Can Laser Eye Surgery Fix Astigmatism?

20 December 2023

By Author: Amir Hamid

Laser eye surgery is a highly safe and effective solution for those grappling with astigmatism.

Astigmatism, a common refractive error caused by an irregular shape of the cornea or lens, can result in blurred or distorted vision. However, the advent of laser eye surgery for astigmatism has revolutionised the field by providing a precise and effective method to reshape the cornea and address this common visual impairment.

At Optegra, we are a group of dedicated eye hospitals located nationwide. We perform tens of thousands of vision correction procedures each year. If you’re considering laser eye surgery, we’re here to answer any questions you may have.


What Causes Astigmatism?

Astigmatism is a common refractive error that occurs when the cornea or lens of the eye has an irregular shape, leading to blurred or distorted vision. The cornea and lens are responsible for focusing light onto the retina at the back of the eye. In the normal eye, these structures have a round or spherical shape, like a basketball.

Astigmatism occurs when the cornea or lens has a more oval or football-like shape, with different curvatures in different meridians. This irregular shape causes light to focus unevenly on the retina, leading to distorted or blurred vision. The specific causes of astigmatism can include:

Genetics: Astigmatism often has a genetic component, meaning it can run in families. If your parents or siblings have astigmatism, you may be more likely to develop it as well.

Eye injury: Trauma to the eye can alter the shape of the cornea and contribute to astigmatism.

Keratoconus: This is a condition where the cornea progressively thins and bulges outward, leading to astigmatism. While keratoconus itself may not be directly inherited, a genetic predisposition may be a factor.

Excessive eye rubbing: Constant rubbing of the eyes may affect the shape of the cornea and contribute to astigmatism.

Certain diseases: Some diseases, such as keratoglobus, pellucid marginal degeneration, and certain types of corneal degeneration, can cause astigmatism.

Astigmatism can vary in severity, and it often coexists with other refractive errors such as nearsightedness (myopia) or farsightedness (hyperopia). Eyeglasses or contact lenses are commonly prescribed to correct the vision problems associated with astigmatism by compensating for the irregular shape of the cornea or lens. For those who would like clear eyesight without the use of glasses or contact lenses, laser eye surgery is an ideal solution.


How To Know If You Have An Astigmatism

Almost 50% of the UK population has astigmatic vision. Individuals with astigmatism may experience a range of symptoms related to distorted or blurred vision. Common symptoms of astigmatism include:

Blurred Vision: Objects at any distance may appear blurry or distorted.

Eyestrain: Prolonged focusing on tasks, especially those that require clear vision, may lead to eyestrain.

Headaches: Persistent headaches, particularly after activities that require visual concentration, can be a symptom of astigmatism.

Distorted or Wavy Vision: Straight lines or edges may appear slanted; you may confuse the number eight with six, for example.

Difficulty Seeing at Night: Astigmatism can contribute to difficulty seeing clearly in low-light conditions.

It’s important to note that these symptoms can vary in severity, and individuals may not necessarily experience all of them. If you suspect you have astigmatism or are experiencing any of these symptoms, it’s advisable to schedule an eye examination with an optometrist or ophthalmologist for a comprehensive eye assessment.

Headaches can be a sign of astigmatism
Man holding his head with a headache

Can Laser Eye Surgery Fix an Astigmatism?

Laser eye surgery, such as LASIK or LASEK, is a viable and effective option for correcting astigmatism. These procedures use a laser to reshape the cornea, correcting its irregular curvature and improving the focus of light on the retina. Here’s why laser eye surgery is worth considering for patients with astigmatism:

High Success Rates: Laser eye surgery has demonstrated high success rates in correcting astigmatism. Many individuals experience significant improvements in visual acuity and a reduction or elimination of dependence on glasses or contact lenses.

Precision and Customisation: Laser eye surgery is highly precise and can be customised to address the specific characteristics of an individual’s astigmatism. The surgeon can tailor the procedure to the patient’s unique corneal shape and vision needs.

Quick Recovery: Many patients experience a relatively quick recovery after laser eye surgery. While individual recovery times can vary, some people notice improved vision within a day or two, with full stabilisation occurring over a few weeks.

Reduced Dependence on Corrective Lenses: One of the primary benefits for many patients is the potential to reduce or eliminate the need for glasses or contact lenses after laser eye surgery. This can enhance lifestyle convenience and freedom.

Long-Term Results: Laser eye surgery typically provides long-term results for astigmatism correction. The reshaped cornea tends to maintain its improved curvature, offering sustained visual benefits.

It’s important to note that the suitability of laser eye surgery depends on various factors, including the severity of astigmatism, overall eye health, and individual preferences. Not everyone with astigmatism may be a suitable candidate for these procedures, and a thorough pre-operative evaluation by an eye care professional is crucial.


How Does Laser Eye Surgery Correct Astigmatism?

Laser eye surgery, specifically LASIK, LASEK, and SMILE, corrects astigmatism by reshaping the cornea, the transparent front part of the eye. The cornea plays a crucial role in focusing light onto the retina, and when it has an irregular shape, as is the case with astigmatism, vision can be blurred or distorted. Here’s how laser eye surgery works to correct astigmatism:

Pre-operative Evaluation: Before the surgery, a comprehensive eye examination is conducted to assess the specific characteristics of the astigmatism, including its degree and axis. This evaluation helps determine the parameters for the laser treatment.

Corneal Reshaping: During LASIK and SMILE (the most popular forms of laser eye surgery), a femtosecond laser is used to create a thin flap on the cornea. An excimer laser is then used to precisely remove microscopic amounts of corneal tissue. The laser ablation is tailored to correct the irregularities in the cornea’s shape, thereby improving its ability to focus light accurately.

Customisation: Advanced wavefront technology is employed to create a detailed map of the patient’s cornea. This map guides the laser in customising the treatment to the unique characteristics of the individual’s astigmatism, addressing not only the degree of astigmatism but also other refractive errors.

Corneal Healing: Following the laser treatment, the corneal flap is repositioned in LASIK. The cornea gradually heals, and the reshaped surface allows light to focus properly on the retina, improving vision.

Post-operative Care: Patients are provided with post-operative care instructions, including the use of prescribed medications and follow-up appointments to monitor healing and ensure optimal visual outcomes.

LASIK, LASEK and SMILE  are considered safe and have been performed successfully on millions of individuals worldwide. Complications are rare, and advancements in technology and surgical techniques have further enhanced safety and precision.


Does An Astigmatism Come Back After Laser Eye Surgery?

In general, the reshaping of the cornea through laser eye surgery is a permanent change, and astigmatism does not “come back” in the same way it might if you were not treated. The goal of the surgery is to address the irregularities in the cornea that cause astigmatism and provide a long-term correction.

However, it’s important to note that while the surgical correction is permanent, other factors could influence visual changes over time. These factors may include:

Ageing: The eyes can undergo natural changes with age, and these changes may affect vision. It’s possible that individuals who undergo laser eye surgery may experience age-related changes that can impact vision, but these changes are not a recurrence of astigmatism.

Other Eye Conditions: The development of other eye conditions or diseases not related to astigmatism, such as cataracts or glaucoma, could affect vision over time.

Changes in Refraction: Refractive errors, including astigmatism, can be influenced by changes in the eye’s refractive components. While the corneal reshaping is permanent, changes to the eye over time may cause a residual prescription to occur; this is usually small and usually does not require treatment.

Corneal Healing: In the early stages of recovery after surgery, changes in corneal healing may affect vision. However, these are typically temporary and are part of the normal healing process.

It’s important for individuals who have undergone laser eye surgery to attend regular follow-up appointments with their eye care professional to monitor their eye health and address any changes in vision.

Additionally, while laser eye surgery can significantly reduce or eliminate the need for glasses or contact lenses, some individuals may still experience minor residual refractive errors. Enhancements or adjustments may be possible in such cases.

Laser eye surgery can correct astigmatism
Laser eye surgery microscope

What Are The Pros And Cons Of Having Laser Eye Surgery To Fix Astigmatism?

The potential pros of laser eye surgery far outweigh any potential negatives. These include:

Improved Vision: Laser eye surgery can significantly improve or even eliminate astigmatism, providing clearer and sharper vision without the need for glasses or contact lenses.

Quick Recovery: Many patients experience a relatively quick recovery, with improved vision noticed within a day or two after surgery.

Customisation: Laser eye surgery is highly customisable, with advanced technology allowing for precise and tailored treatments based on the individual’s unique corneal characteristics.

Long-Term Results: The reshaping of the cornea is typically permanent, offering long-term results in astigmatism correction.

Convenience: Reduced dependence on glasses or contact lenses can enhance lifestyle convenience and activities, especially for those with active lifestyles.

High Success Rates: Laser eye surgery, when performed on suitable candidates, has high success rates and patient satisfaction.

Potential patients may want to consider the following before deciding if surgery is for them:

Potential Risks: While complications are rare, there are potential risks and side effects associated with laser eye surgery, such as dry eyes, glare, halos, and infection. In case this happens, a quality laser eye surgery provider like Optegra will be able to apply adjustments to correct any side effects.

Not Suitable for Everyone: Not everyone is a suitable candidate for laser eye surgery. Factors such as age, overall eye health, and certain medical conditions may limit eligibility. Book a free consultation with us to see if you are eligible.

Cost: Laser eye surgery can be relatively expensive and not covered by insurance, making it a financial consideration for some individuals. On the flip side, over the course of several years, laser eye surgery may be more economically appealing than constantly having to replace contacts and glasses.

Temporary Discomfort: laser eye surgery is painless. However, some patients may experience mild temporary discomfort, dryness or itching, or sensitivity to light during the initial healing period. At Optegra, we have a comprehensive aftercare program included with every surgery option to ensure your recovery from laser eye surgery is as convenient and quick as possible.


Can Astigmatism Get Worse After LASIK?

Typically, stigmatism will not get worse after LASIK; however, age-related changes over time can impact overall vision.


The Cost of Laser Eye Surgery to Fix An Astigmatism

The cost of laser eye surgery will depend on the type of procedure the patient opts for. At Optegra, we offer LASIK, LASEK, and SMILE. Patients may opt for one of our 0% finance options too.

To see how much you’ll pay per month for your preferred laser eye surgery option, check our costs page.


What Next? Contact us to discuss your laser eye surgery requirements

Set up your free virtual consultation with one of our experts, and we can guide you further. The consultation can be set-up at a time convenient to you from the comfort of your own home. We also offer Saturday appointments.

Amir Hamid Headshot

By Author: Amir Hamid

Mr. Amir Hamid is a Clinical Lead for Vision Correction and an expert refractive surgeon, based in London.

Medically Reviewed Date: 20th December 2023


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