Astigmatism - different types

This is part of an ongoing saga since January 08 when I had a Toric lens implanted following cataract surgery.  The story is that 3 surgeons have since told me that I was not a candidate for the toric lens that was implanted because my astigmatism was too low.  As a result my astigmatism is now more than it was and the axis was rotated by 90 degrees.  

My other eye also has a low astigmatism and a very mild cataract which I am not going to have removed until more options for IOLs appear on the market and I can mentally and emotionally deal with trusting to have surgery again - certainly by a different surgeon.  

One thing I'm left with is what is called against-the-rule astigmatism in one eye and with-the-rule astigmatism in the other.  Does this have a name? - having opposing astigmatisms?  Is it common?  What would be the visual symptoms?

Also as an update, all 3 surgieons have said that the risk of having an explant of a Toric lens outweighs the hoped for benefits.  Some issues are getting better - especially the positive and negative dysphotopsias.  That was truly miserable.  For this I am grateful  Next comes the solutions for ballancing both eyes. One symptom - what I describe as a wet unreal look, improves when eyes are balanced by glasses.  Interesting.

Of all this, having these two different types of astigmatism is what I hope to have responses to.

Laura4

[John C Hagan III, MD, FACS, FAAO]

Astigmatism means not spherical  ie not round. In against the rule astigmatism the eye has a steeper curveatur horizontally while in with the rule the steepest radius of curvature is verytical.'

With the rule   football laying on its sides
Agains the rule football standing up (like for kickoff)

JCH III MD

[Laura4]

Thank you, Dr. Hagan - the football analogy helps.  And what would vision be like for someone with one of each?

I have had 2 very different prescriptions - both opthamologists - neither was the original surgeon.  I've never had a prescription for glasses so all of this is new to me.  I did not think it was possible to have such different approaches.

This first has helped me with the wet unreal look and distance vision is great - like perfect in left Toric eye.  Other eye has not had surgery.  The goal of this opthamologist was to bring my Toric eye back to match my right eye.  In other words, what it was before I had the Toric implanted.  He said this was a beginning step.

OD   Plano
OS   -0.75    +1.00    165
Add   2.25

Here's the other - I think it's a different attempt to improve distance vision in right eye and left and to match both eyes.  How could one is the OS be a +1.00 and the other prescription be a -1.00???  

OD  +0.50    -0.75 x 155
OS  +0,25    -1.00 x 95
Add 2.50


Laura4

[Laura4]

Forgot to mention that my astigmatism before the Toric implant was .80.  It's now 1.00 and the axis was rotated 90 degrees.  I have the SN60T3 with lowest power of 1.50.


I haven't haven't filled the 2nd prescription

Laura4

[JodieJ]

I recall reading about problems with against-the-rule astigmatism when laser vision correction (e.g., LASIK) goes wrong.  I believe the symptoms include halos, starbursts and glare.  There is sometimes improvement over time.

Ophthalmologists use a + sign for astigmatism.  Optometrists use a minus sign.  Although your scripts look very different, they are nearly identical.

It sounds like you've found some good doctors.  Hope you see improvement in your vision.

[John C Hagan III, MD, FACS, FAAO]

plus cylinder   is like pounds
minus cylinder is like kilograms.

They look different but they are both satisfactory.


Your left eye in plus cylinder is
-0.75 + 1.00 axis 5 degrees  

and there isn't much difference between the two.

JCH III MD