ASTIGMATISM

Nishita afrin
ICO
B.OPTOM
What is Astigmatism ?
O one type of refractive error ,where
in refraction varies in different
meridian

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O For example, the image may be
focused on the retina in the
horizontal (sagittal )plane,but not
on the retina in the vertical plane
O Most Astigmatic cornea have two
curves,one is steeper and another
oner a flatter curve
OPTICS OF ASTIGMATISM
O In Astigmatism , the rays of light
from one sector fall on one point and
rays from aanother sector fall on
another point.
O The configuration of rays refracted
through the Astigmatic surface (toric
surface) is called sturms conoid
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INCIDENCE
O No eye is perfectly stigmatic ,
almost all individuals have a minor
degree of physiological Astigmatism
O About 60 % cases of refractive
error have Astigmatism which
needs to be corrected

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O Occurs with equal frequency in males and
female
O Approximate distributation recording to
degree of Astigmatism
0.25 - 0.50 50%
0.75 - 1.0 25%
1.00 4.00 24 %
> 4.00 1%

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O One study report as
WTR 38%
ATR 30%
Oblique 32%
SEVERITY OF
ASTIGMATISM
O Classified as follows
Mild Astigmatism <1 D
Moderate Astigmatism 1.00 to
2.00 D
Severe Astigmatism 2.00 to 3.00 D
Extreme Astigmatism >3.00 D
CLASSIFICATION
O Regular Astigmatism



O Irregular Astigmatism
REGULAR ASTIGMATISM
Aeitiology -

1. Corneal Astigmatism
2. Lenticular Astigmatism
Curvatural, Positional,
Index
3. Retinal Astigmatism

TYPES OF REGULAR
ASTIGMATISM
O With the rule Astigmatism
O Against the Astigmatism
O Oblique Astigmatism
O Bi-oblique Astigmatism
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REFRACTIVE TYPES OF
ASTIGMATISM
O Simple Astigmatism simple
myopic,simple hyperopic
astigmatism
O Compound Astigmatism
compound myopic,compound
hyperopic astigmatism
O Mixed Astigmatism
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SYMMETRIC ASTIGMATISM
O Regular Astigmatism
O principal meridian of each eye
have similar but opposite axes
O which together add upto 18015
SYMPTOMS OF REGULAR
ASTIGMATISM
O DISTORTION OR BLURRING
OF VISION
O ASTHENOPIC SYMPTOM
O TILTING OF HEAD
O SQUINTING OF EYE
O READING MATERIAL MAY BE
HELD CLOSE TO EYES
O BURNING AND ITCHING
SENSATION
IRREGULAR ASTIGMATISM
O IRREGULAR CHANGE IN
REFRACTIVE POWER IN
DIFFERENT MERIDIAN
O AEITIOLOGICAL TYPE
Corneal irregular Astigmatism
Lenticular irregular Astigmatism
Retinal irregular Astigmatism
SYMPTOMS OF IRREGULAR
ASTIGMATISM
O DEFECTIVE VISION
O IMAGE DISTORTION
O POLYOPIA
RESIDUAL ASTIGMATISM
O The largest element of the Astigmatism is due
to anterior corneal surface
O While the other components like
Posterior corneal surface
Lens
Refractive indices
Constitute the residual Astigmatism
RESIDUAL ASTIGMATISM = TOTAL
CORNEAL ASTIGMATISM
INVESTIGATION OF
ASTIGMATISM
I. VA with and without correction
monocularly
II. Retinoscopy
III. keratometry
IV. keratometry with placido disc
V. computerized corneal
topography
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O SUBJECTIVE REFRACTION
I. Jacson cross cylinder
II. Astigmatic fan and block
technique
III. stenopic slit
IV. trial and error technique
TREATMENT
1. OPTICAL-
SPECTACLES
CONTACT LENS
2. SURGICAL
LASER
LASIK
3. KERATOPLASTY