1. astigmatism

2. Astigmatism is a type of refractive error wherein the refraction varies in the different meridian.
Astigmatism is a defect in which light
entering the eye is unable to be brought to
a single focus on retina resulting in blurred
vision at all distances.

3. It simply means that there is a variation
and disturbance in the shape of the
cornea or lens. It is usually due to an –
*Irregularly shaped cornea
* Scarring of the cornea
*Abnormities in the crystalline lens

4. **Some eyes conditions are seen along with astigmatism as
Nystagmus
Cataract
Ptosis
Retinitis pigmentosa
Albinism
Inflammation
degeneration

5. Symptoms:-
Eye strain
discomfort
headache
dry eye
sensitivity to light
Blurred vision

6. classification

8. Type of astigmatism :-
there are two type of astigmatism:-
Regular astigmatism
Irregular astigmatism

9. Regular astigmatism
The astigmatism is regular when the refractive power changes uniformly from one meridian to another

10. A etiology :-
Corneal astigmatism
Lenticular astigmatism
Retinal astigmatism

11. corneal astigmatism
it is the result of abnormality of curvature of cornea
It is usually congenital
acquired corneal astigmatism is often irregular

12. Causes Congenital curvature astigmatism Keratoconous
Trauma to the cornea or lens
After cataract operation

13. Lenticular astigmatism
Mainly due to
*congenital abnormality of lens
*refractive index of lens
*congenital or traumatic subluxation of the lens

14. Retinal astigmatism *Due to oblique placement of macula
* It can be corrected by visual aid

15. type of regular astigmatism It is subdivided into four type ;–
With-the-rule astigmatism
Against-the-rule astigmatism
Oblique astigmatism
bi-oblique astigmatism

16. With-the-rule astigmatism:
Refractive power of the vertical meridian is greatest
.The vertical meridian is steepest than horizontal meridian.
Eyes see vertical lines more sharply than horizontal lines.
Requires concave cylinders at 180+ /-20
Or convex cylinders at 90+/-20 degrees

17. Against-the-rule astigmatism:
the refractive power of horizontal meridian is greatest than vertical meridian.
Horizontal meridian is steepest than vertical meridian.
Eyes see horizontal lines more sharply than vertical lines.
Requires concave cylinders at 90 +/-20degrees
Or convex cylinders at 180+/-20 degrees.

18. Oblique astigmatism:
In which the two principle meridians lies somewhere between the axis defining either with-the-rule or against-the-rule astigmatism.
Complementary (45 in one meridian,135 in other meridian)

19. Bi –oblique astigmatism
Principle meridian are not at right angle
One at 30 , other at 100

20. optics of regular astigmatism

21. Light entering the eye cannot converge to a point focus but form focal lines
Configuration of rays refracted from the astigmatic surface –( sturms conoid) .
Lens with cylinder produces an astigmatic focus .this astigmatic focus contains vertical line ,corresponding to the focus of the horizontal principal meridian .and horizontal focal line corresponding to the focus of the vertical principal meridian .

22. The region between these two lines is known as the conoid of sturm .
At the dioptric mid –point between these two focal line , the astigmatic focus forms a circular patch known as circle of least confusion

23. refractive type of regular astigmatism

24. a. Simple hypermetropia astigmatism
When refracted rays from one meridian takes focus on the retina and refracted rays from other meridian takes focus behind the retina.

25. b)Simple myopic astigmatism
When refracted rays from one meridian takes focus on the retina and refracted rays from other meridian takes focus in front of retina.

26. c) Compound hypermetropic astigmatism:
In this condition of astigmatism refracted rays from both meridians take focus behind the retina.

27. d) Compound myopic astigmatism:
In this condition of astigmatism refracted rays from both meridians take focus in front of retina.
e) Mixed astigmatism: When refracted rays from one meridian take focus in front of retina and refracted rays from other meridian take focus behind the retina.

28. b) Irregular astigmatism:
Irregular differences in curvature or refractive index of the optic components or misalignment of any optical component may lead to irregularity.
It is often the result of trauma,
pterygium,
corneal scars,
and complication of refractive surgery.
Another not uncommon condition is conical cornea (keratoconous)

29. Diagnostic Objectively: With the help of retinoscopy Autorefractometer
Keratometer
Corneal topography
Subjectively:
By Jackson’s cross cylinder
By astigmatic fan
By stenopaeic slit

30. management CONSERVATIVE MANAGEMENT: Prescription eye wear
Spherical soft contact lenses
Spherical RGP contact lenses
Toric soft contact lenses

31. SURGICAL MANAGEMENT Conventional LASIK Astigmatic Keratotomy
Photorefractive Keratectomy
PAI LASIK
LASEK
Orthokeratology
Phakic Intraocular Lens(PIOL)

32. Physiological astigmatism
Almost all have minor degree of astigmatism {physiological }
Diameter of cornea in vertical axis is 11.5mm and in horizontal meridian is 12mm.
This means horizontal meridian is flatter than vertical.
Because diameter is inversely proportional to curvature.

33. Occur as lid press on anterior corneal surface.
Make vertical meridian steeper
Only small astigmatic error
Usually 0.12D
NO TREATMENT REQUIRED,

34. thank you have a nice day &
life is an echo ,all comes back ,the good ,the bad, the false and the true ,
so give the world the best u have and the best will come back to u .
thank you
have a nice day &

35. For Further Queries Contact :
Ms. Priyanka Singh
Head – Optometry Service –