What Causes Astigmatism To Worsen?

Astigmatism is a common vision problem caused by an irregularly shaped cornea or lens. For most people, it stays fairly stable over time. But in some cases, it does get worse. The main causes of worsening astigmatism are normal aging, certain eye conditions, and sometimes surgery or injury. Understanding why it changes can help you know when to see an eye doctor and what to expect.

What Is Astigmatism and How Does It Progress?

Astigmatism happens when the front surface of your eye, the cornea, is shaped more like a football than a basketball. Light entering the eye bends unevenly. That causes blur at both near and far distances.

Most people have some degree of astigmatism, even if they do not notice it. Small amounts may not need correction. Larger amounts cause clear symptoms like eyestrain, headaches, and blurry vision.

Astigmatism can change slowly over time. It can also change quickly in certain situations. The progression depends on the underlying cause. Some causes are normal parts of aging. Others are medical conditions that need attention.

What Causes Astigmatism To Worsen?

The most common reason astigmatism worsens is the natural aging process. The cornea and lens change shape and flexibility as you get older. These changes can increase the amount of astigmatism you have.

Another common cause is a condition called keratoconus. In keratoconus, the cornea thins and bulges outward into a cone shape. This causes astigmatism to increase significantly over time. Keratoconus usually starts in the teenage years or early adulthood and can progress for a decade or more.

Eye surgery can also change astigmatism. Cataract surgery, corneal transplants, and some laser vision correction procedures can alter the shape of the cornea. In many cases, surgeons plan for this and can reduce astigmatism during the procedure. But sometimes astigmatism gets worse after surgery.

Injury to the eye is another cause. A scar on the cornea from a scratch, a foreign object, or trauma can change how light enters the eye. That scar can create or increase astigmatism.

Can Eye Rubbing Make Astigmatism Worse?

Yes, especially if you have keratoconus or a family history of it. Vigorous eye rubbing puts physical pressure on the cornea. Over time, that pressure can contribute to the cornea thinning and bulging.

Research has linked chronic eye rubbing to the progression of keratoconus. Some studies suggest that stopping eye rubbing can slow the condition’s advance. If you rub your eyes frequently due to allergies or dry eyes, treating those underlying issues may help protect your corneas.

For people without keratoconus, occasional eye rubbing is unlikely to cause permanent changes. But if you notice your vision getting worse and you rub your eyes often, it is worth discussing with an eye doctor.

Does Pregnancy Affect Astigmatism?

Pregnancy can cause temporary changes in vision, including increased astigmatism. Hormonal shifts affect fluid retention throughout the body, including in the cornea. The cornea can swell slightly and change shape.

These changes are usually temporary. Vision often returns to its pre-pregnancy state within weeks or months after delivery. However, some women find their prescription changes permanently after pregnancy.

If you are pregnant and notice vision changes, tell your obstetrician and eye doctor. Most changes are harmless, but sudden vision changes can sometimes signal conditions like preeclampsia or gestational diabetes that need medical attention.

What Are the Symptoms of Worsening Astigmatism?

You might not notice gradual changes right away. But as astigmatism worsens, symptoms become harder to ignore.

• Blurry or distorted vision at all distances
• Increased eyestrain, especially after reading or screen time
• Frequent headaches
• Squinting to see clearly
• Difficulty seeing at night, especially while driving
• Double vision in one eye

If you already wear glasses or contacts, you may find yourself needing a stronger prescription more often. A sudden or rapid change in your prescription is a reason to see an eye doctor promptly.

When Should You See an Eye Doctor?

Adults should have a comprehensive eye exam every one to two years. If you have a condition like keratoconus or have had eye surgery, your doctor may recommend more frequent visits.

See an eye doctor sooner if you notice any of these signs:

• Vision that worsens over weeks or months
• Sudden vision loss
• Eye pain or redness
• Flashes of light or new floaters
• A curtain or shadow over your vision

These symptoms can indicate conditions more serious than astigmatism, including retinal detachment or glaucoma. Do not wait for a scheduled appointment if you experience any of them.

Can Worsening Astigmatism Be Treated or Slowed?

Treatment depends on the cause. For age-related changes, new glasses or contact lenses usually restore clear vision. There is no way to stop the natural aging process, but regular exams keep your prescription current.

For keratoconus, treatment aims to slow progression. A procedure called corneal collagen cross-linking can strengthen the cornea and reduce further bulging. It is the only treatment shown to actually halt keratoconus progression. Specialized contact lenses, such as scleral lenses, can improve vision in advanced cases.

For people with cataracts, cataract surgery can correct astigmatism at the same time. Toric intraocular lenses are designed to address both cataract and astigmatism. Your eye surgeon can discuss whether you are a candidate.

Laser vision correction, such as LASIK or PRK, can treat mild to moderate astigmatism. However, these procedures are not right for everyone. People with keratoconus or thin corneas are generally not good candidates. Your eye doctor will do a thorough evaluation before recommending any surgical option.

Does Screen Time Make Astigmatism Worse?

No. Screen time does not cause astigmatism or make it worse. This is a common myth.

What screens do cause is digital eyestrain. Staring at a screen for hours can make your eyes feel tired and your vision seem blurry. But this is a temporary effect of eye fatigue, not a change in the shape of your cornea.

If your astigmatism is uncorrected or undercorrected, screens can make symptoms feel more noticeable. The fix is proper vision correction, not reducing screen time. That said, taking regular breaks using the 20-20-20 rule — look at something 20 feet away for 20 seconds every 20 minutes — can reduce eyestrain.

Can Diet or Supplements Prevent Worsening Astigmatism?

No. No diet, vitamin, or supplement can change the shape of your cornea or lens. Astigmatism is a structural issue, not a nutritional one.

Some nutrients, like vitamin A, lutein, and zeaxanthin, support overall eye health. They may help protect against age-related conditions like macular degeneration. But they will not prevent or reverse astigmatism.

Be wary of products claiming to cure astigmatism with eye exercises, supplements, or special diets. No clinical evidence supports these claims. The only proven ways to manage astigmatism are corrective lenses, contact lenses, or surgery.

Is Worsening Astigmatism Ever a Sign of Something Serious?

Sometimes. A rapid increase in astigmatism can be a sign of keratoconus, especially in younger people. It can also indicate a cataract forming, particularly in older adults.

In rare cases, an irregular cornea can be a sign of a systemic condition. Certain connective tissue disorders, like Marfan syndrome or Ehlers-Danlos syndrome, can affect the eye’s structure. If your eye doctor sees unusual changes, they may refer you to a specialist for further evaluation.

More often, worsening astigmatism is simply part of aging or a natural change in your eye’s shape. But because serious conditions can present this way, it is important to have regular eye exams. Your eye doctor can tell the difference between normal changes and ones that need treatment.