keratoconus. Irregular astigmatism needs a different plan.

Why is my vision still blurred with new glasses?

Because glasses correct only regular astigmatism; surface irregularity (as in keratoconus) needs specialty lenses or other examination-guided solutions.

Astigmatism: Symptoms, Diagnosis and Treatment Options

Contents: The two types · Symptoms · Diagnosis · Treatment options · FAQs

The Two Types: Regular and Irregular

Aspect	Regular astigmatism	Irregular astigmatism
Shape	Even oval curvature with two clear axes	Uneven surface with no clear axes
Common causes	Mostly congenital and stable	Keratoconus, scars, post-surgical or post-injury change
Glasses	Usually correct it well	Alone insufficient; vision improves but never clears
Plan	Glasses, toric lenses, or LASIK with conditions	Corneal imaging, then specialty lenses, cross-linking or rings per cause

Symptoms Worth Noting

Blurred vision at all distances, eye strain and headache with concentration.
Ghosting or doubling of letters, especially at night and around lights.
Warning signs: rapidly changing glasses prescription, deteriorating vision despite updates, frequent eye rubbing at a young age — all warrant corneal imaging.

Diagnosis: More Than a Glasses Test

Refraction measures the degree but never reveals the cause. Full diagnosis includes visual acuity, slit-lamp examination and Pentacam corneal imaging whenever irregularity is suspected. How are the maps read?

Schematic of the role of Pentacam maps in diagnosing the cause of astigmatism — The map is what separates simple astigmatism from early keratoconus.

Treatment Options by Cause

Glasses and soft toric lenses: for simple stable regular astigmatism.
Specialty lenses (rigid/hybrid/scleral): for irregularity — lens guide.
LASIK and vision correction: for regular astigmatism only, with a healthy stable cornea after excluding keratoconus — LASIK assessment.
Cross-linking, rings and transplantation: when the cause is progressive keratoconus — cross-linking · rings · transplantation.

FAQs

Does astigmatism increase over time?

Congenital regular astigmatism is usually stable; rapid increase — especially in teenagers — warrants corneal imaging to exclude keratoconus.

Can astigmatism be cured permanently?

Regular astigmatism is corrected by glasses, lenses or LASIK with its conditions; irregular astigmatism is managed per cause — no single fix fits all.

My child rubs his eyes and the prescription keeps changing — should I worry?

Yes, it deserves early examination and corneal imaging; eye rubbing is a risk factor and early detection changes the plan — keratoconus in children.

Are regular contact lenses enough for irregularity?

Usually not; an irregular surface needs rigid or scleral lenses that create a new optical surface.

Selected references: Rabinowitz YS. Keratoconus. Surv Ophthalmol. 1998;42(4):297–319. · Gomes JAP et al. Global consensus on keratoconus and ectatic diseases. Cornea. 2015;34(4):359–369.

Prof. Dr. Amr Said Cornea & Refractive Surgery Clinic

Prof. Dr. Amr Said — Assistant Professor of Ophthalmology, Faculty of Medicine, Alexandria University; consultant in corneal and refractive surgery, keratoconus treatment and cataract surgery.

Smouha branch: 5 Dr Sayed Fahmy Street, off Bahaa El-Din Ghatwary Street, Smouha — behind Sidi Gaber railway station. Branch map
Amreya branch: In front of Amreya bridge — Omar El-Mokhtar Tower, 3rd floor, Amreya. Branch map

Phones: 01226154154 · 01032037199 · 01021031651 · Amreya: 01096615751

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