Your Eye Symptoms: Is It Glaucoma or Astigmatism?

Glaucoma or astigmatism?

Hello, Doctor: About three months ago, I started experiencing shadows when looking at objects or text.
Sometimes my eyes feel sore, and I also have pain around the eye socket.
Initially, I thought it might be due to fatigue, but gradually, I found it difficult to open my eyes in the morning.
They feel sore, and my vision is not very clear.
I have to squint slightly to focus on things, but it quickly becomes unclear again.
A month ago, I noticed that even squinting didn't help much, and seeing things became very strenuous.
Therefore, I visited a nearby ophthalmologist.
The doctor conducted a vision test (without refraction) and found my vision to be 0.9 and 1.0 (my previous vision was always 1.0 and 1.2).
He believed it was caused by eye fatigue, but I informed him that this happens as soon as I wake up.
My sleep quality is not bad.
He prescribed eye drops for me, but after using them, my symptoms remained the same.
During my second visit, a refraction test was performed, revealing astigmatism of 75 degrees in one eye and 100 degrees in the other.
The doctor prescribed eye drops again, but the results were still unsatisfactory.
I thought getting glasses might help, and initially, everything was clear when I wore them, but after about ten minutes, the soreness and blurred vision returned.
Later, I went back to the optical shop for another refraction test, and the optometrist said my eyes were too fatigued, causing my focus to fluctuate.
He asked if I had seen a doctor, and I mentioned that I had, but without measuring intraocular pressure.
He suggested that I visit a larger hospital's ophthalmology department.
I am unsure and would like to ask the doctor what this situation might indicate.

gigi, 30~39 year old female. Ask Date: 2006/11/28

Dr. Ke Meilan reply Ophthalmology

Dear g115gigi1,
1.
Please undergo dilation first to obtain an accurate prescription.

2.
Then, proceed with the fitting of your glasses.

3.
Your eyes are too fatigued (all symptoms resemble those of a 40-year-old).

4.
Make sure to look at distant objects more often.

Thank you for your message.
Wishing you a speedy recovery.

Sincerely,
Dr.
Ke Mei-Lan, Ophthalmology Department

Reply Date: 2006/11/28

More Info

Based on your detailed description of your eye symptoms, it appears that you are experiencing a range of visual disturbances that could be attributed to several potential causes, including astigmatism, eye strain, or possibly more serious conditions such as glaucoma.
Firstly, the symptoms you describe, such as seeing shadows or ghosting when looking at objects, eye pain, and difficulty focusing, can indeed be associated with astigmatism. Astigmatism is a common refractive error caused by an irregular curvature of the cornea or lens, leading to blurred or distorted vision. The fact that you have been diagnosed with astigmatism (75 degrees in one eye and 100 degrees in the other) supports this possibility. However, the persistent nature of your symptoms, especially the pain and difficulty in opening your eyes upon waking, suggests that there may be additional factors at play.

Eye strain, often referred to as asthenopia, can occur due to prolonged periods of focusing on tasks such as reading or using screens. Symptoms of eye strain include discomfort, fatigue, and difficulty focusing, which align with your experience of needing to squint to see clearly. While the eye drops prescribed by your doctor may provide temporary relief, they may not address the underlying cause of your discomfort.

Another important consideration is the possibility of glaucoma, a condition characterized by increased intraocular pressure that can lead to optic nerve damage and vision loss. Although you mentioned that your eye pressure has not been measured, it is crucial to have this assessed, especially given your symptoms of pain and visual disturbances. Glaucoma can sometimes present with vague symptoms, and early detection is key to preventing serious complications.

Given that your symptoms have persisted despite treatment and that you are experiencing significant discomfort, I recommend seeking a comprehensive eye examination at a specialized ophthalmology clinic. This examination should include a thorough assessment of your eye pressure, a detailed evaluation of your optic nerve, and possibly imaging studies to rule out any serious conditions.
In the meantime, consider implementing some strategies to reduce eye strain. These may include taking regular breaks during prolonged visual tasks (the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds), ensuring proper lighting while reading or working, and adjusting your screen settings to reduce glare.
If your symptoms continue to be unmanageable, and especially if you find that your vision is deteriorating or if you experience any new symptoms such as flashes of light or sudden vision loss, do not hesitate to seek immediate medical attention.
Lastly, regarding your question about laser eye surgery, it is generally not advisable to pursue such options until your current symptoms are fully evaluated and understood. Laser surgery can be an effective solution for refractive errors, but it is essential to ensure that any underlying conditions are addressed first to avoid complications.

In summary, your symptoms warrant further investigation to determine their cause and appropriate treatment. Please prioritize a visit to an ophthalmologist who can provide a comprehensive evaluation and guide you on the best course of action for your eye health.

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