Astigmatism

Laser eye surgery can successfully treat astigmatism

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Summary of astigmatism

  • Astigmatism means your eye isn’t round
  • Blurry vision is a common symptom of astigmatism
  • Glasses and contact lenses can correct astigmatism
  • Laser eye surgery is a permanent cure for astigmatism
  • PRK, LASIK or SMILE can safely and effectively treat astigmatism

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An introduction to astigmatism

Astigmatism is a defect of the curvature of one or more of three ocular structures:

  • The cornea
  • The crystalline lens and
  • The posterior segment.

Corneal astigmatism is the significant component of ocular astigmatism.

The radii of curvature of the cornea of an astigmatic eye don’t have the same power on all the meridians. The light rays that pass through an astigmatic eye focus in two main lines that are not on the same plane, distorting the image.

Because of this anomaly, the visual blur the patient sees depends on the orientation of the targets they observe. Astigmatism is rarely isolated (18% of cases). Myopia or hyperopia often presents with astigmatism, which we call myopic or hypermetropic astigmatism, or mixed astigmatism, depending on the situation.

Astigmatism affects more than a quarter of the population.

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BEFORE AND AFTER

Astigmatism, before treatmentAstigmatism, after treatment

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Emmetropia, ametropia, and refraction

The emmetropic eye enjoys normal vision without optical correction. It is an eye whose anatomical qualities allow the image of a fixed object to form directly on the retina.

Only 14% of the French are emmetropic. An eye whose anatomical qualities are non-compliant is called ametropic. The image of an object does not form on the retina.

The different ametropia are myopia, hyperopia and astigmatism. The refractive power of the eye determines their importance. Refractive power is the nature and power of the optical correction that allows the image of an object to form on the retina of an ametropic eye.

The analysis of your vision that we measure in tenths, and your optical correction that we measure in diopters (negative for myopic ametropia and positive for hypermetropic ametropia) is called refraction.

Astigmatism symptoms and lifestyle impacts

The light rays that pass through an astigmatic eye focus in two main lines not located in the same plane, causing a distortion of the image. The visual blur induced by astigmatism concerns both near and far vision.

Thus, in the case of astigmatism, there is no distance where the vision is clear. The presence of myopia or hyperopia accentuates the deterioration of visual acuity without correction.

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Astigmatism causes

Astigmatism is the most common ametropia and it is most often moderate. Ophthalmologists cannot yet determine the causes of astigmatism except in cases of pathology of the cornea (keratoconus).

Astigmatism examination at Clinique de la Vision

A preoperative assessment is essential in refractive surgery.

It allows your surgeon to choose the most appropriate surgical technique for you (which may be PRK, LASIK, or implants) and to check the absence of contraindications.

Indeed, even if refractive surgery corrects visual defects (myopia, hyperopia and astigmatism), compliance with the contraindications avoids post-operative complications. The quality of the preoperative indication determines the quality of the result. This consultation also helps to answer the patient’s questions.

At Clinique de la Vision, for example, a preoperative consultation includes:

  • Measurement of ametropia (visual defect) to be corrected by refraction analysis
  • The complete ophthalmic assessment with measurement of the intraocular pressure, examination of the fundus and especially the analysis of the transparency of the lens
  • The analysis of corneal morphology (curvature, shape, thickness) thanks to corneal topography eliminates the contraindications to laser surgery and to choose the most appropriate surgical technique for the patient
  • Aberrometric examination analysis of the optical quality of the eye
  • We calculate the implant if we’re considering lens surgery
  • Other explorations can be done depending on the context.

It is only at the end of this assessment that a surgeon can make a recommendation, and choose the most suitable refractive surgery technique for you. The surgeon will clearly explain the advantages, the possible undesirable effects and the expected results of their recommended procedure.

Astigmatism treatment at Clinique de la Vision

Like other ametropia, surgeons can correct astigmatism with several laser techniques (PRK, LASIK, SMILE).

The principle is then to regularise the curvature of the corneal meridians to erase the difference between the flatter meridian and the more domed meridian. Doing so makes the eye emmetropic by converging light beams no longer in two focal lines but at one point.

The goal is to equalise the radius of curvature between the two extreme meridians. When the astigmatism is associated with a strong ametropia, the correction can also be done by phakic implant type ICL .

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What is the difference between presbyopia and astigmatism?

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TÉMOIGNAGES

“Le jour de l’intervention, je n’ai ressenti aucune gêne et aucune douleur. Après 2 h de repos j’ai pu reprendre mes activités tout à fait normalement. Deux jour après l’intervention il ne subsiste aucune gêne. Je tenais également à insister sur le fait que, contrairement aux idées reçues, ce n’est pas une intervention réservée aux personnes jeunes. J’ai 59 ans et c’est une totale réussite.”

L.B.

“Le Docteur Albou-Ganem m’a opérée de la presbytie il y a un an, et je suis très heureuse du résultat, plus besoin de lunettes pour lire, même ma vue de loin est bonne. C’est un vrai soulagement pour moi, car j’ai hésité pendant un moment avant de sauter le pas, difficile de prendre une telle décision.”

C.T.

“Après une opération rapide et sans douleur j’ai quasiment immédiatement remarqué une nette amélioration de ma vue de près et de loin. Au fil des semaines cela n’a fait que se confirmer et je n’ai jamais reporté mes lunettes depuis! Je ressens une telle liberté dans ma vie de tous les jours ainsi qu’une impression d’avoir rajeuni que je recommande à toute personne de le faire sans hésitation si cela leur est possible!”

V.S.

“Docteur Catherine Albou-Ganem l’a immédiatement dissipée. Contact et confiance se sont installés immédiatement. Ses explications ont été claires, précises et je peux dire que le Jour J de l’opération, j’y suis allé les yeux fermés! Pour les rouvrir quelques heures plus tard avec la vue parfaite d’un homme de 30 ans!”

M.A.

“L’opération a été un franc succès. J’ai maintenant 10/10e, sachant qu’auparavant j’avais une assez forte myopie (-5 et et -4,5) et un léger astigmatisme.”

R.B.

“Vous m’avez opérée il y a maintenant plus de deux ans. A part pour conduire et regarder la télévision, et encore… je n’ai plus besoin de lunettes, moi qui n’ai jamais rien vu… Il m’a fallu plusieurs mois pour que ma vue s’adapte. Je tenais donc à vous remercier de cette opération qui a changé ma vie! Plus d’ulcères douloureux dus aux lentilles et la possibilité d’ouvrir les yeux sous l’eau et d’admirer les jolis poissons!”

F. LB.

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About the author

Doctor Catherine Albou-Ganem
Consultant Ophthalmic Surgeon 

I am Catherine Albou-Ganem and I am an ophthalmic surgeon brought up in a family of ophthalmologists. I had a passion for ‘the eye’ and ‘the vision’ from my childhood. This was the subject of my first presentation at school.

Today, I share my refractive surgery activity between the hospital and the private sector.

I am proud to have contributed to the development of new laser refractive surgery techniques that can correct vision defects with accurate, effective and safe results when respecting the indications.

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