Can Astigmatism Get Worse? Progression with Age Explained

Can Astigmatism Get Worse Over Time?

Astigmatism is a common vision condition caused by an irregular curvature of the cornea or lens in the eye. This results in blurred or distorted vision at any distance. Many people are born with astigmatism, while it can also develop later in life. This leads to the question - does astigmatism tend to get worse with age? Or does it remain stable throughout life once it develops?

Understanding Astigmatism

With normal vision, light enters the eye and focuses directly on the retina, allowing for clear vision. With astigmatism, the irregular shape of the cornea or lens prevents light from focusing properly. This leads to blurred vision at all distances and difficulty seeing fine details.

Astigmatism occurs when the cornea has an oval rather than round shape. This causes light to focus at more than one spot on the retina rather than one clear focal point. Genetics play a major role in developing astigmatism, which is present from birth in many cases. It can also develop later due to injury, infection, or surgery that alters the cornea's shape.

Measuring the Severity of Astigmatism

The severity of astigmatism depends on how much the cornea deviates from a round shape. Ophthalmologists measure this using units called diopters. The higher the diopter measurement, the more irregular the cornea's curvature.

Mild astigmatism usually ranges from 0.50 to 1.00 diopters. Moderate astigmatism measures between 1.00 to 3.00 diopters. Severe astigmatism is over 3.00 diopters.

Does Astigmatism Typically Get Worse With Age?

In most cases, the degree of astigmatism present at birth or early childhood remains stable throughout life. It does not normally worsen significantly with age alone. However, there are a few factors that can cause astigmatism to progress later in life:

Development of cataracts
Injury, infection, or surgery affecting the cornea
Increase in eye pressure (glaucoma)

Barring these influences, astigmatism resulting from the shape of the cornea tends to remain consistent over time. But many people do find their vision worsens with age due to other age-related eye diseases.

Role of Cataracts in Worsening Astigmatism

One of the most common reasons astigmatism increases with age is the formation of cataracts. A cataract is a clouding of the lens inside the eye that develops slowly over time. Cataracts often lead to increasing astigmatism as they progress.

As the lens grows cloudy, it can also become more irregular in shape. This contributes to greater distortion in how light enters the eye, compounding astigmatism issues.

In one study published in the Journal of Cataract & Refractive Surgery, nearly 60% of people with cataracts were found to have more than 1 diopter of astigmatism. Treating the cataracts with surgery typically helps reduce astigmatism severity.

Corneal Changes That Worsen Astigmatism

The cornea can also change shape with age, leading to increased astigmatism. With normal aging, the cornea may gradually thin and weaken. This can make it more susceptible to irregular shaping from relatively minor bumps or irritation.

Issues like chronic dry eye and recurrent eye infections become more common with older age. The inflammation and rubbing of the eyes associated with these conditions can deform the shape of the cornea over time. Using certain medications long-term like steroids can also thin the cornea.

In some cases, the cornea develops swelling and scarring from injuries, ulcers, or surgeries. All of these factors can contribute to worsening irregularity in the cornea's curvature.

When Does Astigmatism Usually Start and Worsen?

Here is an overview of when astigmatism typically first develops and progresses:

Congenital astigmatism - Present from birth and usually remains stable
Childhood astigmatism - Occurs from age 3 to around 8 years old, usually does not worsen significantly
Later onset astigmatism
- From injury or infection - Can happen at any age
- From cataracts - Most common after age 50
- From refractive surgery - Shortly after procedures like LASIK

Astigmatism arising from corneal shape is often detected in early childhood. Vision screenings around ages 4 to 6 can catch astigmatism that was present from birth but not noticed by parents early on.

Astigmatism that develops later in life is most commonly related to cataract development, corneal changes from dry eye or inflammation, or refractive surgery complications. Regular eye exams can help detect increasing astigmatism before vision worsens substantially.

Role of Refractive Surgery

Refractive eye surgeries like LASIK and PRK are aimed at reducing dependence on glasses or contacts. But in some cases these procedures can actually increase astigmatism:

Irregular healing of the cornea
Scarring
Over or undercorrection

Higher degrees of astigmatism before surgery lead to greater likelihood of surgical complications. Additional correctional procedures may be needed if surgically-induced astigmatism becomes bothersome.

Options for Managing Worsening Astigmatism

If your astigmatism does increase to the point of affecting vision, there are effective management options. Which approach is best depends on the cause and severity of your astigmatism.

Updated Eyeglass or Contact Prescription

Often the simplest solution is to get an updated prescription with greater astigmatism correction. If your degree of astigmatism increases by at least .50 diopters, new glasses or contacts can bring your vision back into focus.

Be sure to get your eyes examined annually or biannually. This allows early detection of any changes in your astigmatism so your prescription can be adjusted in a timely manner.

Toric Contact Lenses

Toric contact lenses are designed specifically to correct astigmatism. They have a weighted, asymmetric shape that counters the irregular curvature of the astigmatic eye.

If your astigmatism worsens to the point that regular soft contacts no longer provide clear vision, talk to your eye doctor about switching to toric lenses.

Cataract Surgery

When worsening astigmatism results from cataract development, cataract surgery can help. Along with removing the clouded natural lens, cataract surgery allows for insertion of a clear artificial lens.

The surgeon can select an intraocular lens with properties to counter astigmatism. Following cataract surgery, patients often find their vision significantly improved, including reduction in astigmatism.

Corneal Surgery

For more severe astigmatism not fixable with corrective lenses, corneal surgery may be an option. Types of astigmatism-reduction surgery include:

LASIK - Reshapes cornea with laser
PRK - Removes thin layer from cornea surface
Corneal implants - Alters curvature with rings or segments

These surgeries come with risks like infection, scarring, and vision loss. Success rates are lower with high degrees of astigmatism. Thoroughly discuss benefits and risks with your ophthalmologist.

Lifestyle Changes to Slow Astigmatism Progression

While you can't change innate cornea shape, healthy lifestyle habits can help slow development of age-related causes of worsening astigmatism like cataracts and dry eye. Steps to take include:

Quit smoking - Smoking increases risk of cataracts.
Get regular eye exams - For early detection of issues.
Wear sunglasses - To protect eyes from UV damage.
Use lubricating eye drops - To combat chronic dry eye.
Maintain normal eye pressure - Reduce risk of glaucoma-related changes.
Eat eye-healthy foods - Like leafy greens and omega-3s.

While astigmatism often remains stable over time, certain age-related eye diseases can cause it to worsen. Getting regular eye care helps detect changes early so vision can be corrected before it impacts your daily life.

Understanding Your Child's Astigmatism Diagnosis

Astigmatism is quite common in children, with an estimated 15-20% born with some degree of it. As a parent, finding out your child has astigmatism often raises concerns. Will it get worse? How will it impact their vision and learning? Here is an overview of what to expect with childhood astigmatism:

Causes of Astigmatism in Children

Most astigmatism in children is congenital, meaning present from birth. It results from an irregular shape of the cornea that disrupts how light focuses in the eye. Genetics play a major role, so astigmatism often runs in families.

Other causes include:

Complications during birth resulting in corneal irregularities
Injuries, infections, or surgeries affecting the cornea

Astigmatism may also develop later, most commonly from a condition called keratoconus that progressively thins the cornea.

Signs of Astigmatism in Children

Unlike adults, children don't always realize their vision is blurry. Signs of astigmatism in a child can include:

Squinting or rubbing eyes
Sitting very close to the TV
Trouble seeing classroom board
Headaches or eye strain after reading
Holding books very close
Poorer than expected school performance

Eye exams around ages 4-6 help detect astigmatism early so vision correction can be started before schoolwork is impacted.

Will Your Child's Astigmatism Get Worse?

If present from birth, the degree of astigmatism tends to remain stable through childhood rather than worsening. But some children do experience progressive astigmatism, so regular eye exams are key.

Astigmatism usually follows one of these courses:

Congenital - Remains consistent, doesn't worsen significantly
Progressive - Slowly worsens over time
Irregular - Unpredictable pattern of worsening

Eyecare professionals can monitor astigmatism changes annually and update prescriptions as needed. Early treatment helps prevent vision problems from impacting learning and development.

Treatment for Children's Astigmatism

The main treatments for astigmatism in children are:

Eyeglasses - With toric lenses to correct astigmatism
Contact lenses - Rigid gas permeable lenses often most effective
Surgery - Rarely done, usually LASIK or PRK for severe cases

Eyeglasses or contacts allow clear, focused vision for school, sports, and play. Make sure your child wears them as prescribed for best results.

Astigmatism often remains stable through childhood. With regular eye care and vision correction as needed, it should not pose any long-term threat to your child's eyesight or learning abilities.

The Impact of Astigmatism on Eyesight at Any Age

Astigmatism typically causes blurry, distorted vision at all distances. Images often appear stretched out. The effects of astigmatism can include:

Difficulty seeing details
Squinting, eye strain, headaches
Trouble reading small print
Halos or starbursts around lights
Fatigue or eye discomfort from overworking eye muscles
Poor night vision, light sensitivity

Without correction, chronic blurry vision from astigmatism can lead to amblyopia (lazy eye) in children. Ongoing eye strain can reduce focusing ability.

Impact of Uncorrected Astigmatism in Children

Astigmatism can significantly affect school performance if left uncorrected. Children may have trouble seeing the board, reading books, and doing close-up work like writing. This can lead to:

Falling behind in class
Avoiding reading and other near tasks
Behavior issues from eye discomfort
Misdiagnosis of learning disorders

Catching and correcting astigmatism early prevents it from interfering with learning and development.

Effects of Astigmatism in Adults

For adults, uncorrected astigmatism can make daily activities more challenging. Potential effects include:

Difficulty reading small text
Trouble working on a computer
Avoiding night driving
Problems following conversations
Headaches and watery eyes from eye strain

Many adults don't realize their vision is impaired by astigmatism, assuming blurry vision is just part of aging. But correcting astigmatism can bring significant quality of life improvements.

Final Thoughts

In most cases, the degree of astigmatism present from birth or early childhood remains stable throughout life. It typically does not worsen significantly on its own with age.

However, developing cataracts, corneal changes from dry eyes or surgery, and glaucoma can sometimes exacerbate astigmatism. Getting regular eye exams allows early detection of any changes in your prescription needs.

Options like new eyeglasses, toric contacts, cataract surgery, and corneal procedures can help correct increased astigmatism. While you can't prevent innate astigmatism, healthy lifestyle habits help maintain eye health as you age.

Astigmatism often has a genetic component, so it is quite common in children. But with early treatment, most children with astigmatism can see clearly and perform well in school.

Blurry or distorted vision from astigmatism can disrupt normal functioning. But the right eyecare and correction measures let people of any age enjoy clear sight and everyday activities.

FAQs

Does astigmatism get worse as you age?

In most cases, the degree of astigmatism you are born with remains stable over time and does not get worse with age alone. However, developing age-related eye diseases like cataracts can exacerbate astigmatism in older adults.

What causes astigmatism to worsen over time?

Common causes of worsening astigmatism include cataracts forming, corneal changes from dry eye or surgery, injuries affecting the shape of the cornea, and increased eye pressure from glaucoma.

At what ages does astigmatism progress?

Congenital astigmatism usually remains consistent from childhood onward. Astigmatism typically worsens later in life, most commonly after age 50 due to factors like cataracts. Refractive surgery can also induce astigmatism at any age.

How is worsening astigmatism treated?

Increasing astigmatism is treated with an updated prescription for glasses or contacts, toric contact lenses, cataract surgery, or corneal procedures like LASIK. The best approach depends on the cause and severity.

Can lifestyle changes prevent astigmatism from getting worse?

You can't prevent innate astigmatism, but healthy habits like not smoking, wearing sunglasses, treating dry eye, and controlling eye pressure may help slow age-related changes that exacerbate astigmatism.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.