Summary about Disease
Irregular astigmatism is a refractive error where the cornea (the clear front surface of the eye) or, less commonly, the lens, has an uneven curvature. Unlike regular astigmatism, where the curvature is uniform in one direction and steeper in another, irregular astigmatism has multiple or unpredictable curves. This prevents light from focusing properly on the retina, resulting in distorted or blurred vision at all distances.
Symptoms
Blurred vision at all distances
Distorted vision
Halos around lights
Glare, especially at night
Double vision (monocular diplopia - double vision in one eye)
Eye strain
Headaches
Causes
Corneal scarring: Injury, infection (e.g., keratitis), or surgery can cause corneal scarring, leading to irregular astigmatism.
Keratoconus: A progressive thinning and bulging of the cornea into a cone shape.
Pellucid Marginal Degeneration: A corneal thinning disorder similar to keratoconus, but the thinning occurs at the inferior (lower) edge of the cornea.
Corneal dystrophies: Inherited conditions affecting the structure of the cornea.
Post-surgical complications: Refractive surgeries like LASIK or PRK can sometimes induce irregular astigmatism.
Dry eye disease: Severe or chronic dry eye can contribute to corneal surface irregularities.
Medicine Used
There isn't a "medicine" to cure irregular astigmatism directly. Treatment focuses on correcting the refractive error and managing underlying conditions. Options include:
Specialty Contact Lenses: Rigid gas permeable (RGP) lenses or scleral lenses can mask corneal irregularities and provide a smooth refractive surface.
Eyeglasses: In mild cases, eyeglasses may provide some improvement, but are often not sufficient for significant irregular astigmatism.
Corneal Cross-linking (CXL): Used in keratoconus and pellucid marginal degeneration to strengthen the cornea and slow progression.
Corneal Transplantation: In severe cases with significant corneal damage, a corneal transplant (keratoplasty) may be necessary.
Topography-guided LASIK/PRK: Rarely used and only for specific cases of mild irregular astigmatism after careful evaluation.
Treatments for Dry Eye: Artificial tears, lubricating ointments, prescription eye drops, and other treatments to improve corneal surface health.
Is Communicable
No, irregular astigmatism is not communicable. It is not caused by an infection that can be spread from person to person.
Precautions
Protect your eyes from injury: Wear appropriate eye protection during activities that could pose a risk of eye injury.
Manage underlying conditions: If your irregular astigmatism is due to a condition like keratoconus or dry eye, follow your doctor's recommendations for managing that condition.
Regular eye exams: Schedule regular eye exams to monitor the condition and adjust treatment as needed.
Proper contact lens care: If you wear contact lenses, follow your eye doctor's instructions carefully for cleaning, disinfecting, and wearing them.
Avoid rubbing your eyes: Rubbing your eyes can worsen corneal irregularities.
How long does an outbreak last?
Irregular astigmatism is not an "outbreak" and is generally a chronic condition, not an acute one. The duration of symptoms depends on the underlying cause and the effectiveness of treatment. It is a long-term management condition, not something that resolves quickly like an infection.
How is it diagnosed?
Comprehensive Eye Exam: Includes visual acuity testing, refraction (measuring refractive error), and slit-lamp examination (examining the structures of the eye).
Corneal Topography: Maps the curvature of the cornea to identify irregularities.
Keratometry: Measures the curvature of the central cornea.
Pachymetry: Measures corneal thickness, which can be helpful in diagnosing keratoconus.
Wavefront Analysis: More advanced technique that measures the entire optical system of the eye.
Timeline of Symptoms
The timeline of symptom development depends on the cause:
Keratoconus: Symptoms typically develop gradually during adolescence or early adulthood and progress over time.
Corneal Scarring (from injury): Symptoms appear relatively quickly after the injury.
Post-Surgical: Symptoms may appear soon after surgery or develop over several weeks or months.
Dry Eye: Symptoms may fluctuate with dry eye flares. There is no single timeline, as each case is different, and progression rates vary.
Important Considerations
Early Diagnosis is Key: For progressive conditions like keratoconus, early diagnosis and treatment are crucial to slow or halt progression.
Finding the Right Contact Lens Fit: Fitting specialty contact lenses for irregular astigmatism can be challenging and may require multiple visits to achieve optimal comfort and vision.
Regular Monitoring: Regular follow-up appointments with your eye doctor are essential to monitor the condition and adjust treatment as needed.
Consult a Specialist: If you have irregular astigmatism, it's best to consult with an eye doctor who specializes in corneal diseases and refractive surgery.
Realistic Expectations: While treatment can significantly improve vision, it may not always restore vision to 20/20. Understand the limitations of each treatment option.