lecture four

Astigmatism
Gizachew T.
09/27/2020 1
 Outline
– Definition of astigmatism
– Classification of astigmatism
– Risk factors of astigmatism
– Common signs and symptoms and complications of
astigmatism
– Diagnosis of astigmatism
– Management of astigmatism
– summary

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Definition:
Astigmatism is an optical defect in which vision is
blurred due to the inability of the optics of the eye to
focus a point object into a sharp focused image/point
image on the retina.

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 Classification of astigmatism

Astigmatism can be classified based on

1. Axis of the principal meridians
2. Focus of the principal meridians
3. Anatomical position

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1. Based on axis of the principal meridians
A. Regular astigmatism – principal meridians are
perpendicular to each other.
I. With-the-rule astigmatism
-cyl x 180±20
II. Against-the-rule astigmatism
- cyl x 90±20
III. Oblique astigmatism
B. Irregular astigmatism – principal meridians are not
perpendicular/orthogonal to each other.

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 ASTIGMATISM

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 ASTIGMATISM
• In astigmatism there are two different power meridians
perpendicular to each other, which gives two different focal
lines that forms a circle of least confusion.
RETINA

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2. Based on focus of the principal meridians
Simple astigmatism
 Simple hyperopic astigmatism.
 Simple myopic astigmatism.
Compound astigmatism.
 Compound hyperopic astigmatism.
 Compound myopic astigmatism.
Mixed astigmatism.

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3. Anatomical position
– Corneal astigmatism - the cornea has an irregular
shape and responsible for the astigmatism
– Lenticular astigmatism - the lens has an irregular
shape responsible for astigmatism

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 “Astigmatism is not a disease
nor does it mean that you
have "bad eyes."
It simply means that you have
a variation or disturbance in
the shape of your cornea”

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Which structures are primarily responsible for
properly focusing light entering your eyes?
• Astigmatism occurs due to the irregular
shape of the cornea or the lens inside the
eye.
• In astigmatism, the front surface of the
cornea is curved more in one meridian than
the other.

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Corneal astigmatism
tendency to develop astigmatism is usually inherited.
– babies born prematurely
– babies with low bodyweight
– Surgery or eye injuries.
– Keratoconus
– deformation of the eyeball.
Lenticular astigmatism
– People with diabetes
– Having surgery

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 What are the symptoms of astigmatism?

– Blurred or distorted vision at all distances.

– Headaches
– Excessive squeezing
– squinting
– constantly closing of eyes.
– Eye strain.

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 Diagnosis of astigmatism

Astigmatism can be diagnosed using:

Vision testing charts
Keratometer (ophthalmometer)
Corneal topography
Autorefractor
Retinoscopy
Phoropter
Keratoscope (Placido's disk )

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 Management of astigmatism

Astigmatism may be corrected with;

– Spectacles(spherocyl or cylindrical lenses)
– Contact lenses(RGP)
– Refractive surgery
– Medication

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 SUMMARY
1. To correct the refractive error in WTR/ATR
astigmatism, in which axis a minus cylinder is
placed?
– In WTR adding a minus cylinder with axis
horizontal makes the vertical meridian
“flatter”and that makes both meridians equal
– In Against-the-rule astigmatism a minus cylinder
is added with the axis in vertical meridian.

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 Any Question???

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