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Astigmatism Severity Scale

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Medically Reviewed by Written by

Dr. Melody Huang, O.D. AnnaMarie Houlis

Evidence Based 6 sources cited

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E ects of Astigmatism on Visual Impairment

5 Types of Astigmatism

Astigmatism Severity Scale

What Level of Astigmatism Requires Glasses?

Can LASIK Fix Astigmatism?

Overview: What is Astigmatism?

Astigmatism refers to a common eye condition that causes your vision to
be blurry at all distances—both near and far—because the curvature of
your cornea (the clear front cover of your eye) or natural lens is irregularly
shaped. This refractive error occurs because your eye cannot focus light
properly, directly onto your retina, the light-sensitive surface that lines
the back of your eye.

If your cornea is shaped more like a football than a soccer ball, your eye
won’t be able to focus light rays at a single point. If the eye’s lens
curvature changes, this can worsen your astigmatism. This can happen in
adulthood and with naturally occurring cataracts.

There are three di erent types of refractive errors, including astigmatism:

Myopia (Nearsightedness) — This occurs when your eye focuses light in

front of the retina, so you have trouble seeing objects that are far away.
Hyperopia (Farsightedness) — This occurs when your eye focuses light
behind the retina, so you have trouble seeing objects that are nearby.
Astigmatism — This occurs when your eye focuses light at di erent
points both in front of and behind the retina, so you have trouble seeing
objects both far away and close up.
shaped. This refractive error occurs because your eye cannot focus light
properly, directly onto your retina, the light-sensitive surface that lines
the back of your eye.

If your cornea is shaped more like a football than a soccer ball, your eye
won’t be able to focus light rays at a single point. If the eye’s lens
curvature changes, this can worsen your astigmatism. This can happen in
adulthood and with naturally occurring cataracts.

There are three di erent types of refractive errors, including astigmatism:

Myopia (Nearsightedness) — This occurs when your eye focuses light in

front of the retina, so you have trouble seeing objects that are far away.
Hyperopia (Farsightedness) — This occurs when your eye focuses light
behind the retina, so you have trouble seeing objects that are nearby.
Astigmatism — This occurs when your eye focuses light at di erent
points both in front of and behind the retina, so you have trouble seeing
objects both far away and close up.
 You can inherit corneal errors like astigmatism through your genetics or
develop it after an eye injury, eye surgery, or eye disease like keratoconus,
which causes your cornea to form into a conical shape. Keratoconus is an
eye disease that causes irregular and often high amounts of
astigmatism.

E ects of Astigmatism on Visual Impairment

Whether you’re born with it or it develops later in life, the symptoms of
astigmatism generally include the following:

Blurry vision
Trouble seeing objects both close up and far away
Fluctuating vision
Eye strain
Squinting
Headaches
Di culty seeing at night
Seeing glare and halos at night
Seeing shadowy images

If you only have a mild case of astigmatism, you may not notice any of
the above symptoms or require correction. However, if you do need
treatment, options are available, including corrective eyeglasses, contact
lenses, and refractive surgery.
 You can inherit corneal errors like astigmatism through your genetics or
develop it after an eye injury, eye surgery, or eye disease like keratoconus,
which causes your cornea to form into a conical shape. Keratoconus is an
eye disease that causes irregular and often high amounts of
astigmatism.

E ects of Astigmatism on Visual Impairment

Whether you’re born with it or it develops later in life, the symptoms of
astigmatism generally include the following:

Blurry vision
Trouble seeing objects both close up and far away
Fluctuating vision
Eye strain
Squinting
Headaches
Di culty seeing at night
Seeing glare and halos at night
Seeing shadowy images

If you only have a mild case of astigmatism, you may not notice any of
the above symptoms or require correction. However, if you do need
treatment, options are available, including corrective eyeglasses, contact
lenses, and refractive surgery.
 You can inherit corneal errors like astigmatism through your genetics or
develop it after an eye injury, eye surgery, or eye disease like keratoconus,
which causes your cornea to form into a conical shape. Keratoconus is an
eye disease that causes irregular and often high amounts of
astigmatism.

E ects of Astigmatism on Visual Impairment

Whether you’re born with it or it develops later in life, the symptoms of
astigmatism generally include the following:

Blurry vision
Trouble seeing objects both close up and far away
Fluctuating vision
Eye strain
Squinting
Headaches
Di culty seeing at night
Seeing glare and halos at night
Seeing shadowy images

If you only have a mild case of astigmatism, you may not notice any of
the above symptoms or require correction. However, if you do need
treatment, options are available, including corrective eyeglasses, contact
lenses, and refractive surgery.
If you leave it alone, astigmatism can get better or worse over time. If you
have vision problems, you should see your eye doctor to take an eye
exam and discuss your options to help you achieve clear vision.

SUMMARY

Astigmatism is an eye condition caused by an irregularly-shaped

cornea. People with astigmatism have blurry vision from both
near and far distances. Mild forms of astigmatism usually do not
require correction. For those with severe astigmatism, contact
lenses, eyeglasses, or surgery may be needed.

5 Types of Astigmatism
Astigmatism can be broken down into ve categories. Here’s what you
should know about each of them:

1. Simple Myopic Astigmatism

Simple myopic astigmatism refers to when the light hits two focal points:
one before the eye’s retina and one on the eye’s retina.

2. Simple Hyperopic Astigmatism

Simple hyperopic astigmatism happens when light comes to two focal

points: one directly on the eye’s retina and one behind the eye’s retina.
3. Compound Myopic Astigmatism

Compound myopic astigmatism happens when the light hits two focal
points at two di erent locations in front of the eye’s retina.

4. Compound Hyperopic Astigmatism

Compound hyperopic astigmatism refers to when the light comes to two

di erent virtual locations behind the eye’s retina.

5. Mixed Astigmatism

Mixed astigmatism happens when rays of light hit two focal points: one
before the eye’s retina and one behind the eye’s retina.

Astigmatism Severity Scale

Not all astigmatism is the same. Astigmatism can vary in severity. The
degree of astigmatism is measured in diopters. For context, a perfect eye
that has no astigmatism has 0 diopters, but some people have between
0.5 and 0.75 diopters of astigmatism. People who have about 1.5 or more
diopters of astigmatism usually opt to have corrective treatment such as
glasses, contacts, or eye surgery.
There are three numbers on any glasses or contact prescription, and the
last two refer to astigmatism. Spherical indicates whether you are
nearsighted (a minus sign) or farsighted (a plus sign). Cylinder measures
the severity of astigmatism. Axis measures where astigmatism is located
in degrees from 0 to 180.

Mild Astigmatism: < 1.00 diopter

Nearly 33 percent of Americans have astigmatism to some degree. Mild

astigmatism is considered normal. Most people have it and do not need
corrective lenses or surgery to see clearly. You may not even notice any
symptoms with a mild case of astigmatism.

Moderate Astigmatism: 1.00 to 2.00 diopter

Moderate astigmatism is a little more serious and generally requires

corrective lenses or laser surgery in order for you to see clearly. While you
may be able to get by without wearing glasses or contacts, chances are
that you will notice the symptoms of moderate astigmatism and glasses
and contacts can certainly help.

Severe Astigmatism: 2.00 to 3.00 diopter

Severe astigmatism can cause serious symptoms that a ect your day-to-
day functioning. Blurred vision from severe astigmatism can give you
headaches that can take a toll on your health.

Extreme Astigmatism: > 3.00 diopter

Extreme astigmatism will require treatment so that you can see objects
both near and far with ease. If you do not treat extreme astigmatism, you
will not be able to see clearly at all.

SUMMARY

There are ve types of astigmatism: simple myopic, simple

hyperopic, compound myopic, compound hyperopic, and mixed.
They are categorized into di erent levels of severity: mild,
moderate, severe, and extreme.

What Level of Astigmatism Requires Glasses?

Because most people have mild astigmatism, wearing glasses or other
astigmatism treatment is not typically necessary unless you have
moderate astigmatism or worse.

Again, it’s important to schedule regular checkups with an optometrist

because astigmatism can change over time. If you wear glasses, you need
to be sure that your prescription stays correct. And, if you don’t wear
glasses because you don’t need them now, it’s still important to pay
attention to your eye health in case you develop worse astigmatism later
on.

Can LASIK Fix Astigmatism?

Yes, LASIK (laser in situ keratomileusis) and PRK (photorefractive
keratectomy) can x astigmatism. LASIK removes the tissue from the
inner layer of the cornea with an excimer laser, and PRK removes it from
the super cial and inner layers of the cornea. Both types of laser surgery
permanently x the shape of your cornea so you do not need to wear
eyewear for clear vision.

In LASIK surgery, the LASIK surgeon will use a mechanical microkeratome

(a blade) or a femtosecond laser to cut a ap in your cornea. They’ll leave
a hinge at one end of the ap and fold it back to reveal the stroma (the
middle section of the cornea). They’ll then use pulses from a computer-
controlled laser to vaporize a portion of the stroma and replace the
corneal ap.

While this may sound painful, the LASIK procedure only takes about 10
minutes per eye — and the laser itself only takes about 20 to 50 seconds
to correct your vision, depending on how much correction you need.

It’s important to note that, while LASIK will x your astigmatism, other
refractive errors and vision changes can also develop over time. Because
your eyes change over the course of your lifetime, you may experience
new refractive errors after LASIK surgery. This is not a result of regression
following the surgery. LASIK only treats existing conditions.
 SUMMARY

While mild cases of astigmatism do not require correction,

moderate to severe ones can bene t from prescription glasses,
LASIK, or PRK.

Related Pages:

Best Contacts for Astigmatis m

 Astigmatism Glasse s

LASIK for Astigmatis m

Astigmatism Test s

Astigmatism: Causes & Treatmen t

Hom e » Eye Car e » Astigmatism Severity Scale

Author: AnnaMarie Houlis | UPDATED July 28, 2021

Medical reviewer: Dr. Melody Huang, O.D.

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