Corneal Issues: Astigmatism and Double Vision Explained

Q: Corneal Issues: Astigmatism and Double Vision Explained

Hello, classmate： Astigmatism becomes more pronounced at a distance, which is why distant vision is particularly noticeable, while near vision is relatively better. <br>It is normal to experience this sensation when looking at a mobile phone. <br>White text on a black background

Corneal issues / Astigmatism / Diplopia

Hello, doctor.
Recently, I've noticed that when I wear glasses at night, bright objects like streetlights and traffic signals appear to have a layer floating above them, or sometimes there are multiple layers.
Occasionally, the halos around the lights seem to have some patterns, which I find hard to describe.
In the morning, I also see some objects with a layer floating above them, especially white ones.
However, this phenomenon is particularly noticeable at night and when looking at distant objects; it’s less pronounced when looking at things up close.
For example, on my phone screen, with black background and white text, I also see a floating effect, and the shadow of the white text appears to have colors.
When I take off my glasses, the light also shows patterns.
I'm very concerned about my eyes.
I've seen an ophthalmologist and had an OCT scan, and the doctor said everything is normal but did not explain the reason.
I researched double vision and other related information online, and I'm worried that I might have keratoconus.
Could this be keratoconus? I am currently 20 years old, with approximately -6.00 diopters of myopia in my right eye and -6.75 diopters in my left eye, with astigmatism of about 0.50 and 1.00 diopters in both eyes.
I also have floaters and mild dry eye.
Thank you, doctor.

Tongxue, 20~29 year old female. Ask Date: 2020/04/25

Dr. Gao Pilin reply Ophthalmology

Hello, classmate: Astigmatism becomes more pronounced at a distance, which is why distant vision is particularly noticeable, while near vision is relatively better.
It is normal to experience this sensation when looking at a mobile phone.
White text on a black background is more distinct.
High astigmatism can occur with keratoconus, but that should not be the case here.
In Taiwan, the ophthalmology department at Puzi Hospital is open on Monday, Tuesday, Thursday, and Friday mornings from 8:00 AM to 12:00 PM, and on Wednesday afternoons from 2:00 PM to 4:30 PM.
Online responses can only serve as a reference; it is still necessary to seek medical attention at a healthcare facility if needed.
I hope to have the opportunity to serve you.
Gao Pilin

Reply Date: 2020/04/25

More Info

Hello,
Thank you for reaching out with your concerns regarding your vision. Based on your description, it sounds like you are experiencing some visual disturbances, particularly at night, which can be quite distressing. Let's break down the potential causes and considerations regarding your symptoms.

Understanding Your Symptoms
1. Double Vision (Diplopia): The phenomenon you describe, where lights appear to have multiple images or halos, can be a form of double vision. This can occur due to various reasons, including refractive errors, corneal irregularities, or even issues with the eye muscles.

2. Astigmatism: This is a common refractive error caused by an irregular shape of the cornea or lens, leading to blurred or distorted vision. Astigmatism can cause light to focus on multiple points in the eye, resulting in the visual effects you are experiencing, especially at night when light sources are more pronounced.

3. Keratoconus: You mentioned concerns about keratoconus, a condition where the cornea thins and bulges into a cone shape. This can lead to significant visual distortion and sensitivity to light. While your symptoms could suggest keratoconus, especially given your age and the presence of astigmatism, it is essential to rely on diagnostic tests performed by your eye care professional.

4. Visual Disturbances: The "floating" effect you describe, particularly with bright lights and white backgrounds, could also be related to your existing conditions, such as myopia (nearsightedness) and astigmatism. Additionally, the presence of floaters and dry eyes can exacerbate these visual disturbances.

Diagnostic Considerations
Since you have already undergone an OCT scan and your doctor indicated that everything appeared normal, it is reassuring. However, if you still have concerns, consider the following steps:
- Corneal Topography: This test maps the surface curvature of your cornea and can help identify conditions like keratoconus or other irregularities that might be contributing to your symptoms.

- Refraction Test: A comprehensive refraction test can ensure that your glasses prescription is accurate and that any astigmatism is properly corrected.

- Consultation with a Specialist: If your symptoms persist or worsen, it may be beneficial to consult with a corneal specialist or an ophthalmologist who focuses on refractive surgery. They can provide further insights and possibly additional testing.

Management Strategies
1. Proper Prescription: Ensure that your glasses or contact lenses are up to date. Sometimes, a slight adjustment in prescription can alleviate symptoms.

2. Dry Eye Management: If you have mild dry eye symptoms, using lubricating eye drops can help improve comfort and reduce visual disturbances.

3. Regular Monitoring: Given your age and the presence of myopia and astigmatism, regular eye exams are crucial. This will help monitor any changes in your vision or the health of your eyes.

4. Lifestyle Adjustments: Reducing screen time, ensuring proper lighting when reading or using devices, and taking regular breaks can help alleviate eye strain.

Conclusion
While your symptoms can be concerning, it is essential to approach them systematically. The fact that your OCT scan was normal is a positive sign, but if you continue to experience visual disturbances, further evaluation may be warranted. Always communicate openly with your eye care provider about your symptoms and concerns, as they can guide you toward the appropriate tests and treatments.

Take care of your eye health, and don't hesitate to seek further evaluation if needed. Your vision is important, and addressing these concerns early can lead to better outcomes.

Best wishes for your eye health!

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