Astigmatism generally gets worse because of changes in the shape of your eye’s structures, particularly the cornea (the clear front surface of your eye) or the lens inside your eye. While it’s not a condition that typically goes from zero to severe overnight, certain factors can contribute to its progression over time. Understanding these can help you manage your eye health better.
1. Age-Related Changes to Your Eyes
Just like many other parts of our bodies, our eyes change as we get older. These changes aren’t always about developing new problems; sometimes, they’re about existing conditions like astigmatism shifting or progressing.
Gradual Corneal and Lens Reshaping
One of the most common reasons astigmatism changes over time is the natural reshaping of the cornea and the lens within your eye due to aging. It’s a slow, ongoing process. Think of it like subtle shifts in a structure that’s been under constant pressure and use for decades. These microscopic changes can alter how light enters your eye and focuses on your retina, which is the definition of astigmatism getting worse or changing its axis.
Shifting Astigmatism Types
Interestingly, age doesn’t just make astigmatism more severe; it can also change its type. In younger individuals, astigmatism is often “with-the-rule,” meaning the steepest curve of the cornea is vertical. As we age, especially into later adulthood, astigmatism frequently shifts to “against-the-rule,” where the steepest curve becomes horizontal. This isn’t just an increase in severity; it’s a fundamental reorientation of the astigmatism itself, which might require updated prescriptions for glasses or contacts. This particular shift is a well-documented age-related phenomenon, distinct from just a simple increase in power.
Astigmatism is a common refractive error that can worsen over time due to various factors, including changes in the shape of the cornea or lens. For those looking to understand more about the progression of astigmatism and its potential impact on vision, a related article can be found at SmilePro Blog. This resource provides valuable insights into the causes of worsening astigmatism and offers tips on managing the condition effectively.
2. Progressive Corneal Conditions
While many causes of worsening astigmatism are gradual and subtle, some underlying eye conditions can lead to more significant and rapid progression. These often involve structural integrity issues with the cornea itself.
Understanding Keratoconus
Keratoconus is a prime example of a condition that causes astigmatism to worsen significantly. It’s a progressive eye disorder where the cornea, which is normally round, thins and bulges outward into a cone-like shape. This irregular shape drastically distorts the light entering the eye, leading to blurry and distorted vision that can’t be fully corrected with standard glasses. The astigmatism caused by keratoconus is often highly irregular and can progress quite rapidly, particularly during adolescence and early adulthood. It’s not just an increase in astigmatism; it’s a change in the very nature of it, making it much more challenging to correct.
Impact of Other Corneal Dystrophies
Beyond keratoconus, other less common corneal dystrophies or conditions can also affect the structural integrity of the cornea. These conditions might involve deposits forming within the cornea, weakening its structure, or causing irregular thickening or thinning. Any process that alters the smooth, regular curvature of the cornea can induce or worsen astigmatism. Regular eye exams are crucial for detecting these conditions early, as their progression can sometimes be slowed or managed.
3. External Forces and Trauma
Sometimes, what we do (or what happens to us) can have a direct physical impact on the shape of our eyes, leading to changes in astigmatism. These are often more abrupt causes compared to the gradual age-related shifts.
The Problem with Eye Rubbing
It might seem harmless, but repeated, vigorous eye rubbing can actually mechanically alter the shape of your cornea. The cornea is a delicate structure, and applying consistent pressure can cause it to thin or change its curvature over time. This is especially problematic for individuals who already have a predisposition to corneal weakness, such as those with keratoconus or even just thinner corneas. While an occasional rub won’t cause damage, habitual, forceful rubbing can accelerate the worsening of astigmatism or even contribute to the development or progression of conditions like keratoconus. It’s a habit worth breaking if you want to protect your corneal health.
Eye Injuries and Surgical Impact
Any significant trauma to the eye can distort the cornea’s shape. This could range from a blunt force injury to a penetrating wound. Even after the initial injury heals, the resulting scar tissue or changes in corneal architecture can induce or increase astigmatism. Similarly, eye surgeries, especially those involving the cornea (like some types of cataract surgery or corneal transplants), can temporarily or permanently alter the eye’s shape. While surgeons aim to minimize astigmatism, it can be an unavoidable side effect or even an intentional therapeutic alteration in some cases. For example, some cataract surgery techniques are designed to correct pre-existing astigmatism, while others might induce a small amount. Post-surgical astigmatism often stabilizes after initial healing but is a direct consequence of the physical changes to the eye.
4. Internal Eye Changes and Vision Correction Practices
Beyond the cornea, the internal lens of your eye plays a big role in focusing light. Changes here, or even how you use your vision correction, can influence astigmatism.
Lens Changes and Cataracts
As we age, the natural lens inside our eye undergoes changes. It gradually thickens and hardens, and eventually, it can become cloudy, leading to cataracts. These changes in the lens’s shape, density, and clarity can directly affect how light passes through it and is focused onto the retina. This means that even if your cornea remains stable, changes in your lens due to aging or cataract formation can induce or worsen astigmatism. Sometimes, the removal of a cataract and replacement with an artificial intraocular lens (IOL) can even correct pre-existing astigmatism, depending on the type of IOL chosen. Conversely, some early cataracts can cause an increase in astigmatism or a shift in its axis, contributing to blurry vision before the cataract itself becomes visually significant.
The Role of Incorrect Contact Lens Use
While properly fitted contact lenses are excellent for correcting astigmatism, improper use or an ill-fitting lens can cause problems. If contact lenses are worn incorrectly, beyond their recommended wear time, or if they don’t fit the curvature of your eye properly, they can put undue pressure on the cornea. This constant, improper pressure can potentially induce temporary or even long-term changes in corneal shape, contributing to or worsening astigmatism. It’s also important to note that if your astigmatism changes, your current contact lenses might become uncomfortable or provide less clear vision, prompting the need for a new prescription and a better fit. Always follow your eye care professional’s advice on contact lens care and wear schedules to minimize these risks.
Astigmatism can worsen over time due to various factors, including changes in the shape of the cornea or lens, and it’s important to stay informed about eye health. For those looking to understand more about the progression of astigmatism and its implications, a related article can provide valuable insights. You can read more about this topic in the article found here, which discusses the potential causes and effects of worsening astigmatism.
5. Genetic and Hereditary Factors
| Factor | Description | Impact on Astigmatism | Typical Progression Rate |
|---|---|---|---|
| Age | Natural changes in the cornea and lens shape over time | Gradual worsening, especially in middle age and older adults | 0.25 to 0.50 diopters per decade |
| Eye Injury or Surgery | Trauma or surgical procedures affecting corneal shape | Can cause sudden increase in astigmatism severity | Variable; immediate or within weeks post-injury/surgery |
| Corneal Diseases (e.g., Keratoconus) | Progressive thinning and bulging of the cornea | Significant worsening of astigmatism over months to years | Up to 1.00 diopter or more per year |
| Eye Rubbing | Frequent or vigorous rubbing causing corneal distortion | May accelerate progression, especially in susceptible individuals | Variable; can increase astigmatism within months |
| Uncorrected Vision | Not wearing prescribed glasses or contacts | May contribute to eye strain but less direct impact on worsening | Minimal to none |
While many causes of worsening astigmatism are environmental or age-related, there’s also a component that’s simply passed down through families. Sometimes, you’re just more prone to it.
Family History and Predisposition
Genetics play a significant role in determining whether you develop astigmatism in the first place, and they can also influence its stability or progression. If you have close family members with astigmatism, especially those whose astigmatism progressed or was severe, you might have an inherited tendency for similar development. While genetics don’t dictate progression in every case, they can raise the likelihood of experiencing shifts or increases in astigmatism over your lifetime. It’s not about inheriting the exact prescription, but rather the anatomical predisposition for certain corneal or lens shapes that are more prone to astigmatic changes.
Underlying Genetic Conditions
In some rarer instances, astigmatism and its progression can be linked to specific genetic syndromes or conditions that affect the connective tissues of the body, including those within the eye. For example, conditions like Marfan syndrome or Ehlers-Danlos syndrome can sometimes be associated with corneal abnormalities, including keratoconus, which in turn leads to severe and progressive astigmatism. While not common, these genetic links highlight that for some individuals, the progression of astigmatism is part of a broader genetic picture rather than an isolated eye issue. Knowing your family’s eye health history can be a helpful piece of information for your eye care provider.
FAQs
What causes astigmatism to worsen?
Astigmatism can worsen due to a variety of factors, including changes in the shape of the cornea or lens, eye injuries, or certain eye conditions.
Can astigmatism worsen with age?
Yes, astigmatism can worsen with age as the shape of the eye changes over time, leading to an increase in the degree of astigmatism.
Does untreated astigmatism get worse over time?
Untreated astigmatism can worsen over time, as the irregular shape of the cornea or lens continues to affect the way light enters the eye, leading to further vision problems.
Can eye strain make astigmatism worse?
Eye strain can exacerbate astigmatism symptoms, but it does not directly cause astigmatism to worsen. However, prolonged eye strain can lead to discomfort and worsen existing vision issues.
How can I prevent astigmatism from getting worse?
To prevent astigmatism from worsening, it is important to have regular eye exams, follow your eye doctor’s recommendations for corrective lenses or surgery, and protect your eyes from injury or strain.
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