Astigmatism patients make 8 common mistakes in their astigmatism treatment & correction. Do you?
So, if you want to get rid of your glasses or contacts and get your 20/20 vision back naturally without any side-effects, click the "Start Here" button to learn more.
A Comprehensive Guide To All Astigmatism Types
Last Reviewed: January 16, 2020
But the question is, no matter what type of astigmatism you have, what are your root causes? Astigmatism is a distortion of your lens due to a weak lens. So what's causing that weakness in your circumstances?
Click here to find out.
Professionally Reviewed by
Mark Bushby
Optometrist
Professionally Reviewed by
Dr. Andrew Simon
Chiropractor
Professionally Reviewed by
Linda Loh
Naturopath
Professionally Reviewed by
Dr. Jonathan Kaplan
Psychologist
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The Questions Answered In This Article:
What Are The Two Types Of Astigmatism?
When you hear people refer to the different types of eye astigmatism, and they mention two, they are referring to regular and irregular astigmatism.
But there are 5 types of astigmatism. Some would even say there are even 5 types of regular astigmatism. What are the five types of astigmatism? We'll list all of them with detailed explanations below.
Yet they often refer to the different combinations astigmatism comes with other eye conditions.
The key to remember is that astigmatism types are important for diagnosis and treatment options. But at the end, you can improve all astigmatism and its types, whether it's different for each eye or the same.
You can correct all astigmatism types naturally.
Astigmatism vs Stigmatism?
The correct way of referring to the eye condition is astigmatism. Stigmatism is as variation listed in the dictionary, but correctly you would define astigmatism as the correct way of saying it.
What Are The Types Of Astigmatism?
Many visitors are asking me, "what type of astigmatism do I have?" And often that is not a straightforward answer. Because of all the types of mixed astigmatism.
Let's start with examples of mixed types.
Astigmatism with...
- 20/20 vision or perfect vision, but without blurry vision
- amblyopia
- cataracts
- farsightedness
- keratoconus
- lazy eye
- nystagmus
- pterygium
- presbyopia
- red dot sights
Obviously, some of these are rare types of astigmatism.
And then we have the types of astigmatism that compound; with myopia and farsightedness. These different types are explained with examples below.
Astigmatism itself is not an eye disease. It's just a refractive error that bends the light incorrectly into the eye. If any type of astigmatism is considered an eye disease, it is because the combination is with an eye disease.
For example, astigmatism with glaucoma or with keratoconus.
What are Clinical Types Of Astigmatism?
Examples of clinical types of astigmatism include the combinations with myopia, hyperopia, and presbyopia. These are explained below as myopic astigmatism, hyperopic astigmatism, and hypermetropic astigmatism.
Is There A Specific Test For Each Type Of Astigmatism?
No. There is one test for all eye astigmatism types. If you have any eye disease with it, or it's compound astigmatism, you will have to test for other eye problems. But it's the same test for astigmatism.
How Many Types Of Astigmatism Are There?
We identified 10 types that are worth to discuss in detail. Here they are:
What Is Regular Astigmatism?
- Regular astigmatism can show up in three different ways:"With-The-Rule"
- "Against-The-Rule"
- Oblique
So what does regular astigmatism mean?
It means that astigmatism appears on clearly define
degrees. There are three types of regular astigmatism:
With-The-Rule Astigmatism:
Here astigmatism shows up straight ahead. The distortion or bend rounding out vertically, so from top to bottom of the eye, at a 90-degree angle.
It's like an American football or rugby egg lying on the side.
Against-The-Rule Astigmatism:
It's almost the same rounding like with-the-rule astigmatism, but this time, the football or rugby egg is standing on the end.
Meaning the rounding is 90 degrees straight ahead but along the horizontal plane.
Oblique Astigmatism:
Here the distortion of the cornea shows up between 30 - 60 degrees or 120 - 150 degrees. Meaning it's like an American football tilting to the left or right.
How Many Types Of Regular Astigmatism Are There?
As you can see above, there are three regular astigmatism types.
What Is The Difference Between Regular And Irregular Astigmatism?
If your cornea distortion appears along the varying degrees explained above, you have regular astigmatism.
If the distortion appears to a different degree, it'll be irregular astigmatism. A simple astigmatism test will help you to determine your angle.
What Causes Regular Astigmatism?
The physical issue is an incorrectly shaped cornea. Instead of being a smooth, round dome, it's distorted and shaped unevenly as explained above.
What Regular Astigmatism Symptoms?
The symptoms range from hardly noticeable to blurry vision, headaches, light sensitivity, and a whole host of issues.
You can read about all the symptoms of astigmatism on our page dedicated to discussing all astigmatism symptoms.
What Is Irregular Astigmatism?
It is considered irregular astigmatism when the cornea is distorted along different degrees than regular astigmatism.
So, what's the definition of irregular astigmatism?
Irregular astigmatism occurs when the corneal distortion is not at a set, regular pattern. It's an unnatural damage to the cornea.
What Causes Irregular Astigmatism?
Irregular astigmatism is a corneal damage. It's often connected to LASIK eye surgery. Or it can be a side-effect after cataract surgery.
Other patients get it as a result of keratoconus or other eye diseases. So it's not a case of irregular astigmatism vs keratoconus. It's just possible that keratoconus causes irregular astigmatism because keratoconus is an eye disease that weakens the cornea.
That weakness causes corneal distortion.
How To Know If You Have Irregular Astigmatism?
Many website visitors ask me, "do I have regular or irregular astigmatism?" and "what is the difference between regular astigmatism and irregular astigmatism?".
In order to find out, a simple astigmatism test will do. To find out the exact details of your eye disorder after that, you'll need to go to proper astigmatism checkup. You will need to find out the exact axis along which your corneal distortion occurs.
How To Diagnose Irregular Astigmatism?
Once you established that your astigmatism is not regular, you have to identify irregular astigmatism with topography.
It's basically a scan of your visual field to work out where your symptoms appear.
After an irregular astigmatism topography, you'll receive your prescription. With that, you can get glasses or contact lenses specifically for irregular astigmatism.
So, yes, glasses can correct irregular astigmatism. Do irregular astigmatism glasses look any different? No, it's just a special astigmatism lens to correct your corneal distortion.
Can Irregular Astigmatism Be Corrected?
Most of the time, yes. Either with glasses or lenses. But now you can even use LASIK to correct irregular astigmatism in some cases as well. Remember, however, eye surgery to correct astigmatism is a correction. It's not a treatment.
Often times eye surgeries don't last. Plus, irregular astigmatism can appear after LASIK. It can be a side-effect after LASIK.
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How To Cure Irregular Astigmatism?
To fix, cure, or treat irregular astigmatism, you have to use a safe, natural approach that helps you to get rid of the underlying root causes.
A proper irregular astigmatism treatment will correct your eyesight, so you don't need any glasses afterward anymore. To find out, if natural ways can work for you, click here.
What Is Corneal Astigmatism?
Corneal astigmatism is when the curvature of astigmatism appears on the cornea rather than in the lens.
It is "with-the-rule" when it has a specific direction. Here the corneal distortion is vertical. "Against-the-rule" describes a corneal distortion that is horizontal. And oblique is a deformation along specific degrees.
These three types are the types of regular astigmatism.
Irregular corneal astigmatism refers to a situation where the cornea is deformed differently than the three scenarios above.
How To Measure Corneal Astigmatism?
It's best to measure and calculate corneal astigmatism with a specialist in a proper test. Which process is useful for measuring corneal astigmatism is better decided by a patient visit to a specialist. Online analysis is too vague in this case.
Severe corneal astigmatism is too dangerous to play with. And trying to calculate corneal astigmatism from k readings is a guess at best.
To get an accurate analysis, you should do a corneal topography for astigmatism. That way you will know exactly where the corneal distortion is, and how strong it is.
How To Correct Corneal Astigmatism?
That really depends on how severe corneal astigmatism is. You may simply get away with astigmatism lenses or glasses.
In other cases, corneal reshaping is the best form of astigmatism treatment. Allowing to smooth out and even out the cornea.
If the case is too severe, and surgery for astigmatism doesn't bring the desired results through reshaping, a corneal transplant or corneal implant for astigmatism may be necessary.
Fact is corneal astigmatism changes with age. So any type of correction should consider that.
It is possible to improve corneal astigmatism naturally as well. To find out, if this can work for you, click the "Start Here" button in the navigation bar above.
So, let's have a look at lenticular vs corneal astigmatism...
What Is Lenticular Astigmatism?
Corneal astigmatism refers to a distortion of the cornea. To define lenticular astigmatism we have to look at a distortion of the lens. Meaning, lenticular astigmatism happens below the cornea.
So the definition is that it's a distortion of the lens.
What Causes Lenticular Astigmatism?
The ophthalmic industry just mentions a distortion of the lens. The question is, what causes the distortion of the lens?
Diabetes and high blood pressure are said to be reasons for the lens to change shape. Going into the mental and emotional aspects of your eyesight as well, lenticular astigmatism has to do with not wanting to see yourself the way you are.
Meaning, there is an aspect of yourself that you are not very fond of, so you are trying to blur it out. As an effect, your body will distort the lens to accommodate for what your mind is trying to achieve.
How Common Is Lenticular Astigmatism?
It's a common type of astigmatism. And the number of diagnosed patients is increasing steadily. Age may also play a role in the development.
The question is whether measuring lenticular astigmatism has become better, or if the tests are marketed more to sell more glasses.
How To Calculate Lenticular Astigmatism?
The lenticular calculation is best done by a professional if you want an accurate measurement.
Unlike corneal astigmatism, it can't be measured with keratometry. But it can be calculated with this formula:
Lenticular Astigmatism = Total Astigmatism - Corneal Astigmatism
Therefore you need to have a proper test in order to be able to calculate astigmatism accurately.
How To Correct Lenticular Astigmatism?
Of course, the most common lenticular astigmatism correction is glasses or contacts for the condition.
For example, contact lenses that specifically correct the curvature of the lens.
LASIK is tricky here because it reshapes the cornea. But lenticular astigmatism is a lens issue. So only a lens transplant could fix that.
Because it is a lens issue, it's often connected to cataract. Yet, lenticular astigmatism doesn't mean that cataract is present or vice verse.
But the refractive surgery procedure for both eye conditions is similar.
The best way it still to cure astigmatism naturally. Not matter what type of astigmatism.
What Is The Definition of Myopic or Nearsighted Astigmatism?
What does myopic astigmatism mean? Astigmatism is a refractive error. Meaning that the light is falling into the eye incorrectly. It's either falling in too short or too far.
Meaning instead of merging the light rays perfectly on the retina, the back part of your eye. The rays of light are merging before the retina, or behind it.
With myopic astigmatism, they are merging in front of the retina.
Myopia or nearsightedness is a refractive error where light rays fall in front of the retina. The reason is that the eyeball is too long.
So when astigmatism distorts the rays of light in the cornea or lens, it's called myopic, if the light merges too early.
This is not to confuse with a situation where a patient has myopia and astigmatism. Or astigmatism with myopia.
Myopic astigmatism refers to the need to correct the refractive error of astigmatism with minus lenses. Minus lenses only for astigmatism.
So, are myopia and astigmatism the same?
Both are a refractive error. Meaning both conditions bend the light incorrectly into the eye. So they cause a blurry image.
But they are not the same. Myopia without astigmatism is just myopia. So you can have myopia or astigmatism.
Astigmatism vs Myopia
The cause of the refractive error in myopia is a longer than usual eyeball. For astigmatism, it's due to an imperfection in the cornea or the lens.
Because of the different causes for of the refractive error, both conditions cause blurry vision differently.
What Causes Myopic Astigmatism?
A distortion of either the cornea or the lens. One of the two is shaped incorrectly and leading the rays of light to merge too early in the eye. Before the retina, so the perceived image becomes blurry.
Basically, the medical term myopic astigmatism simply means that your prescription for astigmatism lenses will read:
CYL: -1 ; Axis: 90.
Three Types Of Myopic Astigmatism
What Is Simple Myopic Astigmatism?
Simple myopic astigmatism refers to the situation where the astigmatism is only on regular distortion. It's a single correction at a specific angle.
For example, if your refractive error is just one bump on the cornea at 90 degrees.
What Is High Myopic Astigmatism?
High myopic astigmatism refers to a situation where the myopic distortion is very strong. Meaning that the light rays fall and merge very short in the eyeball. With a great distance to the retina.
This leads to very distorted vision and a very blurry image.
Basically, the higher myopic astigmatism, the greater the correction needed. So the stronger your glasses and prescription.
What Is Compound Myopic Astigmatism?
Compound myopic astigmatism means that there are more than one distortions of the cornea or lens.
All distortions lead to the light falling in and merging in front of the retina, rather than behind.
So it's multiple degrees of astigmatism, and all are myopic.
What Is Bilateral Myopic Astigmatism?
Bilateral myopic astigmatism means that both eyes have myopic astigmatism. In both eyes, the light is bent incorrectly into the eye, so it merges in front of the retina.
Yet the amount of refractive error is different for each eye.
So one eye may need OD CYL: -1 ; Axis: 90. And the other eye is OS CYL: -1.75 ; Axis: 120.
It's different from myopia with astigmatism that is bilateral. Because in that would mean that the patient has bilateral astigmatism. In this case, it'd probably be one eye is myopic astigmatism, the other eye hyperopic astigmatism.
And that patient would be nearsighted with myopia at the same time.
So bilateral myopic astigmatism refers to the same condition in both eyes. But each eye requires a different correction.
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What is Hyperopic or Hypermetropic Astigmatism?
Hyperopic astigmatism means that the refractive error of the cornea or lens causes the rays of light to focus behind the retina.
In a normal functioning eye without astigmatism, light rays fall into the eye in a way that they merge and focus right on the retina. That's why the image is clear.
With hypermetropic astigmatism, the light is bent incorrectly by the lens or cornea, in a way that the focal point where they merge is behind the retina.
The retina is the back part of the eye where the cone cells and light receptors perceive the picture in the human eye.
Hyperopic astigmatism is not to be confused with astigmatism with hyperopia or hypermetropia. That's a situation where a patient suffers from astigmatism and hyperopia/hypermetropia.
Even though astigmatism and hyperopia are both refractive errors, they differ. With hyperopia or hypermetropia, the eyeball is too short, so that the rays of light merge and focus behind the retina.
With astigmatism, the distortion happens in the lens or the cornea. It the refractive error is caused by the lens or the cornea and the light merges and focus too far behind the retina, the condition is called hyperopic or hypermetropic astigmatism.
What Is Simple Hyperopic Astigmatism?
Simple hyperopic astigmatism refers to a condition where both eyes have the same refractive error. Both eyes have a single distortion in the cornea or lens. And both eyes require the same correction.
Both eyes need the same strength and angle to correct the respective refractive error.
What Is Bilateral Hyperopic Astigmatism?
Bilateral hyperopic astigmatism is a situation where both eyes have different refractive errors. The correction for each eye is different.
For example, the left eye has a stronger distortion of the cornea than the right. So the left eye needs a correction of CYL +3, whereby the right eye only requires CYL +2.
Yet for both eyes, it's hyperopic astigmatism. So in both eyes, the focal point of the light rays entering the eye merge behind the retina.
What Is Compound Hyperopic Astigmatism?
Compound hyperopic astigmatism is a situation where there are multiple angles of hyperopic distortions. So the cornea or lens has multiple distortions, yet all of them cause the light to merge behind the retina.
Again, this is different than conditions where you have astigmatism with presbyopia or astigmatism with amblyopia.
The compound refers to the same condition, in this case, hyperopic astigmatism, appearing multiple times in the eyes of the same patient.
What Is High Astigmatism?
Basically, when the astigmatism prescription exceeds 3 diopters or more, it counts as high astigmatism. Some would call it moderate to high astigmatism.
Some would argue that astigmatism numbers above 5 are considered high astigmatism only, but the definition of astigmatism grades is not set in stone.
High astigmatism means that it's a high amount of astigmatism. And because the distortion of the eyesight with astigmatism is high than with myopia, presbyopia, or hyperopia, 3 is considered a high level of astigmatism.
How Much Is High Astigmatism?
It depends on the person defining what a high astigmatism prescription is. But the signs of high astigmatism are hard to miss.
A strongly distorted vision that makes it hard to see is considered to be high astigmatism.
How High Can Astigmatism Go Or Be?
That's a great question. After high astigmatism, there is severe astigmatism too. So it depends on what level of astigmatism becomes too bad to live with. What's considered high astigmatism by one person can be fine for somebody else to live with.
What Causes High Astigmatism?
The stronger the distortion of the cornea or the lens, the more the high astigmatism number grows. What is considered high, is the amount of correction the refractive error causes.
So, depending on the type of high astigmatism you have, whether it's high myopic astigmatism or high hyperopic astigmatism, it's how far in front of or how far behind the retina the light merges and focuses.
It always comes down to how bad or how high the prescription is that it needs to merge the light rays exactly onto the retina.
What Are The Symptoms Of High Astigmatism?
Very simple; if you have normal astigmatism and your vision gets blurry again, that's it. If you get headaches from the blurry vision that would be another indication that you moved from astigmatism to moderate astigmatism to high.
When Is Astigmatism Severe?
There is no clear-cut rule where high astigmatism ends and severe astigmatism starts. Again, it comes down to how severely the condition impacts your life.
But it would be safe to say that anything above a refractive error of 5 in the prescription can be considered severe astigmatism.
How To Correct High Astigmatism?
The treatment of high astigmatism is the same like most others.
If you need to treat high astigmatism because of a corneal distortion, LASIK can be an option. High corneal astigmatism can be corrected with LASIK.
That's different for high lenticular astigmatism. Here only a lens transplant could work as a surgical solution for the correction of high astigmatism.
Otherwise, you can obviously wear astigmatism lenses or astigmatism glasses for high astigmatism. It's just a very strong prescription. Some people would argue that toric contact lenses are best for high astigmatism. Especially in the case of high corneal astigmatism.
How To Cure High Astigmatism?
That's obviously one of the most common questions we get. Can you cure or treat or fix high astigmatism naturally?
The short answer is, yes!
To get started, you need to find out if you can cure high astigmatism in your specific situation. If yes, you need to uncover your true root causes for astigmatism. And then to fix the refractive error, you just need to get rid of the root causes one by one.
Click here to get started with a free analysis.
What Is Severe Astigmatism?
It is considered severe astigmatism when your astigmatism severely impacts the life of the patient. Personally, I would put the definition at a refractive error of 5 or above.
What Is A Severe Astigmatism Range?
Again, it's above 5 that severely impacts the life of the patient. It'll look like a very blurry image of a person.
When astigmatism is severe it becomes difficult for a person to use normal astigmatism contact lenses. Toric lenses become a stronger option.
What Causes Severe Astigmatism?
A strong distortion of the cornea or the lens. Or possibly a combination of the two.
LASIK is only an option as severe astigmatism corrective surgery when the astigmatism is corneal. In the case of lenticular astigmatism, LASIK is not an option.
Only a lens transplant could fix severe lenticular astigmatism.
The limitations for LASIK with severe astigmatism is the thickness of the cornea. If the cornea is too thin than LASIK is not an option.
For both cases, severe lenticular and severe corneal astigmatism it is wise to pursue natural ways to cure astigmatism before opting for surgery. Because surgeries are invasive, permanent procedures that may be unnecessary if natural astigmatism correction brings the desired results.
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