Worsening Astigmatism: Symptoms and Solutions - Ophthalmology

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Astigmatism is a common refractive error that occurs when the cornea or lens of the eye is irregularly shaped, leading to blurred or distorted vision. Your description of experiencing halos around lights, rainbow-like effects, and increased light scattering at night suggests that your astigmatism may be worsening. These symptoms can indeed be attributed to astigmatism, especially when they manifest predominantly in low-light conditions.


Symptoms of Worsening Astigmatism
1. Halos and Glare: The halos you see around lights, particularly at night, are a classic symptom of astigmatism. This occurs because the light rays entering your eye are not focused evenly, causing a scattering effect that creates a halo or glare around bright objects.

2. Increased Light Sensitivity: As astigmatism worsens, you may find that your eyes become more sensitive to bright lights, leading to discomfort and difficulty seeing clearly in bright conditions.

3. Distorted Vision: The "stabbing" sensation you describe, where light sources appear to have spikes or rays, is also associated with astigmatism. This distortion can make it challenging to drive at night or navigate in poorly lit environments.

4. Floaters: The presence of floaters, or "flying spots," in your vision can be unrelated to astigmatism but may indicate other underlying issues, especially if they are new or increasing in number.


Potential Causes of Worsening Symptoms
1. Contact Lens Fit: You mentioned wearing orthokeratology lenses (corneal reshaping lenses). If these lenses are not fitting properly, they can exacerbate astigmatism or cause other vision issues. An improper fit can lead to uneven pressure on the cornea, which may worsen your refractive error.

2. Changes in Eye Shape: The shape of your cornea can change over time due to various factors, including age, eye conditions, or even the use of certain contact lenses. This can lead to an increase in astigmatism.

3. Underlying Eye Conditions: Conditions such as keratoconus, where the cornea thins and bulges, can also lead to worsening astigmatism. Regular eye exams are crucial to monitor for such changes.


Solutions and Management
1. Regular Eye Exams: It's essential to have regular check-ups with an eye care professional. They can assess the degree of your astigmatism and determine if your current lenses are suitable or if a different prescription is needed.

2. Lens Adjustment: If your orthokeratology lenses are contributing to your symptoms, your eye care provider may recommend adjustments or a different type of lens altogether. Sometimes, switching to glasses or different contact lenses can alleviate symptoms.

3. Corrective Surgery: In some cases, if astigmatism is severe and unresponsive to corrective lenses, surgical options such as LASIK or PRK may be considered. These procedures can reshape the cornea to correct refractive errors.

4. Managing Light Sensitivity: Wearing anti-reflective glasses or lenses can help reduce glare and halos. Additionally, using sunglasses with polarized lenses during the day can help manage light sensitivity.

5. Addressing Floaters: If floaters become bothersome or increase significantly, it’s important to consult an eye care professional. While many floaters are harmless, sudden changes in their appearance can indicate more serious conditions that require attention.


Conclusion
The symptoms you are experiencing are likely related to worsening astigmatism, and it is crucial to address them with an eye care professional. They can provide a comprehensive evaluation and recommend appropriate solutions tailored to your specific needs. Regular monitoring and adjustments to your corrective lenses can significantly improve your visual comfort and quality of life, especially during nighttime activities.