What astigmatism is
A cornea with astigmatism is curved more steeply one way than the other, more rugby ball than football, so light focuses in two places and things look smeared or doubled at every distance. On your prescription it is the CYL number, with an axis.
Which treatment for how much
| Astigmatism (CYL) | Treatments usually considered |
|---|---|
| Up to about 3 | LASIK, LASEK or PRK, SMILE |
| About 3 to 4.5 | LASIK or LASEK if the cornea allows; toric implantable contact lens |
| Above that, or from about 50 | Toric lens replacement; sometimes a lens plus a laser top-up |
These are typical ranges, not rules. The corneal scans decide.
When astigmatism is a warning sign
Astigmatism that keeps increasing, especially in your teens and twenties, can be a sign of keratoconus, a thinning of the cornea. Laser that removes tissue is usually not done on keratoconus. The assessment scans look for it.
Recovery and risks
The same as for the treatment chosen. Astigmatism correction depends on the laser lining up precisely with the axis, so the clinic marks or tracks the eye. A small amount of astigmatism left over is the most common reason for a top-up.
What it costs
Usually no more than the same treatment without astigmatism: LASIK €1,500 to €2,600 per eye, LASEK €800 to €2,600, an implantable lens €2,900 to €3,900.
Questions people ask
Can you have laser eye surgery with astigmatism?
Yes. Most everyday astigmatism is treated in the same session as the short or long sight.
What is the most astigmatism laser can treat?
It depends on the cornea. SMILE is approved up to 3 in the United States; LASIK and LASEK often go higher; toric implantable lenses go to about 4.5.
Is astigmatism the same as keratoconus?
No. Most astigmatism is simply the shape you were born with. Keratoconus is a progressive thinning that causes increasing astigmatism, and the scans tell them apart.