Sudden Increase in Astigmatism: Should You Worry About Keratoconus? - Ophthalmology

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When discussing the sudden increase in astigmatism and the potential concern for keratoconus, it is essential to understand both the nature of astigmatism and the characteristics of keratoconus. Astigmatism is a common refractive error caused by an irregular shape of the cornea or lens, leading to blurred or distorted vision. A sudden increase in astigmatism, as you've experienced, can be alarming, particularly when considering the possibility of keratoconus, a progressive eye disease that affects the cornea.

Keratoconus is characterized by a thinning and conical shape of the cornea, which can lead to significant visual impairment. Early stages of keratoconus can indeed be subtle and may not present with obvious symptoms. However, there are several factors to consider in your situation. The increase in astigmatism from 125 degrees to 175 degrees, while it may seem significant, falls within a range that some practitioners might consider normal, especially if the K-values (keratometry readings) are within normal limits and no other signs of corneal distortion are present.

Your ophthalmologist's assessment that the increase in astigmatism could be attributed to external factors, such as the thickness of your eyelids and your eye posture, is plausible. These factors can influence how light enters the eye and may lead to variations in refractive error without indicating a pathological condition like keratoconus. Additionally, your history of rheumatoid arthritis and eczema (汗皰疹) does not directly correlate with keratoconus, and the absence of family history of the condition is also a positive sign.

However, given your concerns and the sudden change in your vision, it would be prudent to seek further evaluation, particularly if you experience other symptoms such as increased sensitivity to light, distortion of vision, or changes in your night vision. A comprehensive eye examination at a specialized center, such as a large hospital or a clinic with expertise in corneal diseases, can provide more definitive answers. Tests such as corneal topography, which maps the surface curvature of the cornea, can help detect early signs of keratoconus that may not be visible through standard refraction tests.

In summary, while your current increase in astigmatism may not necessarily indicate keratoconus, it is essential to monitor your symptoms closely and consider further evaluation if you have ongoing concerns. Early detection and intervention are crucial in managing any potential corneal conditions effectively. Regular follow-ups with your eye care provider will ensure that any changes in your vision are addressed promptly, allowing for appropriate management strategies to be implemented if necessary.