Astigmatism is a condition where the light entering the eye does not come to a single sharp focal point. Instead, the light focuses as a "smear" across a region of the eye. The result is blurred vision.
Astigmatism is usually due to a cornea that is ovalled like the side of a football, rather than round like a baseball. But it can also be caused by abnormalities in the lens of the eye.
Astigmatism can be corrected by glasses. It can also be corrected by special soft contact lenses called "toric" lenses, or by rigid contact lenses. These methods do not do away with the astigmatism, but only mask it. When the glasses come off, or the contacts come out, the astigmatism is there again.
Astigmatism, however, can often be treated surgically. LASIK, a laser procedure, can treat astigmatism with precision. LASIK is often used for astigmatism when it is also accompanied by nearsightedness or farsightedness.
There are, however, other ways to treat astigmatism. During cataract surgery a special implant, called a toric implant, may be used. These lenses cost extra, over and above the insurance coverage, but afterwards do help one see at distance better without glasses.
Another non-laser procedure is called a "limbal relaxing incision (LRI)." Like LASIK, this procedure is on the cornea, but whereas LASIK treats the center of the cornea, the LRI treats the peripheral cornea. One or two partial thickness incisions are made (painlessly) to relax the tight fibers of the cornea that are causing the astigmatism. This can be done in the office. It can also be done at the time of cataract surgery, as an adjunct.
The LRI can occasionally be used instead of LASIK to treat patients who have astigmatism only. It can also be used to reduce astigmatism in nearsighted patients who have difficulty with toric contacts and want spherical contacts.
The LRI procedure is well tolerated, has a quick recovery, and is much less expensive than LASIK. It costs about the same as a fancy pair of glasses.