Astigmatism Progression and Cone Keratoconus Risks - Ophthalmology

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Astigmatism, or the irregular curvature of the cornea or lens, can lead to blurred vision and discomfort. Your experience of increasing astigmatism from 220 degrees at age 16 to 550 and 600 degrees at age 27 is significant and warrants careful monitoring. While astigmatism itself is common, it is important to differentiate it from more severe conditions like keratoconus, which is characterized by a progressive thinning and conical shape of the cornea.

Keratoconus typically presents with symptoms such as increased sensitivity to light, distorted vision, and frequent changes in prescription glasses. The risk factors for developing keratoconus include a family history of the condition, eye rubbing, and certain systemic conditions like Down syndrome or Ehlers-Danlos syndrome. Regular eye examinations, as you are doing, are crucial in monitoring for any signs of keratoconus or other corneal issues.

Your concern about not wearing glasses and squinting to see better is valid. While squinting may temporarily improve focus by changing the shape of the eye, it does not cause keratoconus. However, prolonged squinting can lead to eye strain and discomfort. It is essential to address the discomfort you experience from wearing glasses, as this can lead to avoidance of vision correction, which may further impact your quality of life.

If you are experiencing discomfort from glasses, consider discussing alternative options with your eye care professional. Contact lenses, particularly specialized ones like toric lenses for astigmatism or even scleral lenses, may provide better comfort and vision correction. Additionally, refractive surgery options, such as LASIK or PRK, may be suitable for some individuals with astigmatism, depending on the thickness and health of the cornea.

It is also important to maintain regular follow-ups with your eye doctor to monitor the progression of your astigmatism and to check for any early signs of keratoconus. They may perform tests such as corneal topography, which provides a detailed map of the cornea's surface, helping to detect any irregularities early on.

In summary, while your increasing astigmatism is concerning, not wearing glasses does not directly cause keratoconus. However, it is crucial to continue monitoring your eye health and to seek comfortable vision correction options. Regular check-ups will help ensure that any potential issues are caught early, allowing for timely intervention if necessary. Always consult with your eye care professional regarding any changes in your vision or discomfort you may experience.