Refractive Astigmatism: Vision Distortion and Laser Eye Surgery
- The Straits Eye Centre
- Sep 20
- 3 min read
Introduction: Blurred Vision at Any Distance
Unlike myopia (short-sightedness) or hyperopia (long-sightedness), astigmatism affects vision both near and far. It occurs when the cornea or lens has an irregular curvature, preventing light from focusing evenly on the retina. The result: vision that is distorted or blurred at all distances.
In Singapore, refractive astigmatism is increasingly managed through both non-surgical and surgical methods, including glasses, contact lenses, and laser eye surgeries like SMILE, PRK, and ICL.
What Is Refractive Astigmatism?
Refractive astigmatism refers to blurred or distorted vision due to irregular light refraction by the eye’s cornea or lens. Unlike pathological causes (such as keratoconus), refractive astigmatism is correctable with optical aids or refractive procedures.
Causes and Risk Factors
Irregular curvature of the cornea or lens.
Genetic predisposition.
Often present from birth.
Can occur alongside myopia or hyperopia.
May increase with age or after eye surgery.
Symptoms of Refractive Astigmatism
Blurred or distorted vision at all distances.
Squinting or eye strain, especially when reading.
Headaches after prolonged near work.
Difficulty seeing clearly at night.
Complications if Untreated
Chronic eye strain and discomfort.
Reduced academic or work performance.
Increased risk of amblyopia (lazy eye) in children if left uncorrected.
Diagnosis
Visual acuity test to measure clarity.
Keratometry to assess corneal curvature.
Corneal topography for detailed mapping.
Refraction test to determine lens prescription.
Correction and Treatment Options
Spectacles
Cylindrical lenses to correct uneven focusing.
Easy, safe, and widely accessible.
Contact Lenses
Toric lenses designed for astigmatism.
Provide clearer peripheral vision compared to glasses.
Refractive Surgery
For adults with stable prescriptions:
SMILE: Minimally invasive laser procedure, effective for low-to-moderate astigmatism.
PRK: Surface-based laser reshaping, suitable for thinner corneas.
ICL: Implantable lenses for higher degrees of astigmatism or unsuitable corneas.
Lifestyle and Prevention
Regular eye screenings to monitor progression.
Reduce eye strain by following the 20-20-20 rule during screen time.
Early correction in children to prevent amblyopia.
Frequently Asked Questions
1. Can astigmatism worsen over time?
Yes. It can progress, especially with age or after eye trauma. Regular monitoring is essential.
2. Is laser surgery safe for astigmatism?
Yes. Procedures like SMILE and PRK are safe and effective for correcting refractive astigmatism in suitable candidates.
3. What is the difference between regular and irregular astigmatism?
Regular astigmatism involves uniform corneal curvature, while irregular astigmatism (e.g., keratoconus) is more complex and harder to correct with glasses alone.
4. Can children have astigmatism?
Yes. Many children are born with it. Early detection prevents learning difficulties and amblyopia.
5. Is astigmatism the same as myopia or hyperopia?
No. Myopia and hyperopia affect distance or near vision specifically, while astigmatism blurs vision at all distances.
6. Are toric contact lenses comfortable?
Yes, though proper fitting is important. Some patients may take time to adapt.
7. Who is suitable for refractive surgery?
Adults with stable prescriptions, healthy corneas, and no contraindications such as severe dry eye or keratoconus.
8. How often should I check my eyes if I have astigmatism?
At least once a year, or sooner if you notice worsening vision or new symptoms.
Meet Our Specialists
At The Straits Eye Centre, your vision care is in the hands of a dedicated team of experienced ophthalmologists. Each of our doctors brings unique expertise and a shared commitment to delivering thorough, patient-focused care for all ages. Whether you need advanced cataract surgery, paediatric eye management, or treatment for complex eye conditions, our team works together to provide the same attentive care we would want for our own families.
Dr Jayant V Iyer
Senior Consultant Eye Surgeon
Special interest: Cataract, Glaucoma, General Ophthalmology With specialist training in Singapore and the UK, Dr Jayant V Iyer has served as Head of Department at Sengkang General Hospital and Senior Consultant at Tan Tock Seng Hospital. He is committed to delivering safe, precise surgical care with clear communication at every stage.
Dr Jason Lee
Senior Consultant & Medical Director
Special interest: Oculoplastics, General Ophthalmology, Myopia, Cataract, Diabetic Retinopathy Dr Jason Lee has extensive training in eyelid, orbital, and tear system surgery, with fellowships completed in Taiwan and China. Previously a Senior Consultant at Khoo Teck Puat Hospital, he co-founded The Vision Mission, a non-profit bringing sustainable eye care to communities in Asia.
Cost, Medisave, and Insurance
Many procedures at The Straits Eye Centre are eligible for Medisave claims under MOH guidelines, and certain insurance plans may cover part or all of your treatment costs. Our patient care team will guide you through eligibility, claim limits, and paperwork, so you can focus on your recovery. For more details, refer to our Medisave & Insurance Guide.
Secure Your Appointment at The Straits Eye Centre
at Parkway East Hospital
Your vision health deserves timely and professional attention. Book your appointment now at our Parkway East Hospital clinic and take the first step towards clearer, healthier sight.
