trouble with low grade astigmatism

[pranay27]

hi i am a 24 year old male MBBS doctor.i was first prescribed glasses in 2006 when i was given a power of -.0.25 at 180 deg in the left eye and -0.5 at 10 deg to which i got comfortable easily and all the problems(headache and asthenopia) vanished.this continued for 6 months after which i noticed these symptoms again and then  since i am not comfortabe.i was told by the optometrist that my axis had changed new number being -0.25 at 160 deg in left eye and -0.5 at 180 deg.i have had multiple consultations most of which give me different numbers without much improvement.i have also seen the autorefractrometer report which constantly shows -.25 at 165 deg and -.5 at 5 deg.i have worn glasses with a varying axis that ranging from 155 deg to 170 deg in the left eye and 180 deg to 10 deg in the right eye.WITH POWERS TO UPTO -.5 in the left eye and -.75 in the right eye.
i am unable to study much with my glasses as my eye start becoming heavier and i get a headache which starts with eye ache.i have had this problem now for one and a half year and am getting depressed as i cannot prepare much for further studies.i wanted to know whether an axis of 5 deg is sufficient enough to make a headache.what should i do now to get out of this problem. PLEASE HELP ME.

[pranay27]

thanks sir for your helping reply.i thought no one would be able to understand the problem.i read our reply and was gathering knowledge about refraction testing and was wondering if i should go in for cycloplegic refraction and cycloplegic auto refraction.please tell me if they will be of any use with my problem.and also if there's something i can do to get my problem solved as early as possible.

[Michael J Kutryb, MD]

When the amount of astigmatism is so very low (next to nothing at 0.25 to very low amount at 0.5) is is often very hard to get the axis right on because the patient often cannot tell the exact axis.  Why don't you try going without glasses as much as possible.  In these situations, I often use the manual refraction which is closest to the autorefractor and use the lowest amount of astigmatism possible.  All these minor changes you are referring to are fairly minute refractive changes.  If the glasses don't work for you bring them back and ask to be refracted again - eventually they should be able to get them satisfactory for you.

MJK MD