Astigmatism

How astigmatism can affect your vision and what to do about it.

What is astigmatism?

Astigmatism is common in Australia and happens when your eye isn’t perfectly round. This can cause blurry or distorted vision. You might have it from birth or notice it later in life. It can show up on its own or with other vision problems like short‑sightedness or long‑sightedness.

Astigmatism means your eye has more of a rugby ball shape than a football. That shape affects how light hits the retina and can make things look blurry. Your optometrist (sometimes still called an optician) can spot astigmatism during a standard eye test.

Understanding astigmatism

To understand astigmatism, see how your eye is shaped and how it focuses light.

  1. 1 of 3

    Cornea

    Astigmatism usually starts in the cornea. If it’s not evenly curved, light bends in the wrong direction and things may look out of focus or skewed.

  2. 2 of 3

    Lens

    Located behind the iris, the lens can also cause astigmatism if it’s misshapen. That’s what we call lenticular astigmatism.

  3. 3 of 3

    Retina

    At the back of your eye is the retina. It’s where light should land, but with astigmatism, the light spreads out, making things appear blurry.

How does astigmatism change how you see?

Astigmatism can make your vision blurry, particularly at the sides. Things might look stretched, distorted or wobbly, a bit like a mirror at a carnival.

You might notice halos around lights when driving at night. Small text can be harder to read, and shifting your focus may feel strange. If both eyes are affected, it might throw off your depth perception. Eye strain or a feeling of imbalance can be common, too.

What signs and symptoms come with astigmatism?

Wondering if you have astigmatism? Look out for these signs:

  1. Blurry or distorted vision

  2. Difficulty reading or focusing on screens

  3. Light scatter or glare at night

  4. Eye strain or headaches after reading or driving

  5. Reading small text or using screens is causing discomfort and eyestrain

If something does not feel right, book a comprehensive eye test with your local Optometrist.

Book an eye test

Are there different kinds of astigmatism?

There are various types of astigmatism, based on which part of the eye it affects:

Corneal astigmatism

This is when the front surface of the eye (the cornea) isn’t perfectly round. It’s more like a rugby ball, bending light unevenly and causing blurred or distorted vision. 

Lenticular astigmatism

This kind of astigmatism is caused by the lens inside the eye being slightly irregular or tilted. It stops light from focusing properly, which can lead to vision that’s blurry or distorted, particularly at certain distances. 

Myopic astigmatism

This occurs when one or both principal meridians of the eye are myopic. If both meridians of the eye are short‑sighted, but by different amounts, it’s called compound myopic astigmatism. If only one is, it’s simple myopic astigmatism. 

Hyperopic astigmatism

Similar to myopic astigmatism. Light focuses behind the retina. If both meridians of the eye are long‑sighted, but not equally, it’s called compound hyperopic. If only one is hyperopic, it’s simple hyperopic astigmatism.

Mixed astigmatism

Mixed astigmatism means the principal meridian is short‑sighted, and the other is long‑sighted. So vision can be blurred, no matter how close or far things are. 

What leads to astigmatism?

Most people with astigmatism are born with it. It often runs in families and happens when the front of the eye (the cornea), or sometimes the lens inside, has a curve that’s steeper in one direction. That slight difference can affect how clearly you see.

It’s more common in premature babies or those with a lower birth weight. And while many kids grow out of it as their eyes develop, some don’t.

Astigmatism can also show up later in life, either naturally or due to changes in your eyes.

Other causes of astigmatism

Age‑related changes

As you get older, your eyes change shape, which can cause or worsen astigmatism. It often appears alongside other issues like short or long‑sightedness.

Keratoconus

This is a rare eye disease that causes your cornea to thin and bulge outward. It often leads to more severe astigmatism.

Eye surgery

Damage to the eye, like a knock or scratch, can leave a scar that changes its shape, affecting how it focuses.

Eye injury

Damage to the eye, like a knock or scratch, can leave a scar that changes its shape, inducing astigmatism.

Infections and scarring

If you’ve had a bad eye infection or a corneal ulcer, it can leave scarring on the cornea, which might cause astigmatism.

Contact lenses

Wearing hard contact lenses for too long, or ones that don’t fit well, can change the shape of your eye temporarily. That usually sorts itself out once the lenses are adjusted, swapped or discontinued. 

What’s the link between dilated pupils and astigmatism?

When your pupils are more dilated, like in low light or at night, you might notice your vision gets blurrier. A dilated pupil allows more peripheral light to enter the eye. This increase in light entering the eye exacerbates the refractive error that leads to astigmatism.

This can make vision seem blurrier at night or when light levels shift. Toric Contact lenses for astigmatism can help you see more clearly, whatever the conditions.

View contact lenses for astigmatism


What the eye care experts say about astigmatism

Our expert optometrists see people with astigmatism every day. Here, one of our optometrists talks about what to look out for, what to expect during an eye test, and how they help people see clearly again often with just a small change in prescription.

Who tends to get astigmatism?

Anyone can get astigmatism, but you might be more likely if:

It can also develop slowly over time. If your vision’s changed, book an eye test.

How we test for astigmatism at your eye appointment

When you book an eye test, your optometrist will ask a few questions about your vision and go over your earlier test results.

One of those early checks is an autorefractor test. This scans how your eyes bend light. It’s helpful in spotting astigmatism, especially if your eye bends light unevenly.

An optometrist examines an older male patient’s eyes using a slit lamp in a clinical setting.

We may also use a handheld tool called a retinoscope. It shines a light into your eye, and by watching how it reflects, your optometrist can spot any signs of astigmatism and work out the level. 

Then there’s the Jackson cross cylinder test, a key step. You’ll be asked to choose between two lenses; neither will look perfect, but one will feel just a bit better. This helps us fine‑tune your prescription for sharp, comfortable vision. 

Treatment options for astigmatism

An optometrist will help work out what’s right for your vision and lifestyle.

  • Stylish glasses

    Glasses

    Glasses are an easy and effective fix. The lenses are specially shaped to guide light correctly into your eyes so you can see clearly.

    Explore glasses
  • Woman holding contact lenses

    Contact lenses

    Toric lenses are designed for eyes with astigmatism. They sit comfortably on your eye and help focus light properly, so your vision is sharper and more stable.

    Explore contact lenses
  • Eye tests

    A simple eye test can show if you’ve got astigmatism and help work out the right lenses for your vision.

    Book an eye test
  • Woman smiling

    Laser eye surgery

    Laser eye surgery can be a long‑term solution for astigmatism. It’s something many Australians consider.

    Find out more

Is there any way to prevent astigmatism?

You can’t prevent astigmatism; most people are born with it and can be further influenced by developmental and environmental factors. But regular eye tests are the best way to keep your vision healthy and up to date. 

Changes can be slow, so having your eyes checked regularly helps us catch any issues early and keep your lenses working as they should.

What can happen if astigmatism goes untreated?

Astigmatism isn’t a disease; it’s a focusing issue. But if left uncorrected, especially in children, it can lead to other complications.

Lazy eye (amblyopia)

If one eye is blurrier, the brain may start to ignore it. This can lead to lazy eye, or amblyopia. Regular eye tests for kids help catch this early.

One eye might do more work than the other, leading the brain to favour inputs from the stronger eye, resulting in the weaker eye becoming lazy or amblyopic. Regular eye tests for kids help catch this early.

Strabismus (squint)

Strabismus is characterised by the misalignment of the eyes. To compensate for uncorrected astigmatism, unequal focusing efforts are required by the eyes. This results in muscle imbalance and misalignment, leading to the development of strabismus and can cause a squint.

Astigmatism: your questions answered

Did you know?

Eye tests are bulk billed to Medicare, so there are no out‑of‑pocket expenses for you*.

Written with care and checked for accuracy

https://images.ctfassets.net/uuaxywrybmpn/20CooX3JMWudhhs1eaZS8k/48450e8b531c83540b393afe3cfc218f/Joseph_Paul.jpg

Dr Joseph Paul

B.Optom PhD

Dr Joseph Paul studied optometry at the University of Melbourne, graduating in 2011. He then completed a PhD in retinal structure and function at the University of Melbourne and a post‑doctoral position in optic nerve bioenergetics at the Centre for Eye Research Australia.

Alongside this work, Dr Joseph has practised in a wide range of public, private and corporate optometry practices across Victoria over the past decade. He is Head of Professional Services at Specsavers Australia and New Zealand.

Could something else be causing your symptoms?

Getting blurry vision or sore eyes? These symptoms might also be linked to other eye conditions.

Find out more

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