Astigmatism

Last reviewed: 16 Apr 2022
Last updated: 25 Apr 2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • blurred vision
More key diagnostic factors

Other diagnostic factors

  • asthenopia (eye strain)
  • distorted retinal reflex
  • Munson's sign
Other diagnostic factors

Risk factors

  • positive family history
  • presence of myopia
  • East Asian, Hispanic, Native American, or indigenous Brazilian ethnicity
  • eye trauma or surgery
  • genetic syndromes
  • eyelid pathology
More risk factors

Diagnostic investigations

1st investigations to order

  • retinoscopy
More 1st investigations to order

Investigations to consider

  • keratometry
  • corneal topography
More investigations to consider

Emerging tests

  • wavefront analysis technology
  • anterior-segment optical coherence tomography (AS-OCT)

Treatment algorithm

ACUTE

regular astigmatism

borderline astigmatism in patients ≥1 year old (age-dependent dioptre cutoffs)

irregular astigmatism

Contributors

Authors

Erez Bakshi, MD

Department of Ophthalmology

Assaf Harofeh Medical Center

Tel Aviv University

Israel

Disclosures

EB declares that he has no competing interests.

David Zadok, MD

Principal Investigator

Department of Ophthalmology

Assaf Harofeh Medical Center

Tel Aviv University

Israel

Disclosures

DZ declares that he has no competing interests.

Peer reviewers

Michael P. Ehrenhaus, MD

Assistant Professor of Ophthalmology

Cornea External Disease and Refractive Surgery Local Director

Long Island College Hospital Eye Center

Brooklyn

NY

Disclosures

MPE declares that he has no competing interests.

Gus Gazzard, MA, MBBChir, MD, FRCOphth

Consultant Ophthalmic Surgeon

King's College Hospital

Honorary Research Fellow

Institute of Ophthalmology

London

UK

Disclosures

GG declares that he has no competing interests.

Richard Davidson, MD

Assistant Professor

Department of Ophthalmology

Rocky Mountain Lions Eye Institute

University of Colorado Denver School of Medicine

Denver

CO

Disclosures

RD serves on the speakers bureaux for Alcan Inc and Allergan Inc. The work for these companies does not conflict with the review or nature of this topic.

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