What is eye astigmatism in adults and how to treat it. Home treatment for complex, myopic and mixed eye astigmatism

It is rather difficult to explain what astigmatism is (as well as correct it). Astigmatism is one of the most common causes of low vision. Often astigmatism is combined with myopia ( myopic astigmatism) or with farsightedness ( hyperopic astigmatism).

Astigmatism is Latin for the absence of a (focal) point. Astigmatism occurs due to an irregular (non-spherical) shape of the cornea (less commonly, the lens). In a normal state, the cornea and lens of a healthy eye have a smooth spherical surface. With astigmatism, their sphericity is broken. It has different curvature in different directions. Accordingly, with astigmatism, different refractive power is present in different meridians of the cornea surface, and the image of an object when light rays pass through such a cornea is obtained with distortions. Some areas of the image can be focused on the retina, others - "behind" or "in front" of it (there are more complex cases). As a result, instead of a normal image, a person sees a distorted one, in which some lines are clear, others are blurry. You can get an idea of ​​this if you look at your distorted reflection in an oval teaspoon. A similar distorted image is formed with astigmatism on the retina.

Specialists distinguish corneal and lens astigmatism. But the influence of corneal astigmatism on vision is greater than that of the lens, since the cornea has a greater refractive power. The difference in the refraction of the strongest and weakest meridians characterizes the magnitude of astigmatism in diopters. The direction of the meridians will characterize the axis of astigmatism, expressed in degrees.

Degrees of astigmatism

Experts distinguish three degrees of astigmatism:

• mild astigmatism— up to 3D;
• moderate astigmatism- from 3 to 6 D;
• high astigmatism- above 6 D.

Types of astigmatism

According to the nature of occurrence, astigmatism is divided into congenital and acquired.

• congenital astigmatism- up to 0.5 D occurs in most children and refers to "functional", that is, this type of astigmatism does not affect visual acuity and the development of its binocularity. However, if astigmatism exceeds 1 D or more, then it significantly reduces vision and requires treatment in the form of spectacle correction.
• Acquired astigmatism appears due to gross cicatricial changes on the cornea after injuries, injuries, surgical interventions on the eyes.

Correction of astigmatism

To date, there are three ways to correct astigmatism: glasses, contact lenses and excimer laser correction.

Spectacle correction of astigmatism

With astigmatism, special “complex” glasses with special cylindrical lenses are most often prescribed. Experts mention that wearing "difficult" glasses in patients with a high degree of astigmatism can cause unpleasant symptoms, such as dizziness, pain in the eyes, visual discomfort. Unlike simple glasses, in the prescription for astigmatic "complex" glasses, data about the cylinder and the axis of its location appear. It is very important that a thorough diagnosis be carried out before the selection of glasses for the patient. Since there are often cases when a person with a diagnosis of "astigmatism" has to change his glasses several times.

Contact lenses for astigmatism

Speaking about the correction of astigmatism with the help of contact lenses, it is important to note that until recently it was possible to correct astigmatism only with the help of hard contact lenses. Such a model of lenses not only caused inconvenience during wearing, but also had a bad effect on the cornea. However, medicine does not stand still and today special toric contact lenses are used to correct astigmatism.

REMEMBER!

• After the prescription of glasses or contact lenses, it is necessary to be regularly observed by an ophthalmologist for their timely replacement with more “strong” or “weak” ones.
• Glasses and contact lenses are not a way out in the fight against the problem of "astigmatism". These methods only correct vision for a while. You can completely get rid of astigmatism only with the help of surgery!

Excimer laser correction of astigmatism

In recent years, for the treatment of astigmatism (up to ± 3.0 D), excimer laser correction is most often used. Laser correction according to the LASIK method can hardly be called an operation. This procedure is carried out for 10-15 minutes under local drip anesthesia, while the laser exposure does not exceed 30-40 seconds, depending on the complexity of the case.

During LASIK vision correction, the superficial layers of the cornea with a thickness of 130-150 microns are separated by a special device - a microkeratome, opening up access to its deeper layers for the laser beam. Then the laser vaporizes part of the cornea, the flap returns to its place and is fixed by collagen, the cornea's own substance. No suturing is required, as epithelium repair along the edge of the flap occurs naturally. After LASIK vision correction, the rehabilitation period is minimal. The patient begins to see well within 1-2 hours after the procedure, and finally the vision is restored within a week.

Why is astigmatism dangerous?

If astigmatism is left untreated, it can lead to strabismus and severe vision loss. Without correction, astigmatism can cause headaches and pain in the eyes. Therefore, it is very important to visit an ophthalmologist regularly.

Cost of basic services

Treatment of astigmatism in adults is carried out taking into account the cause of the disease. Astigmatism is an eye disease associated with deformation of the cornea and lens. The main symptoms of pathology -. A complication of astigmatism is strabismus.

Medical indications

Older people should know what astigmatism is in the eyes of an adult. The pathology under consideration only causes discomfort to some people. In other cases, the disease does not manifest itself, since the level of astigmatism does not exceed 1 diopter. The altered cornea impairs vision and functionality of the eyes.

Astigmatism is characterized by blurred vision, blurring, double vision and distortion in the eyes. This disease is not farsightedness or nearsightedness. Equally, people see both close and distant objects. The causes of astigmatism are associated with a violation of the sphericity of the lens or cornea. Normally, they have a flat spherical surface.

Astigmatism (taking into account the nature of occurrence) is classified into the following types:

1. Acquired, which appears after damage or injury to the eye. At the same time, gross cicatricial changes appear on the cornea. The acquired form of pathology often develops after unsuccessful eye surgery.
2. Congenital, which is more often diagnosed in children.

If 0.5 diopter is set, this indicates the development of a functional type of pathology. If the value exceeds 1 diopter, vision correction is required. The patient is prescribed glasses or contact lenses.

The course of pathology (symptoms)

Astigmatism can be reverse or direct. Given the degree of change in refraction, mixed, simple and complex forms of the disease are distinguished. The stronger the astigmatism is, the more pronounced the blurring of the “picture”. The disease under consideration is characterized by distorted and crooked lines of objects.

When stressed, the patient experiences irritation and discomfort in the eyes. This state quickly tires. Migraines may occur. It is difficult for the patient to focus on a particular line of text when writing and reading. Such signs can be eliminated by squinting your eyes, but this helps only partially.

If astigmatism is suspected, an ophthalmologist's consultation is required. A comprehensive examination of the organs of vision is carried out. The doctor analyzes the condition of the structures of the eyes, examines refraction. To check the visual acuity, specialists can use a correction.

In this case, the patient is put on a trial frame. One eye is covered with a screen, and lenses with different refractions are placed in front of the other.

To determine the degree of refraction, skiascopy is performed. For this, ophthalmologists use spherical and cylindrical lenses. If necessary, refractometry is performed, the pupil expands. To identify the cause of the disease, biomicroscopy of the eyes is indicated.

Ophthalmoscopy can rule out the pathology of the fundus. Ophthalmometry and ultrasound are used to examine the posterior and anterior segments of the eye. Keratoconus and corneal astigmatism can be detected by CT.

Treatment of the disease

If you experience the above symptoms, it is recommended to make an appointment with an ophthalmologist. Examination of the patient is carried out using lenses and special tables with parallel lines. If necessary, a solution of atropine is instilled into the patient's eyes, after which a special diagnostic procedure is performed.

Can astigmatism be treated at home? The final therapy of the disease at home is impossible. Optometrists use temporary vision correction techniques that help the patient lead a normal life until complete recovery:

1. Spectacle correction. Before the selection of glasses, a complete diagnosis of vision is carried out. Scientists have proven that wearing glasses with astigmatism can cause dizziness and pain in the eyes.
2. lens correction. Vision can be improved with toric contact lenses.

Each lens must have a certain curvature both vertically and horizontally. If astigmatism progresses, glasses are contraindicated. The disease, which is accompanied by farsightedness, requires the wearing of contact lenses or glasses with spherical lenses.

With concomitant pathologies, the doctor combines cylindrical lenses with lenses that are recommended to be worn for farsightedness and myopia. Such patients are registered with an ophthalmologist.

Surgery

But is astigmatism in adults treated? The above methods can only temporarily correct vision. To permanently get rid of the disease, laser correction is used - a manipulation that lasts 15 minutes and is painless. No stitches are required after the operation.

Before treating astigmatism with a surgical method, the doctor determines the degree of pathology. With astigmatism, the following types of operations are used:

• thermokeratocoagulation;
• laser coagulation;
• keratotomy;
• laser correction.

The first and second methods of therapy are similar to each other. Thermokeratocoagulation uses a metal needle to cauterize certain areas of the cornea. During laser coagulation, specialists replace the needle with a laser beam. Such an operation is indicated for those with farsightedness.

During keratotomy or in the process of dissection, incisions are made on the cornea that weaken the curvature. This technique is used for myopia and mixed astigmatism. Laser correction is a harmless method of surgical intervention that requires the use of special equipment. With its help, the doctor gains access to the deep layers of the cornea.

The laser vaporizes a certain area, removing part of the cornea. The process of alignment and return of the cornea to its original shape occurs in each patient individually. This technique is called LASIK.

The manipulation lasts less than 30 minutes. Anesthesia is given first. But such a correction is not carried out if the patient suffers from retinal pathology or other concomitant diseases.

Eye pathology and the army

The military enlistment office requires the passage of an ophthalmologist upon conscription. A conscript may receive one of the following conclusions from an ophthalmologist:

1. Category "D" - myopia of 1-2 eyes exceeds 12 diopters. The conscript is not fit for military service.
2. Category "B" - limited validity, as myopia ranges from 6-12 diopters.
3. Category "B" - the meridian of any eye - 3-6 diopters. The conscript is eligible, but there are some restrictions.

When detecting myopia (4-8 diopters), hyperopia (above 8 diopters) or astigmatism (above 3 diopters), a person is contraindicated to engage in certain sports.

It is allowed to perform bullet and bench shooting, play checkers and chess. Professional sports are contraindicated if the doctor has identified any degree of astigmatism. Otherwise, vision will deteriorate. With a moderate course of astigmatism, everything depends on the level of exerted loads.

Prevention methods

It is necessary to observe the regime of visual and physical activity. If the eyes are constantly tense, it is recommended to perform gymnastics. To support vision, take special vitamins with lutein (Lutein Complex).

Timely treatment of eye pathologies that provoke astigmatism (keratoconus) is required. Physiotherapeutic procedures (color therapy, pneumomassage) are used to relieve visual tension. You can use the device "Points Sidorenko".

Correction of the disease in question can be carried out according to different methods. The main thing is to choose the right method of treatment . Particular attention is paid to the professionalism and experience of the ophthalmologist. The choice of a medical institution is carried out taking into account the cost of therapy and the availability of modern equipment.

Related videos

In order to understand the essence of this pathology and the mechanisms of visual impairment associated with it, certain knowledge from the field of ophthalmology is required ( science dealing with the study of the organ of vision).

The human eye is a complex organ, the main sensitive element of which is the retina. The retina of the eye is located on the back wall of the eyeball and is a huge number of neurons ( nerve cells), which have the ability to capture light particles ( photons) and convert them into nerve impulses, which are then transmitted to certain parts of the brain and perceived by a person as images. However, before reaching the retina, light waves must pass through the refractive system of the eye, as a result of which they are focused directly to the center of the retina, which contains the maximum number of sensitive neurons. The presence of a refractive system allows you to create a clearer image of surrounding objects located at different distances from the eyes ( this phenomenon is called accommodation.).

The refractive system of the eye includes:

• cornea- the most convex part of the anterior surface of the eye, resembling a half ball in shape.
• lens- a transparent elastic formation, shaped like a biconvex lens and located directly opposite the pupil.
• vitreous body A transparent substance that fills the space between the lens and the retina.
• aqueous humor- a small amount of fluid located in the chambers of the eye ( in front and behind the pupil).

Under normal, physiological conditions, all surfaces of the lens and cornea are ideally even and smooth. It is thanks to this that all light rays passing through each specific point of these structures are focused directly on the retina. The essence of astigmatism lies in the fact that with this pathology, the surfaces of the refractive structures of the eyes are bent, that is, dimples or bulges appear on them in some places. As a result, certain light waves, after passing through them, will not be located in the central zone of the retina ( as normal), and in front of it or behind it. As a result of this, a person will not be able to focus his vision on any point, and the images of the surrounding structures will be fuzzy and blurry.

As mentioned earlier, the main link in the development of astigmatism is damage to the lens or cornea. The vitreous body and aqueous humor have a slight refractive power, so their damage ( which is relatively rare) does not lead to the development of astigmatism.

Causes of Astigmatism

congenital astigmatism

The genetic apparatus is a set of chromosomes ( 23 couples), which are located in the nuclei of almost all cells of the human body ( the exception is highly specialized cells that do not have nuclei, such as red blood cells). Each chromosome contains a huge number of genes, each of which is responsible for its specific function. The development of the eye is controlled by several thousand genes that determine not only eye color, but also the shape of the lens and cornea.

During conception, 23 maternal and 23 paternal chromosomes merge, as a result of which the child inherits genetic information from both parents. If any of the parents had damaged genes responsible for the development of the lens and / or cornea, there is a certain probability that the child will inherit these genes, as a result of which he may show clinical signs of astigmatism.

Acquired astigmatism

The causes of acquired astigmatism can be:

• Corneal injury. Astigmatism can develop when the cornea is damaged by sharp or piercing objects.
• Lens injury. With penetrating wounds of the eye, as well as with subluxation of the lens and rupture of its ligamentous apparatus, astigmatism may develop.
• Inflammatory diseases of the cornea ( keratitis). May develop for a variety of reasons when infected, when exposed to chemical or physical factors), contributing to the violation of the integrity of the cornea and its curvature.
• Keratoconus. This is a disease of the cornea, in which its thinning occurs, as a result of which it takes on a pointed, conical shape.
• medical manipulation. The main reason for the development of astigmatism in this case is the incorrect suturing of the area of ​​the cornea in which the incision was made. In this case, too strong suturing can contribute to a change in the shape of the cornea ( contraction) the edges of the wound, as well as the divergence or premature removal of postoperative sutures, as a result of which the edges of the wound diverge ( Excessive intraocular pressure may contribute to the divergence of the sutures).
• Diseases of the dental system. Various pathologies of the teeth or upper jaw can be combined with deformation of the walls of the orbit, which can also contribute to the development of astigmatism. So, for example, visual impairment can be observed with an open bite ( when the upper and lower teeth do not connect when the jaws close, which is due to defects in the development of the jaw bones). Other causes of astigmatism can be prognathia ( excessive forward protrusion of the upper jaw), adentia ( partial or complete absence of teeth) and so on.

Types of astigmatism

From a geometric point of view, the eye is a sphere, the anterior pole of which is the cornea, and the posterior pole is the retina. Many meridians can be drawn through this sphere ( circles) passing through its anterior and posterior poles. Two meridians perpendicular to each other ( vertical and horizontal), which have the most different refractive power, are usually called the main ones. It is the deviations ( deformations) of the main meridians and determine the type of astigmatism.

Depending on the refractive power of the main meridians, astigmatism can be:

• Direct- the vertical meridian has the greatest refractive power.
• Reverse- the horizontal meridian has the greatest refractive power.
• with oblique axles- with this form of the disease, the cornea is deformed in such a way that the main meridians ( with the most different refractive power) lie away from its vertical or horizontal axis.

• correct;
• wrong.

Correct astigmatism

As mentioned earlier, with the normal functioning of the refractive system of the eye, images of surrounding objects are projected directly onto the retina. In various diseases, the focus of the image may occur not on the retina, but in front of it ( in this case we are talking about myopia, that is, myopia) or behind it ( This condition is called hypermetropia, that is, farsightedness.). If the area of ​​the cornea or lens affected by astigmatism increases the refractive power of the eye, it is a myopic form of the disease, if it decreases, it is a hyperopic form.

Depending on the nature of the damage to the main meridians, there are:

• Simple myopic astigmatism. With this form of the disease, the refractive power of one of the meridians ( usually vertical) is increased while the refractive power of the other is normal.
• Simple hypermetropic astigmatism. In this case, there is a weakening of the refractive power of one of the main meridians, and the second also remains normal.
• Complex myopic astigmatism. In this case, the refractive power in both meridians is increased, but in one of them this is more pronounced than in the other.
• Complex hypermetropic astigmatism. With this form of pathology, the weakening of the refractive power in both meridians is determined, expressed to varying degrees.
• Mixed astigmatism. The most severe form of simple astigmatism, in which the refractive power of the cornea is increased in one of the meridians, and reduced in the other. Some of the rays passing through it will be focused in front of the retina, and some behind it, resulting in images of surrounding objects that are very blurry and fuzzy.

Irregular astigmatism

Physiological astigmatism

Symptoms of astigmatism

• Decreased visual acuity. As mentioned earlier, with astigmatism, the images of objects visible to a person are not projected accurately onto the retina, as a result of which visual acuity decreases. With correct astigmatism of the cornea, this deviation can be partially compensated by increasing or decreasing the refractive power of the lens, that is, accommodation. If the patient has a myopic form of astigmatism ( that is, if the refractive power of one of the meridians of the cornea is increased), the refractive power of the lens compensatory decreases, as a result of which the images of visible objects become clearer. If the astigmatism is hypermetropic, there is a compensatory increase in the refractive power of the lens, which also somewhat improves visual acuity. However, it is immediately worth noting that with any form of the disease, visual acuity will never become ideal, since, by normalizing the refractive power in one ( defective) the lens meridian distorts ( increases or decreases) such in another meridian.
• Distortion of visible objects. Distortion of visible objects is one of the main symptoms of astigmatism, and the nature of the distortion will be determined by the form and type of the disease. So, for example, with direct astigmatism, the vertical meridian will have the greatest refractive power, as a result of which the patient will better see vertical lines. With reverse astigmatism, the greatest refraction of light rays occurs in the horizontal meridian, so the patient will see horizontal lines better ( clearer) than vertical ones. With astigmatism with oblique axes, the main meridians are not located in vertical or horizontal planes, however, if the patient begins to slowly turn his head to the right or left, there will come a moment when the main meridians coincide with the horizontal or vertical line of the object, as a result of which its image will become clearer. In the case of incorrect astigmatism, the images of objects can be deformed in different planes, since each of the main meridians can have many notches ( recesses) or bulges with different refractive power.
• Constant squinting. During squinting, there is a decrease in the curvature and, accordingly, the refractive power of the vertical meridian, which leads to an improvement or even normalization of vision in patients with direct astigmatism.
• Pulling the skin of the eyelids outwards. When the skin of the eyelids is pulled outward, the radius and refractive power of the horizontal meridian decrease, as well as a simultaneous increase in the refractive power of the vertical meridian, which improves the clarity of visible objects in patients with reverse astigmatism.
• Accommodative asthenopia. This term refers to the rapid fatigue of the eyes, which occurs due to the constant tension of accommodation ( adaptive mechanisms aimed at improving image clarity). This is manifested by the appearance of heaviness, cutting or aching pain in the eyes, headaches, blurred vision ( objects become even more blurry and fuzzy, and when you try to focus your vision, headaches and eye pain increase).

Diagnosis of astigmatism

• measurement of visual acuity;
• skiascopy ( determination of the degree of refraction);
• refractometry;
• ophthalmometry ( determination of corneal curvature);
• biomicroscopy;
• measurement of intraocular pressure;
• determination of the degree of astigmatism.

Measurement of visual acuity in astigmatism

Measurement of visual acuity is carried out using special tables on which letters of various sizes are located. When examining children who do not yet know letters, various figures are used, and when examining deaf and dumb patients, special signs are used in the form of the letter “Ш”, the free ends of which are turned to the right, left, up or down.

The essence of the study is as follows. The patient enters a room with special lighting and sits on a chair, which should be located 5 meters from the table with letters. Visual acuity is determined for each eye separately. First, the doctor gives the patient a special plate and asks him to cover one eye with it ( while not closing the eyelids), and with the other eye look at the table and name the letters it points to. First, the doctor points to the capital letters located at the very top of the table, and then gradually descends several rows lower, until the moment when the patient cannot correctly name the letter. The patient is then asked to cover the other eye with the plate and the procedure is repeated.

Normal vision is considered if the patient easily ( without squinting) defines the letters located in the tenth row of the table ( some people can recognize even smaller letters, which is not abnormal). In this case, we are talking about 100% vision ( denoted as 1.0). If the patient distinguishes the letters of the ninth row, but does not see the letters of the tenth, visual acuity is assessed as 0.9, and so on.

Skiascopy for astigmatism

The study is carried out in a special darkened room. The patient sits on a chair, and to the side of him ( at eye level) the light source is set ( lamp). The doctor sits opposite the patient at a distance of 1 meter from him and, using a special mirror, directs a beam of light directly into the patient's pupil, after which he begins to move the mirror along the vertical or horizontal axis, observing the appearance and movement of the shadow.

First, the doctor determines the nature of visual impairment ( myopic or hyperopic). After that, lenses with different refractive power are alternately placed in front of the patient's eye until this shadow disappears, on the basis of which conclusions are drawn about the degree of refractive error. Special astigmatism lenses can also be used to examine patients with astigmatism. They are selected in such a way as to eliminate the shadow when the mirror moves in both main meridians, after which, based on the refractive power of the lenses used, conclusions are drawn about the nature and degree of astigmatism.

Refractometry

If the refractive structures of the eye ( cornea and lens) are not affected, the vertical and horizontal lines on the fundus will intersect. If the patient has myopia or hypermetropia, they will diverge. In this case, the doctor begins to rotate a special ring on the device until the lines come together. Based on this, the type and degree of refractive error are determined.

With astigmatism, horizontal lines will also shift vertically. In this case, the doctor begins to rotate the entire device until this displacement is eliminated - in this way one of the main meridians is determined. By rotating the ring mentioned above, the doctor determines the degree of refraction in this meridian, and then rotates the device exactly 90 degrees and determines the refraction of the second main meridian.

It is worth noting that today many clinics have automatic refractometers. The patient sits in front of such a device, his head is fixed, after which he is asked to look into the distance. The device itself studies the refractive systems of the eye, detects deviations from the norm and displays the data obtained on a computer monitor.

Ophthalmometry

Computer keratotopography

The examination takes only a few minutes and is absolutely painless. There are no contraindications to its implementation except for the inadequate mental state of the patient).

biomicroscopy

For the study, a special device is used - a slit lamp. It consists of a light source and a diaphragm that allows a thin, narrow band of light to pass through. The study is carried out in a dark room, resulting in a good contrast between the illuminated and unlit areas of the eye.

Biomicroscopy allows you to examine:

• Cornea. When a beam of light is directed to the cornea, the doctor sees its illuminated optical section, while the front and back walls, as well as the substance of the cornea itself, are clearly distinguishable. This allows you to identify the smallest foreign bodies, the presence of an inflammatory process or other defect.
• lens. When light is focused on the lens, its cut is visible in the form of a biconvex strip, while it is also possible to determine various deformations of its anterior or posterior surface, to identify foreign bodies or holes after a penetrating wound.
• vitreous body. Foreign bodies or other defects may also be found in it.

Measurement of intraocular pressure

Intraocular pressure is determined by the amount of fluid contained inside the eyeball. Under normal conditions, this fluid is constantly updated ( circulates), while the rate of its formation corresponds to the rate of its removal, as a result of which IOP is maintained at a relatively constant level.

The very procedure for measuring intraocular pressure is carried out by specially trained personnel in a hospital or clinic and requires special tools ( weights with a known mass). Before the examination, the patient is laid face up on the couch and a few drops of anesthetic are instilled into the eyes ( a substance that temporarily blocks the sensitivity of the cornea). After that, a special weight is treated with an alcohol solution ( for disinfection) and let it dry, and then a special paint is applied to its lower straight surface. The patient is asked to fix the gaze and not blink, after which the weight is gently placed directly in the center of the cornea for a few seconds. Then it is also carefully removed and placed on a special paper, on which the “imprint” of the paint remains.

The principle of the method is that this weight presses on the cornea and slightly bends it, while the severity of the deflection depends on the intraocular pressure ( the higher it is, the weaker the weight will bend the cornea and the smaller the contact area between them will be). In the place of contact of the weight with the cornea, the paint is erased, as a result of which a ring with a certain internal diameter is formed on the control paper. This diameter is measured using a special ruler, on which each division corresponds to certain numbers of intraocular pressure.

Degrees of astigmatism

After that, using lenses with different degrees of refraction ( refractive power) achieve such a state in which the patient will easily read the letters in the tenth row of the table. The refractive power of the lenses required for this will determine the refraction of this meridian, which is expressed in diopters.

Then the plate with the slot is rotated exactly 90 degrees ( in this case, the gap will correspond to the second main meridian) and also determine the refraction using lenses. The difference between the refractions of the main meridians will be the degree of astigmatism, which is also expressed in diopters. So, for example, if the main meridians have myopic refraction ( that is, the refractive power in both of them is increased), equal to -3.0 and -1.0 diopters, respectively, the degree of astigmatism will be 2 diopters.

Depending on the difference in the refractive power of the main meridians, there are:

• Weak degree of astigmatism- the difference is up to 3 diopters.
• The average degree of astigmatism- from 3 to 6 diopters.
• High degree of astigmatism- more than 6 diopters.

Correction and treatment of astigmatism

For the correction and treatment of astigmatism, you can use:

• glasses;
• contact lenses;
• surgical treatment;

• lens replacement;
• laser correction;
• eye gymnastics.

Glasses for astigmatism

Only an ophthalmologist should prescribe glasses for astigmatism, and only after a thorough examination, without which it is almost impossible to choose corrective lenses correctly.

Before assigning points, you must:

• determine the direction of the main meridians;
• determine refraction in the main meridians;
• determine the type of astigmatism;
• determine the degree of astigmatism;
• if possible, identify and eliminate the cause of astigmatism ( if this is not done, the prescription of glasses may eliminate the symptoms of the disease, however, the pathology that caused it may further progress).

• Cylindrical lenses. The principle of operation of a cylindrical lens is that it refracts light rays passing in a direction perpendicular to the axis of the cylinder and does not refract rays passing parallel to the axis of the cylinder. Such lenses are prescribed for simple myopic or simple hyperopic astigmatism, as they allow compensating for a refractive error in the affected meridian without affecting the unaffected one. A cylindrical lens should be installed in such a way that the axis of the cylinder is perpendicular to the corrected meridian.
• spherical lenses. They have the same refractive power in all meridians. Exclusively spherical lenses are rarely used for astigmatism ( only in mild forms of the disease). More often they are used in combination with cylindrical lenses for complex and mixed astigmatism, when there are refractive errors of varying severity in both meridians. In this case, the defect of one meridian is compensated using a spherical lens, and the defect of the second meridian is compensated by an additional cylindrical lens, which is installed in the spherical one.

Contact lenses for astigmatism

The advantages of contact lenses over regular glasses include:

• More effective vision correction. When wearing glasses, there is a certain distance between the lens and the cornea ( 10 - 12 mm), which creates additional "interference" in the path of light rays. The lens is fixed directly on the cornea and is in close contact with it, forming a single refractive system, which significantly increases the efficiency of vision correction.
• Constant distance to the retina. When wearing glasses, they glasses) are constantly shifted forward or backward by a few millimeters, as a result of which the focal length of the lenses also shifts. This results in a decrease ( albeit insignificant) visual acuity and accommodation tension. When using lenses, the distance from them to the retina is always the same, which ensures stable correction of astigmatism.
• cosmetic effect. Many people are embarrassed to wear glasses and feel uncomfortable wearing them. Contact lenses are invisible and cause almost no inconvenience to the wearer, so they are the ideal solution for these patients.

Lenses vary in how long they are worn. For example, one-day lenses from Bausch + Lomb Biotrue® ONEday (Biotra one-day) are popular. They are made of HyperGel material (HyperGel), which is similar to the structures of the eye and tear, contains a large amount of moisture - 78% and provides comfort even after 16 hours of continuous wear. This is the best option for dryness or discomfort from wearing other lenses. These lenses do not need to be looked after, a new pair is put on every day.

There are also scheduled replacement lenses - silicone hydrogel Bausch + Lomb ULTRA, using MoistureSeal® technology (MoyschSil). They combine high moisture content, good oxygen permeability and softness. Thanks to this, the lenses are not felt when worn, do not damage the eyes. Such lenses need care using special solutions - for example, ReNu MultiPlus (Renu MultiPlus), which moisturizes and cleans soft lenses, destroying viruses, bacteria and fungi, is used to store lenses. For sensitive eyes, the ReNu MPS solution (Renu MPS) with a reduced concentration of active ingredients is optimal. Despite the softness of the formula, the solution effectively removes deep and surface dirt. For long-term moisturizing of lenses, solutions with hyaluronic acid, a natural moisturizing component, have been developed. For example, the Biotrue universal solution (Biotru), which, in addition to removing contaminants, bacteria and fungi, provides 20-hour moistening of the lenses due to the presence of a hyaluronan polymer in the product.

It is worth noting that an important issue when prescribing contact lenses is the way they are fixed. When using a spherical lens, this is not so important, since it has the same refractive power throughout its entire length. At the same time, when using cylindrical or toric contact lenses, it is extremely important that the axes of the cylinders are located strictly perpendicular to the affected meridians, otherwise they will not have the desired effect.

Methods for fixing contact lenses are:

• Ballast use. The essence of this method lies in the fact that a seal is created in a certain area of ​​the lens, which, under the action of gravity, will pull this edge down, as a result of which the lens will always be in the same position. The disadvantage of this method is the fact that when changing the position of the head ( e.g. lying on your side) the center of gravity will shift and the lens will change its position.
• Clipping off the edge of a lens. In this case, the lower edge of the lens is cut off, after which it is installed on the lower eyelid, which holds the lens in the desired position. This method is also not ideal, as the lens can easily come off while blinking.
• Periballast. With this method of fixation, small thickenings are created in the upper and lower edge of the lens, which will be located under the upper and lower eyelids, thereby reliably fixing the lens.

Eye surgery for astigmatism

Indications for surgical treatment of astigmatism are:

• Wrong astigmatism. As mentioned earlier, this type of disease is extremely difficult to correct with glasses or contact lenses, so the only effective treatment for such patients is surgery.
• Intolerance to contact lenses. Many patients may experience allergic reactions to lens materials ( this is manifested by redness of the eyes, pronounced lacrimation, cutting pains in the eyes, and so on.). In addition, many people simply cannot tolerate the constant presence of a foreign body in the eye. For such patients, surgery is the best way to correct astigmatism.

For the treatment of astigmatism, you can use:

• Keratotomy. During this operation, several non-through incisions are made on the outer surface of the cornea, which allows, to some extent, to weaken the refractive power of one of the meridians ( this operation is mainly used for myopic astigmatism). It should be noted that the effectiveness and quality of this operation is very doubtful, since the healing process of the cornea can take quite a long time, after which the defect may resume or intensify.
• Thermokeratocoagulation. This technique is used for hypermetropic astigmatism, when it is required to increase the refractive power of the cornea. For this purpose, a special thin needle is taken and heated, after which the peripheral sections of the cornea are cauterized in the right places, which helps to increase its curvature and refractive power. This method is also used extremely rarely today due to the uncertain prognosis and the risk of side effects ( in particular, there is a possibility of perforation of the cornea during the procedure).
• Phakic lens implantation. The essence of this operation is that a specially selected lens is implanted under the cornea. In fact, this method is similar to the use of conventional contact lenses, however, the lenses themselves are not installed outside, but between the cornea and the lens. This allows you to save the patient from the discomfort associated with wearing contact lenses, while providing a fairly effective correction of astigmatism. The disadvantages of the method include the fact that, if necessary, surgical intervention on the lens ( for example, with the development of cataracts) the lens will have to be removed and then a new one installed, which is associated with additional financial costs.

Lens replacement for astigmatism

The essence of the operation is as follows. After a thorough examination of the patient and determining the type and degree of astigmatism, special intraocular ( intraocular) lenses, which can be spherical or toric ( spherocylindrical) form. The operation itself to replace the lens takes place under local anesthesia, that is, the patient is conscious, but does not feel anything.

After instilling an anesthetic solution into the patient's eye, the doctor produces a small ( 2 - 3 mm) an incision along the upper edge of the cornea, thus providing access to the lens. The patient's natural lens is then destroyed and removed, and an intraocular lens is placed in its place. Thanks to modern technology, these lenses are made from a material that can be easily rolled up and inserted through a small incision into the lens capsule. These lenses are designed in such a way that after they are placed in the lens capsule, they straighten and take the desired shape, and with the help of special "legs" they are securely fixed to the walls of the capsule.

After the operation, the incision above the cornea is sutured, and after a couple of hours the patient can go home. It is important to remember that for several weeks after the operation, it is recommended to observe a gentle regime for the eyes - watch less TV, avoid direct sunlight, and refuse to visit pools and other bodies of water.

Complications after such an operation are not common, but it is important to notice and eliminate them in time. That is why it is recommended to visit the ophthalmologist weekly within a month after the lens replacement, and if signs of inflammation appear ( that is, with redness of the eye, with severe lacrimation, with the appearance of pain) you should consult your doctor as soon as possible.

Lens replacement surgery can be complicated by:

• divergence of seams;
• rupture of the lens capsule;
• displacement of the implanted lens;
• eye infection;
• intraocular bleeding;
• injury to the cornea or lens capsule.

Laser correction of astigmatism

The procedure itself is performed under local anesthesia, so the patient does not experience any discomfort. In the postoperative period, there may be a feeling of pain or burning in the eye, which is associated with the healing process of the damaged cornea.

Complications after laser correction can be infectious or inflammatory, but they are quite rare. This is usually observed when aseptic and antiseptic rules are not observed, aimed at preventing the penetration of infectious agents into the surgical wound.

Laser correction of astigmatism may be contraindicated:

• pregnant women;
• nursing mothers;
• with severe diabetes mellitus;
• in the presence of glaucoma;
• in the presence of cataracts;
• with inflammatory diseases of the eye;
• with retinal damage.

Gymnastics for the eyes with astigmatism

The effectiveness of gymnastics is explained by the fact that during the exercise, the muscles that provide accommodation for the lens relax and rest. They improve blood circulation and normalize metabolic processes, which causes a positive effect.

Gymnastics should be performed at least 2-3 times during the day, and when working at a computer - every 30-60 minutes.

Gymnastics for the eyes with astigmatism may include:

• Exercise 1. Go to the window and try to focus your vision on a nearby object ( e.g. on glass). The field of this is to find the farthest point visible through the window and look at it for 20 - 30 seconds ( this causes relaxation of the ciliary muscle responsible for the accommodation of the lens). Repeat the exercise 3-5 times.
• Exercise 2. Slowly rotate your eyes clockwise and in the opposite direction for 20 to 30 seconds. At the same time, all oculomotor muscles are activated and developed.
• Exercise 3 Stretch your hand forward, stick out your thumb and try to focus on it. Slowly move the hand up and down, right and left, while watching the finger with your eyes.
• Exercise 4 Close your eyes tightly for 5 to 7 seconds, which promotes blood flow and accelerates the metabolism in the involved muscles.

Complications of astigmatism

Astigmatism can be aggravated by:

• strabismus;
• relapse after surgery.

Amblyopia with astigmatism

To prevent the development of this complication, doctors recommend starting the correction and treatment of diagnosed astigmatism as early as possible.

Strabismus with astigmatism

Recurrence of astigmatism after surgery

From this point of view, the method of replacing the lens or installing a phakic lens is considered more reliable, since in the case of a correctly and timely operation, the patient can forget about any vision problems for many years.

Do they take with astigmatism into the army?

Depending on the degree of astigmatism, a conscript may be recognized as:

• Suitable with restrictions. Such a conclusion is received by a conscript if the degree of astigmatism is from 2 to 4 diopters in any eye, regardless of the type and form of the disease. Such soldiers can be drafted into the army to serve in guard units, in chemical warehouses, at gas stations, and so on.

Astigmatism is a type of ametropia in which light rays cannot focus on the retina. Normally, the cornea and lens have a shape close to spherical. With astigmatism, it is violated, as a result of which the refractive power of the optical structures of the eye begins to differ in different planes (meridians).

Astigmatism may be congenital(due to congenital features of the cornea or lens) and acquired(after trauma, some diseases of the cornea, surgical interventions on the eye). The most common cause of astigmatism is an irregular shape of the cornea - in this case it is called corneal. Much less often, astigmatism is caused by an abnormal shape of the lens - it is called lens, or lenticular. Their sum is the total astigmatism.

Usually, two main meridians are distinguished, in one of which the refractive power is the greatest, and in the other - the smallest. The difference between them causes degree of astigmatism. If within each of the meridians the refraction remains constant, and they are perpendicular, then astigmatism is called correct. If the main meridians are not located at an angle of 90, or the refraction changes in its various parts, or when moving from one meridian to another, the refraction changes abruptly, such astigmatism is called incorrect.

Types of astigmatism

Depending on the refraction of the eye, astigmatism can be of the following types: - simple hyperopic or simple myopic - a combination of hypermetropia or myopia in one meridian and emmetropia in another; - complex hypermetropic or complex myopic - a combination of hypermetropia or myopia of varying degrees in the main meridians; - mixed - a combination of hypermetropia in one meridian and myopia in another.

The position of the main meridians is usually indicated on a degree semicircular scale with a countdown counterclockwise from 0 to 180. In this regard, astigmatism is distinguished: 1) direct type - a meridian with a greater refractive power is located vertically or 30 from the vertical; 2) reverse type - a meridian with a greater refractive power is located horizontally or ± 30 from the horizontal; 3) with oblique axes - both meridians lie in the zones 30-50 and 120-150.

Allocate also astigmatism symmetrical(the main meridians of both eyes are symmetrical and their sum is approximately 180) and asymmetric (the main meridians are not symmetrical, their sum is different from 180).

Astigmatism up to 0.5 diopters is inherent in most people and does not lead to visual impairment. It can be called physiological, and it does not need correction. Also, direct astigmatism is often detected in children of the first year of life and disappears later. Reverse astigmatism is more common in older patients.

As shown by a recent study in the United States, among the surveyed 2523 children aged 5 to 17 years, more than 28% had astigmatism of 1 or more diopters. In addition, it was found that this refractive error is more common among children of Hispanic and Asian races (36.9% and 33.6%, respectively) than in children of Caucasian (26.4%) and African American (20%) races. In another study of more than 11,000 UK spectacle wearers, 47.4% had astigmatism of 0.75 diopters or more in at least one eye and 24.1% in both. At the same time, myopic astigmatism occurred approximately 2 times more often (31.7%) than hypermetropic (15.7%).

Most people do not notice a deterioration in vision with their slight astigmatism. However, depending on its size, there may be complaints about: - distortion, blurring, doubling of the image; - rapid eye fatigue; - constant eye strain; - headache; - the need to squint in order to better examine an object.

For the diagnosis of astigmatism, keratometry, keratotopography, skiascopy, autorefractometry are used.

Indications for correction: - decreased visual acuity; - development and progression of myopia against the background of astigmatism; - asthenopia.

Treatment of astigmatism

1) Optical correction is the most common treatment for astigmatism. To do this, cylindrical or spherical-cylindrical spectacle lenses are used. Due to the fact that the brain is able to adapt to a distorted image that is formed due to uncorrected astigmatism, first-time prescribed glasses with such lenses can temporarily lead to disorientation in space, distortion of the contours of visible objects. The older the patient, the longer and more difficult it is to get used to such a correction.

For correction, rigid gas-permeable or soft contact lenses of a toric or regular, spherical shape can also be used. They usually cause less wearing discomfort than glasses, especially with high astigmatism numbers.

2) The cardinal method of treating this type of refractive error is refractive surgery. Various options for laser correction and implantation of a toric IOL allow, unlike contact lenses and glasses, to correct astigmatism as completely and for a long time as possible.

Astigmatism is a condition in which different types of refraction or different degrees of refraction of the same type are combined in one eye.

Refraction with astigmatism

There is such a thing as the main meridians - these are two perpendicular planes of the eye. Depending on their refraction, astigmatism is distinguished:

Direct - more refracts the vertical meridian,

Reverse - more refracts the horizontal meridian,

with oblique axles

In appearance, astigmatism can be correct and incorrect (more often corneal, due to its damage by traumatic, dystrophic and inflammatory processes). In the first view, the same refractive power is in the same meridian.

Correct astigmatism:

Simple - with it in one of the meridians of emmetropia (normal refraction)

Complex - in both meridians the same refraction (myopia or hypermetropia)

Mixed - in the meridians different types of refraction

Normal correct astigmatism up to 0.75 diopters is considered physiological, does not affect visual acuity and does not require correction.

Symptoms of astigmatism

Symptoms by which the presence of a disease can be suspected: the patient confuses similar letters, rearranges them, sees distorted objects, visual acuity decreases. Symptoms of asthenopia are expressed (rapid visual fatigue, a feeling of fullness, "sand" in the eyes), intolerance to glasses and their frequent replacement. Almost always, astigmatism is combined with refractive errors, myopia or hypermetropia.

This is how a person with astigmatism sees:

Usually, the first signs of astigmatism appear at school age, but often in adults. A thorough examination is necessary to exclude such a serious disease as keratoconus.

Keratoconus

Diagnosis of astigmatism

Diagnostic methods:

Visometry (determination of visual acuity) with and without correction. Put on a trial frame. An opaque screen is placed in front of one eye, lenses of different strengths are placed in front of the other (with astigmatism, cylindrical lenses that refract in only one meridian) and achieve maximum visual acuity,

Skiascopy (shadow test) - determine refraction using the movement of the shadow in the pupil area by swinging movements with an indirect ophthalmoscope when viewed with transmitted light,

Refractometry in the state of mydriasis gives the most accurate results,

Biomicroscopy to identify possible causes of astigmatism (inflammatory or degenerative diseases of the cornea),

Ophthalmometry and ultrasound of the eye to determine the anterior-posterior segment, because astigmatism in most cases is combined with myopia and hypermetropia,

Ophthalmoscopy to detect pathology of the vitreous body and fundus,

Computed keratotopography to determine the degree of corneal astigmatism. During the study, the thickness and refractive power of more than 8000 points are measured. Reveal the slightest violations of refraction.

Treatment of astigmatism

Astigmatism must be corrected and treated in a timely manner to prevent the development of complications. Correction: spectacle, contact, laser and microsurgical. Indications: reduced visual acuity, symptoms of asthenopia and progression of myopia or hyperopia.

The first type (glasses) is poorly tolerated by many patients, but still the majority prefer wearing glasses. Lenses are made special, with a cylindrical component. Glasses are selected strictly individually. They cannot be bought just in optics or on the market. The strength of the cylindrical lens should match the degree of astigmatism, and the spherical lenses are selected according to the rules for correcting myopia or hypermetropia. These glasses are prescribed for permanent wear.

Contact correction is carried out using toric lenses. Its advantage is that a single optical system is formed with the eye, unlike glasses that are at some distance. The use of toric lenses requires special skills taught by an ophthalmologist. Night (orthokeratological) lenses have also found use for a small degree of astigmatism.

If there is a difference in the optical power or thickness of the cornea, then after keratotopography, an astigmotomy is possible. in which micro-notches are applied, weakening the strong meridian, on the periphery. Indications: astigmatism more than 6 diopters, children under 18 years old, thin cornea (laser correction is impossible), as well as various refractions in the meridians.

Indications for excimer laser surgery is astigmatism up to 4 diopters. This is an outpatient, almost painless procedure, after which the patient immediately notices a significant improvement in visual acuity. Its essence lies in the fact that after the formation of the valve, the cornea is polished in clearly marked places to a certain depth. After the operation, it is worth limiting physical and visual stress, protecting your eyes from injuries (wearing glasses, for example), hot baths, sauna, alcohol for a period of a month. It is recommended to instill drops of dexamethasone (Oftan-dexamethasone, Maxidex) first 3 times a day, reducing to 1 time, 3 weeks; antibacterial (Tobrex, Floksal, Oftakviks) 3 times a day for a week, as well as moisturizing drops situationally (Oftagel, Oksial, Sistane). Regular check-ups by an ophthalmologist are required.

1-2 times a year it is necessary to take courses of vitamin preparations (Vitrum, Okyuwait-lutein, Bilberry-forte, etc.) and hardware treatment (laser stimulation, computer programs).

Complications of astigmatism

Untimely and inadequate treatment can lead to complications such as reduced visual acuity to the development of amblyopia (“lazy” eye, in which vision does not improve with correction), strabismus.

Prevention of astigmatism

The most important thing for health is disease prevention. With regard to astigmatism, it is necessary to dose visual loads, or rather, alternate them with physical exercises and gymnastics for the eyes. It is strictly forbidden to read lying down or in poor lighting. It is possible to use special perforated glasses.

Ophthalmologist Letyuk T.Z.

Hover over illustration

What is astigmatism is quite difficult to explain (as well as correct). Astigmatism is one of the most common causes of low vision. Often astigmatism is combined with nearsightedness (myopic astigmatism) or farsightedness (hyperopic astigmatism).

Astigmatism is Latin for the absence of a (focal) point. Astigmatism occurs due to an irregular (non-spherical) shape of the cornea (less commonly, the lens). In a normal state, the cornea and lens of a healthy eye have a smooth spherical surface. With astigmatism, their sphericity is broken. It has different curvature in different directions. Accordingly, with astigmatism, different refractive power is present in different meridians of the cornea surface, and the image of an object when light rays pass through such a cornea is obtained with distortions. Some areas of the image can be focused on the retina, others - "behind" or "in front" of it (there are more complex cases). As a result, instead of a normal image, a person sees a distorted one, in which some lines are clear, others are blurry. You can get an idea of ​​this if you look at your distorted reflection in an oval teaspoon. A similar distorted image is formed with astigmatism on the retina.

Specialists distinguish between corneal and lens astigmatism. But the influence of corneal astigmatism on vision is greater than that of the lens, since the cornea has a greater refractive power. The difference in the refraction of the strongest and weakest meridians characterizes the magnitude of astigmatism in diopters. The direction of the meridians will characterize the axis of astigmatism, expressed in degrees.

Degrees of astigmatism

Experts distinguish three degrees of astigmatism:

Types of astigmatism

According to the nature of occurrence, astigmatism is divided into congenital and acquired.

Correction of astigmatism

To date, there are three ways to correct astigmatism: glasses, contact lenses and excimer laser correction.

Spectacle correction of astigmatism

With astigmatism, special "complex" glasses with special cylindrical lenses are most often prescribed. Experts mention that wearing "difficult" glasses in patients with a high degree of astigmatism can cause unpleasant symptoms, such as dizziness, pain in the eyes, visual discomfort. Unlike simple glasses, in the prescription for astigmatic "complex" glasses, data about the cylinder and the axis of its location appear. It is very important that a thorough diagnosis be carried out before the selection of glasses for the patient. Since there are often cases when a person with a diagnosis of "astigmatism" has to change his glasses several times.

Contact lenses for astigmatism

Speaking about the correction of astigmatism with the help of contact lenses, it is important to note that until recently it was possible to correct astigmatism only with the help of hard contact lenses. Such a model of lenses not only caused inconvenience during wearing, but also had a bad effect on the cornea. However, medicine does not stand still and today special toric contact lenses are used to correct astigmatism.

REMEMBER! After the prescription of glasses or contact lenses, it is necessary to regularly observe an ophthalmologist for their timely replacement with stronger or weaker ones. Glasses and contact lenses are not an option in the fight against the problem of "astigmatism". These methods only temporarily correct vision. You can completely get rid of astigmatism only with the help of surgery!

Excimer laser correction of astigmatism

In recent years, excimer laser correction has been most often used to treat astigmatism (up to ±3.0 D). Laser correction according to the LASIK method can hardly be called an operation. This procedure is carried out for 10-15 minutes under local drip anesthesia, while the laser exposure does not exceed 30-40 seconds, depending on the complexity of the case.

During LASIK vision correction, the superficial layers of the cornea with a thickness of 130-150 microns are separated by a special device - a microkeratome, opening up access to its deeper layers for the laser beam. Then the laser vaporizes part of the cornea, the flap returns to its place and is fixed by collagen, the cornea's own substance. Suturing is not required, since the restoration of the epithelium along the edge of the flap occurs independently. After LASIK vision correction, the rehabilitation period is minimal. The patient begins to see well within 1-2 hours after the procedure, and finally the vision is restored within a week.

Why is astigmatism dangerous?

If astigmatism is left untreated, it can lead to strabismus and severe vision loss. Uncorrected astigmatism can cause headaches and stinging eyes. Therefore, it is very important to visit an ophthalmologist regularly.

With astigmatism, there are two optical foci in the eye at the same time, and neither is located in the right (correct) place. In a child with astigmatism, the development of the visual system is inhibited and visual information is perceived with significant distortion.

Astigmatism is a congenital phenomenon and is most often inherited. This disease of the visual system occurs due to an irregular (non-spherical) shape of the cornea (less often, the lens). Approximately every fourth inhabitant of the planet has the so-called "physiological astigmatism" up to 0.5 D. A person does not feel such an optical error, and it does not need to be corrected with glasses. But if the degree of astigmatism exceeds 1.0 D, then this, as a rule, significantly affects visual functions. Since astigmatism is a congenital disease, it can manifest itself at any age, and not necessarily in childhood. However, most often astigmatism is diagnosed in children on examination at 2 years. At this age, the doctor can already predict the further development of the child's visual system.

How to recognize astigmatism?

If a child complains of poor vision, headache, discomfort in the superciliary region, gets tired quickly - all this may indicate the presence of astigmatism. An examination by an ophthalmologist is necessary not only to clarify the diagnosis, but also to select glasses or contact lenses. If the doctor confirms the presence of astigmatism during the diagnostic examination, then glasses or contact lenses are prescribed depending on subjective tolerance and the age of the patient. Usually children with astigmatism are prescribed glasses with cylindrical lenses for permanent wear. Surgical treatment of astigmatism - excimer laser correction is recommended by doctors after the age of 18, when the visual system is fully formed.

Children with astigmatism need to visit an ophthalmologist 2 times a year. If a child wears glasses, it is important to monitor the growth of the eye and change the optics in a timely manner. In contrast to such a disease as myopia. astigmatism does not progress, therefore, if all the recommendations of a qualified specialist are followed, it can be kept under control.

It is important that astigmatism in a child is diagnosed on time and corrective measures are started as soon as possible. After all, if this is not done on time, the likelihood of an irreversible decrease in visual acuity, the slow development of strabismus and amblyopia ("lazy eye"), increases significantly.

How to treat astigmatism in children?

It is necessary that the treatment of childhood astigmatism includes various methods of physical, optical and functional effects. Correctly selected glasses are one of the most important components for the treatment of amblyopia ("lazy eye") with astigmatism.

In addition, modern ophthalmological clinics and centers offer special therapeutic techniques that allow you to gradually reduce the strength of glasses and even completely get rid of spectacle correction.

Astigmatism is a congenital or acquired defect of the human visual system. It is caused by a change in the shape of the lens or cornea of ​​the eye. Often the companions of the disease are severe myopia or hyperopia. With this disease, the eye acts like a distorted mirror, distorting the image. The first signs of a defect are the lack of a clear outline of some objects and the inability to focus the gaze. Often they are accompanied by nearsightedness or farsightedness.

Do not worry about whether astigmatism can be cured. If you suspect that you have a similar disease, make an appointment with an ophthalmologist.

Specificity of the disease

Consider what causes astigmatism and what it is.

What is astigmatism?
First you need to figure it out in order to understand what astigmatism is: the eye has a spherical shape, it is covered on the outside with a thick shell - the sclera. The latter in the central part becomes transparent, which allows light to penetrate into the eye. This transparent part is called the cornea. The lens is responsible for the transmission and refraction of light rays to the retina. On the surface of the eye, two conditional lines can be distinguished, which are called the main meridians. One of them is the strongest and the other is the weakest. In a healthy eye, the meridians are perpendicular. The light refracted in them is collected in the macula - the center of the retina.

The curvature of the spherical shell of the human eye, its lens or cornea changes its shape when astigmatism appears. The curvature of the cornea causes light to refract in different ways at different points in the eye. In this case, the image on the retina is collected not in the macula, but at several points. Hence the name of this eye disease - astigmatism, which is translated from Latin as "lack of a focal point." In some cases, the points are not on the retina, but in front of it or behind it. The condition when the rays, refracted, are collected behind the retina, is called farsightedness, and in front of the retina - myopia.

As a result, such deformation leads to visual distortion of the observed objects and loss of focus. In this case, one of the main meridians has a greater refractive power than the other. This process is called a violation of the refractive power (refraction). The degree of astigmatism depends on how great the difference between the refraction of the meridians is.

This disease can affect both the lens and the cornea. However, distortion of the corneal surface has a much stronger effect on vision.

If you're wondering how people with astigmatism see, remember 3D movies. When you take off your glasses, you see a slightly doubled and slightly blurred image. With this disease, especially a high degree, the objects around look approximately the same.

Types of disease

There are various classifications and, as a result, types of astigmatism.

According to the type of refractive error, the following types are distinguished:

1. Simple farsighted (another name is hyperopic). Farsightedness in one of the meridians of the eye is combined with normal refraction in the second meridian.
2. Simple myopic (or myopic). Here in one of the meridians - myopia, and in the other - normal refraction.
3. Complex farsighted. In both meridians hypermetropic refraction, but expressed with different intensity.
4. Complex nearsighted. Myopic refraction in both meridians has a different degree.
5. Mixed. In one of the meridians there is farsightedness, and in the other - myopia.

In a healthy eye, the meridians are perpendicular. In the case of a change in the position of one or both meridians with astigmatism, the species are distinguished according to a different classification:

1. Straight. The main meridian with maximum refraction deviates from the vertical axis by no more than 30°. This type occurs mainly in children.
2. Back. The meridian with the greatest refraction is located on the horizontal axis or has a deviation of no more than 30° from it. It occurs predominantly in the elderly.
3. Astigmatism with oblique axes. Both main meridians deviate from the vertical or horizontal axis by more than 30°.

Astigmatism in both eyes is more common than in one. In this case, allocate:

• symmetrical, when the meridians in both eyes are located in the same way;
• asymmetric, when the main meridians in different eyes are located in different ways.

Depending on the difference in the refractive power in the meridians, there are 3 degrees of astigmatism:

1. Weak degree with distortion up to 3 diopters. This degree is common. Moreover, with a distortion of less than 0.5 diopters, a person may not even be aware of the presence of a disease. This type of disease is called physiological. It can be corrected within a short time.
2. The average degree of distortion is from 3 to 6 diopters. Correction of the disease of this degree is already more difficult and takes more time. For this, special glasses or lenses are prescribed. In some cases, laser correction is used.
3. Strong degree with distortion over 6 diopters. It is possible to cure a disease of this degree only with the help of surgical intervention or laser correction. Sometimes hard contact lenses are prescribed to improve vision, however, they are very rarely able to correct the situation.

Treatment of astigmatism in adults and children is mandatory. You should not postpone the session to the ophthalmologist: neglecting to correct the defect will certainly lead to a drop in vision. In the initial stages, the disease can be corrected.

Symptoms and causes of the disease

With astigmatism, the causes of occurrence can be completely different. Most often this is a hereditary disease, therefore, if one of the parents has a similar one, it is highly likely that it will also occur in the child. However, it can also manifest itself in a person in whose family this has not been observed in anyone.

The causes of astigmatism can be both congenital and acquired. As a rule, a congenital defect is more common than an acquired one.

The appearance of an acquired disease can occur due to the following factors:

• was damaged as a result of an injury;
• the cornea of ​​the eye was burned;
• multiple outbreaks of conjunctivitis were present;
• inflammation and other diseases of the cornea were present;
• operations were performed on the cornea and sclera of the eye, after which there were stitches;
• some other diseases of the eye or eyelids.

The symptoms of astigmatism are:

• eyes are very tired;
• headaches and dizziness while reading;
• it becomes difficult to focus on any object;
• the lines and boundaries of some objects are distorted, but when the angle of view changes, the object may take on its original form;
• letters are distorted, reading becomes difficult;
• you begin to see worse objects that are very far or very close.

At the very beginning of the development of astigmatism, the symptoms are not pronounced. However, like any other disease, it tends to progress. The stronger its development, the stronger the distortion of the cornea and the worse the quality of vision. If at the initial stages it can be confused with ordinary fatigue, then even with an average degree, you will definitely notice vision problems. So, if you notice symptoms of astigmatism in yourself, do not delay your visit to the optometrist.

Diagnosis and treatment

With timely and professional diagnosis, you won't have to wonder if astigmatism can be treated. After all, everyone knows that the problem is easier to prevent than to eliminate.

Diagnosis of the disease

If you suspect that your eye disease is astigmatism, and not simple fatigue, you should make an appointment with an ophthalmologist as soon as possible.

To make a diagnosis, the doctor will take an anamnesis, conduct a series of tests, and examine the fundus with the help of special devices. Also, the ophthalmologist will be able to determine the causes of the disease using biomicroscopy.

You will alternately close your right and left eyes with the apparatus. In this case, special cylindrical lenses will be placed in front of the free eye.

By changing the refractive power inside the lenses, the corrective effect you need is set.

In order to establish the degree of refraction, shadow tests are carried out. With them, the patient and the ophthalmologist are in a dark room. The doctor uses a mirror to see the shadow on the pupil. Analyzing the nature of the movement of the shadow, an experienced doctor will determine the type of refraction: myopic, hyperopic or emmetropic. With the help of a special ruler, consisting of a number of lenses (skiascopic ruler), the value of the refractive power is selected, at which the shadow completely disappears. This sets the degree of refraction.

Computerized keratometry is used to measure the degree of corneal deformation. This method helps to establish the most accurate curvature values.

Choosing the right treatment strategy is possible only with the help of complex diagnostics.

Often, with a lack of time to visit doctors, people prefer to diagnose this disease at home on their own. Special visual tests can help with this. However, whatever the result, you should not rely on it completely. Remember that only an ophthalmologist can diagnose astigmatism, and even more so, carry out competent treatment.

Treatment of the disease

And yet, astigmatism is treated or not? If you started treatment on time, then the answer is yes. There are 4 ways to correct vision with astigmatism.

1. Wearing cylindrical glasses.
2. Wearing hard or soft contact lenses.
3. laser correction.
4. Eye microsurgery.

Treatment methods for astigmatism may vary depending on the individual characteristics of the patient: age, the cause of the disease and its severity.

Correcting astigmatism with glasses and contact lenses

Eliminating astigmatism using glasses is the most common of all methods used. That is what is being used. Special glasses have cylindrical lenses. Depending on the type of disease, lenses can have a positive or negative value. This method can correct a violation of no more than 2 diopters. However, despite all the simplicity and economy, this method cannot be considered a full-fledged correction of eye disease - treatment can be complicated by a number of disadvantages. Peripheral vision in this case is limited, and the stereoscopic effect is impaired. Moreover, glasses do not give: astigmatism will continue to progress, and soon you will need more powerful glasses.

If wearing glasses is not your preferred option, you should learn how to correct astigmatism with lenses. If the degree of the disease is less than 1.5 diopters, the doctor may prescribe contact lenses. They have a much better effect on the optical system than glasses. Their advantage lies in the fact that the lens fits snugly to the cornea and creates a single system with the eye.

It is believed that hard contact lenses have a better effect on the quality of vision than soft ones. They hold their shape better and are able to partially correct deformed areas of the cornea due to the content of tear fluid in the space between the lens and the cornea. However, a large number of people have an intolerance to hard contact lenses. In such situations, soft toric lenses come to the rescue.

Toric lenses differ from ordinary spherical lenses in that they have a spherical shape. If a spherical lens refracts light equally over its entire surface, then a toric lens is able to correct the refraction of both meridians.

In order to correct the desired area of ​​the eye, the toric lens is installed in a strictly defined way. Its rotation can cause even more visual impairment.

Today there is a wide choice of toric lenses, however, they have one thing in common - high cost. In addition, astigmatism can be cured in this way for quite a long time, while it will not be possible to completely get rid of it. To forget about the problem forever, more serious methods should be used.

Correction of astigmatism with laser correction

How to treat astigmatism with laser correction? Today it is the most effective method of getting rid of the disease. The latest technologies are such that the laser machine is able to change the shape of the cornea. Its upper layer is lifted with a special tool, and the laser beam evaporates the deformed part of the cornea, making the shape as spherical as possible. As a result, refraction returns to normal, and astigmatism disappears. The impact of the laser on the eye takes no more than 40 seconds. Given the preparation time in just half an hour, you can get rid of the disease forever, and improvement occurs on the same day. At the same time, laser correction is the safest procedure: the effect of the laser is such that it is not able to penetrate into the deeper layers of the visual system, and drip anesthesia during the procedure will eliminate discomfort.

Despite all the advantages, this method has a number of contraindications:

• minor age;
• the period of pregnancy and breastfeeding;
• the presence of certain diseases of the eye, such as cataracts, glaucoma or progressive myopia;
• the presence of an allergic reaction;
• inflammatory diseases of the visual system;
• thinning of the cornea;
• the presence of diabetes;
• all autoimmune and immunodeficiency diseases;
• having only one eye.

Correction of astigmatism by surgical intervention

In the presence of any of these factors, it is recommended to resort to eye microsurgery. If the cause of the disease was the deformation of the cornea, then during the operation an artificial or donor graft is installed in its place. This vision-improving technique is called keratoplasty.

If the cause of astigmatism is a change in the shape of the lens, then during the operation it is removed, and an intraocular toric lens is installed in its place.

Only a professional ophthalmologist can select the appropriate treatment for each case. If you have been diagnosed with astigmatism, treatment should begin as soon as possible. Only in this case is it possible to avoid unpleasant consequences.

Prevention of astigmatism

If you do not want to wonder how to cure astigmatism when the disease is already progressing, you should pay more attention to the prevention of the disease. Timely prevention of astigmatism can help to avoid many vision problems in the future.

1. Pay close attention to lighting conditions. Do not strain your eyes if the lighting level in the room is below 60 watts. Reduce the use of fluorescent lamps whenever possible.
2. Eye exercises will help relieve muscle tension if you spend a lot of time at the computer or books.
3. Adjust the brightness of your monitor and computer screen so that you don't have to strain your eyes when working with them.
4. Walking in the fresh air and playing sports will help strengthen the immune system and eliminate some of the causes of the disease.
5. Balance the diet: it must contain all the necessary vitamins and minerals. Don't get carried away with diets.
6. Do not forget to visit an ophthalmologist from time to time: visual impairment can occur at any age. Timely detection of this disease can save you time and money for treatment.

If you have already begun to notice the first signs of astigmatism in yourself, prevention of the further development of the pathology will still not be superfluous.

The danger of this defect

If you're still putting off seeing a doctor, check out the dangers of astigmatism:

• constant tearing;
• premature appearance of wrinkles in the eye area due to frequent squinting;
• excessive irritability;
• children's performance decreases, psychological problems arise;
• severe visual impairment;
• strabismus;

If astigmatism affects both eyes, there is a risk of amblyopia - functional blindness, in which the images coming from the retinas of the eyes are very different, and the brain cannot put them into one picture. In this case, one eye goes blind, because the brain ceases to perceive a signal from it. The disease is reversible with proper treatment.

Remember that astigmatism in adults is more difficult and longer to treat than in childhood. Folk methods with astigmatism will not cope, but will only temporarily relieve some of the symptoms. Timely treatment will help restore visual functions and forget about the problem forever.