Managing Corneal Astigmatism

Abstract

Corneal astigmatism is a refractive error that creates an asymmetric blur in the vision. Corneal astigmatism can arise from trauma, disease, following surgery, or be congenital. In assessing corneal astigmatism, a decision should be made as to whether the astigmatic pattern is regular or irregular. Regular astigmatism is most common, can be congenital and is easier to manage due to the uniform nature of the changes in corneal power. Irregular astigmatism is commonly caused by trauma disease and may be induced by surgery. Corneal astigmatism can sometimes be prevented or its magnitude or irregularity reduced. Using sealants following corneal trauma can reduce suture-induced astigmatism. Management options for corneal astigmatism include glasses, contact lenses, and surgery such as incisional procedures, refractive laser surgery, intraocular lenses or rarely corneal grafting. In children with corneal astigmatism, management of amblyopia is often needed. For keratoconus, which is often a cause of irregular astigmatism, corneal cross-linking should be considered to stabilize progressive disease prior to refractive management. New treatment modalities are needed to enable more patients with corneal astigmatism to have improved vision