Astigmatism Increase and Its Link to Keratoconus - Ophthalmology

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Astigmatism is a common refractive error that occurs when the cornea or lens of the eye has an irregular shape, causing blurred or distorted vision. It can be present at birth or develop over time. The increase in astigmatism, especially in your case, raises some important considerations, particularly regarding the potential link to keratoconus.

Keratoconus is a progressive eye disease where the cornea thins and bulges into a cone-like shape, leading to significant visual impairment. It often manifests in the late teens to early twenties but can occur later in life. One of the hallmark signs of keratoconus is an increase in astigmatism, which can be more pronounced than the increase in myopia (nearsightedness).
In your situation, the increase in astigmatism by 50 to 100 degrees over three years, while the myopia has only increased slightly, is noteworthy. While it is not uncommon for astigmatism to fluctuate, a significant increase, especially if accompanied by symptoms like blurred vision and eye fatigue, warrants further investigation.
At the age of 30, while it is less common for keratoconus to develop, it is not impossible. The condition can progress at different rates for different individuals, and some may experience changes later in life. The symptoms you describe—blurry vision and eye fatigue—are indeed consistent with both astigmatism and keratoconus.
To determine whether you should be concerned about keratoconus, consider the following:
1. Visual Symptoms: If you notice significant changes in your vision, such as increased blurriness, difficulty seeing at night, or frequent changes in your prescription, these could be signs of keratoconus.

2. Corneal Shape Changes: An eye care professional can perform a corneal topography test, which maps the surface curvature of your cornea. This test can help identify irregularities that may indicate keratoconus.

3. Family History: If you have a family history of keratoconus or other corneal diseases, this may increase your risk.

4. Regular Eye Exams: It’s crucial to have regular eye examinations, especially if you notice changes in your vision. Your eye care provider can monitor your condition and recommend appropriate interventions if necessary.

5. When to Seek Further Evaluation: If your astigmatism continues to increase significantly (e.g., more than 1 diopter per year) or if you develop new symptoms such as halos around lights, increased sensitivity to light, or sudden changes in vision, you should seek further evaluation.

In summary, while an increase in astigmatism can occur for various reasons, the degree of increase you are experiencing, combined with your symptoms, suggests that a thorough evaluation by an eye care professional is warranted. They can assess your corneal health and determine if keratoconus or another condition is present. Early detection and management are key to preserving vision and preventing further complications.