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Does an Astigmatism lessen as you get older - I'm about to do LASIK for it...

Does an Astigmatism lessen as you get older - I'm about to do LASIK for it...

Does Astigmatism get better (less) as you get older?  My eye doctor says it does, and when I try to find some info on the internet, the only 'source' there says it doesn't. This will be important because I have been wanting LASIK surgery for many years (I'm too lazy for contacts and I tend to lose/ruin my glasses).  And my eye doctor says if I get the surgery, my astigmatism will be corrected, but then because it normally gets better on its own as you age, it will actually go the other direction and get worse. I'm 33 years old, my eyesight problem is mostly the astigmatism  OD: -0.25-1.25x174  OS:-0.25-1.50x174.  Thanks! Liz
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Avatar_n_tn
great question!  the answer is yes...and no.  the short version is that there are multiple types of astigmatism, and it depends on which type you are talking about.

CORNEAL (surface) astigmatism will never change, barring injury, surgery or a disease process.  thats what your internet "source" is talking about.  a person is born with a certain corneal shape and thats the shape they will always have.

but LENTICULAR can and does change with lens shape changes or refractive (density) changes.  cataracts and lenticular opacification are the most common causes of lenticular shape change, but other causes could be medications, systemic diseases like diabetes, and others.  it is generally accepted that most people will lose "with-the-rule" (WTR) or horizontally oriented lenticular astigmatism with age and lens changes, and they will gain "against-the-rule" (ATR) or vertically oriented lenticular astigmatism.  you have "with-the-rule" astigmatism, so you will likely LOSE some of your astigmatism with age if you follow the percentages.  

so i really have to answer the question with a question:  what type of astigmatism do you have?  corneal or lenticular?  

lets go thru some quick scenarios:

1) you have corneal or lenticular astigmatism and you get lasik.  the lasik would work great.  later your lens gains ATR astigmatism...you would likely be back to wearing glasses or having more surgery

2) you have corneal or lenticular astigmatism and get lasik.  you do not later have significant lens changes.  you would not need glasses or more laser.

3) you have corneal astigmatism and you do not get lasik.  later your lens gains ATR astigmatism which offsets your corneal astigmatism.  you MIGHT just luck out and naturally not need glasses.

by those scenarios it would sem like it wouldnt matter which type you have...EXCEPT that lenticular astigmatism is unlikely to change from WTR.

so its really a **** shoot.  you could do nothing and get lucky by having lens changes that offset your current rx, or you could get laser and get lucky by not having lens changes, or you could get laser and get unlucky and have lens changes.

but!  you're 33.  most lens changes occur in a person's 50's!  so you'd have maybe 20 years of little or no astigmatism if you had lasik.

remember that lasik will NOT keep you from needing readin correction no matter what.  you will need reading glasses or reading surgery or reading contacts no matter what happens with your lasik at age 33.  thats a totally different process...
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Avatar_n_tn
Thanks - your thorough and understandable answer was well worth the effort to get it!  Can't wait to get LASIK!!
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