Astigmatism Complete Guide

Everything you need to know about astigmatism, symptoms, causes, diagnosis, and how contact lenses can correct it.

What Is Astigmatism?

Astigmatism is a common refractive error that occurs when the front surface of the eye (cornea) or the lens inside the eye has an irregular curve.
Instead of being round like a basketball, it’s shaped more like a football — causing light to focus unevenly on the retina.

This leads to blurry, distorted, or fluctuating vision at both near and far distances.

Astigmatism is extremely common. Most people have at least a mild form, and many don’t know it until they get a detailed eye exam.

Astigmatism Symptoms

Astigmatism affects everyone differently. Some people experience only slight blur, while others have noticeable distortion in everyday activities.

Common symptoms include:

  • Blurred or distorted vision at any distance
  • Trouble focusing on fine detail
  • Eye strain or fatigue
  • Headaches (especially after reading or screen use)
  • Difficulty driving at night
  • Squinting to see more clearly
  • Fluctuating clarity (vision seems to “shift”)

If you notice these regularly, an eye exam is recommended.

What Causes Astigmatism?

Astigmatism happens when the cornea or lens has two different curves instead of one smooth curve.

Common causes:

1. Genetics

Most astigmatism is inherited and present from childhood.

2. Eye shape development

As your eyes grow, curvature can change.

3. Eye trauma or surgery

Injuries can alter the cornea.

4. Keratoconus

A progressive thinning of the cornea that leads to irregular astigmatism.

5. Natural aging

The internal lens may change shape over time.

Astigmatism is not caused by reading in the dark, sitting close to screens, or eye strain — these are myths.

Types of Astigmatism

1. Corneal Astigmatism

The cornea has mismatched curves.
This is the most common type.

2. Lenticular Astigmatism

The lens inside the eye has uneven curvature.
Often age-related.

By Orientation (Axis)

Astigmatism is also classified by axis — the angle of irregular curvature.

With-the-Rule Astigmatism

The eye is steeper vertically (common in younger people).

Against-the-Rule Astigmatism

The eye is steeper horizontally (more common as people age).

Oblique Astigmatism

The steepest curve is at a diagonal angle.

These measurements are important when choosing the correct toric contact lens.

How Astigmatism Is Diagnosed

A comprehensive eye exam includes:

Refraction Test

Determines your prescription.

Keratometry / Topography

Maps the curvature of the cornea.

Visual Acuity Test

Checks clarity at multiple distances.

Your prescription will include a Cylinder (CYL) and Axis value — these indicate astigmatism and how it must be corrected.

Can Contact Lenses Correct Astigmatism?

Yes — astigmatism can be corrected using special contact lenses called toric lenses.

Toric lenses contain different powers in different meridians to match your corneal curvature. They also include stabilization features so the lens stays in the correct orientation.

What Are Toric Contact Lenses?

Toric lenses are custom-shaped to correct uneven focusing. Unlike spherical lenses (used for nearsightedness/farsightedness), toric lenses must remain stable and oriented correctly.

Key features of toric lenses:

  • Multiple curvature zones
  • Weighted stabilization (to prevent rotation)
  • Axis alignment marks
  • Custom fit to your CYL & AXIS

When properly fitted, toric lenses offer clear, consistent vision at all distances.

Types of Toric Lenses for Astigmatism

1. Daily Disposable Toric Lenses

✔ Best for comfort
✔ Best for dry eyes
✔ Best for allergy sufferers
✔ No cleaning required

Examples:
Acuvue Oasys 1-Day Toric, Precision1 Toric, Clariti 1-Day, MyDay Toric

2. Monthly Toric Lenses

✔ Most affordable long-term
✔ Durable
✔ High oxygen options

Examples:
Biofinity Toric, Air Optix for Astigmatism, Ultra for Astigmatism, Acuvue Vita for Astigmatism

3. Extended-Wear Toric Lenses

(Some approved for sleeping — not generally recommended.)
Talk to your eye care professional before using.

How Toric Lenses Stay Stable

Astigmatism requires precise rotational stability, otherwise vision fluctuates when the lens rotates.

Manufacturers use technologies such as:

  • Thin-zone design
  • Prism ballast
  • Lateral pressure zones
  • Precision edge sculpting
  • Blink stabilization

Each brand handles stability differently — which is why some people see better with certain toric lenses than others.

Astigmatism Prescription Explained

A full astigmatism prescription includes:

  • Sphere (SPH) – near/far correction
  • Cylinder (CYL) – intensity of astigmatism
  • Axis – orientation of the curvature
  • Base Curve / Diameter – lens fitting
  • Brand – required for contacts

If, for example your lens prescription reads:
-2.00 / -1.25 × 180

Then this means in detail:
Nearsighted: –2.00
Astigmatism strength: –1.25
Orientation: 180 degrees

Best Contact Lenses for Astigmatism

Different lenses work better for different eyes.

Best for Dry Eyes:

Acuvue Oasys 1-Day Toric
Biofinity Toric

Best Vision Stability:

Precision1 for Astigmatism
MyDay Toric

Best Budget Choice:

Clariti 1-Day Toric
Air Optix for Astigmatism

Best for All-Day Comfort:

Acuvue Oasys 1-Day Toric
Ultra for Astigmatism

 

Astigmatism vs. Other Vision Problems

Myopia (Nearsightedness)

Clear up close, blurry far away.

Hyperopia (Farsightedness)

Clear far away, blurry up close.

Astigmatism

Distortion or blur at all distances.

Astigmatism often exists alongside myopia or hyperopia — this is normal.

Astigmatism in Children

Children may not notice blurred vision.
Signs include:

  • Squinting
  • Getting close to screens
  • Head tilting
  • Eye rubbing
  • Struggling with reading

Early correction can improve comfort, learning, and sports performance.

Can Astigmatism Get Worse?

Yes, but usually slowly.

Astigmatism can increase due to:

  • Eye growth (childhood → adulthood)
  • Eye rubbing (especially allergies)
  • Keratoconus
  • Natural aging

Regular eye exams help track changes.

Treatment Options for Astigmatism

1. Toric Contact Lenses

Most popular and convenient option.

2. Eyeglasses

Simple and effective.

3. LASIK / PRK

Good candidates can have long-term correction.

4. Ortho-K (overnight lenses)

Less common for astigmatism, but available for certain prescriptions.

Frequently Asked Questions

Is astigmatism permanent?

Yes, but the level can change over time.

Can astigmatism be cured naturally?

No — exercises and supplements do not cure astigmatism.

Do I need toric lenses?

If your prescription includes Cylinder (CYL) and Axis, then yes.

Why do my toric lenses rotate?

Incorrect fit, dryness, or blinking pattern. A different brand may work better.

Conclusion 

Astigmatism is extremely common and highly treatable. With modern toric lens technology, most people can enjoy clear, stable, comfortable vision all day.

This guide gives you the foundation you need — now explore our reviews, comparisons, and buying guides to find the best toric lenses for your eyes.