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How to treat high astigmatism?

Answered by: Rishi Mohan
Consultant Eye Surgeon
Apollo Hospital
New Delhi

Q. Recently I got my new number which is a nominal increase. But after making new glasses I am seeing, especially letters, with double effect. I again went to the doctor & this time he checked my eyes with some electronic machine and he said that I have high cylinders. The specifications are as follows: Right eye-D.Sph: -3.0 D; Cyl: -0.75; Axis: 20. Left eye- D.Sph: -3.0 D.; Cyl: -1.5; Axis: 160. The new number, especially the cylinders, are Right eye- D.Sph: -3.0; D.Cyl: -4.0; Axis: 10. Left eye- D.Sph: -3.0 D.; Cyl: -3.5; Axis: 175. The problem is that the doctor said there is no point in giving high cylinders to patients. So now I am in a dilemma - should I go for new numbers or not? I feel the doctor is not confident. Please advise.

A.  The patient seems to have high astigmatism (compound myopic astigmatism). The dictum in prescription is to usually prescribe the full cylinder power. However, patient comfort has to be kept in mind & some vision may be compromised. The patient should also be evaluated with cycloplegic refraction and to rule out Keratoconus (a corneal disease with progressive thinning & increase in cylinder power).

A.  The patient seems to have high astigmatism (compound myopic astigmatism). The dictum in prescription is to usually prescribe the full cylinder power. However, patient comfort has to be kept in mind & some vision may be compromised. The patient should also be evaluated with cycloplegic refraction and to rule out Keratoconus (a corneal disease with progressive thinning & increase in cylinder power).

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