Treatment of Regular Astigmatism of Less Than 3.00 D
Clinical Scenario
This protocol applies to patients with regular astigmatism measuring less than 3.00 diopters (D) — a low-to-moderate level of refractive error. In regular corneal astigmatism, the refractive power varies successively from one meridian to the next, and each meridian has a uniform curvature. At this magnitude, targeted optical correction is the first-line consideration.
Treatment Approach
Correction with eyeglasses is the primary intervention for this scenario. Appropriate spectacles represent one of the simplest and most cost-effective strategies to improve vision and are considered before other modalities. The type of correction involves the cylindrical component of the refractive error — however, the extent of correction that is appropriate and well tolerated varies by individual and prescribing history. The complete prescribing strategy is detailed in the full protocol.
Clinical Goal
The target outcome for successful correction is:
Corrected visual acuity of 20/25 or better
References
- In regular corneal astigmatism, the refractive power varies successively from one meridian to the next, and each meridian has a uniform curvature.
- In this document, low to moderate refractive errors are defined as spherical equivalents of less than 6.00 diopters (D) of myopia, less than 3.00 D of hyperopia, and less than 3.00 D of regular astigmatism.
- Provision of appropriate spectacles is one of the simplest, most cost-effective strategies to improve vision; therefore, eyeglasses should be considered before contact lenses or refractive surgery.
- Full correction may not be needed for individuals with regular astigmatism.
- Adults with astigmatism may not accept full cylindrical correction in their first pair of eyeglasses or in subsequent eyeglasses if their astigmatism has been only partially corrected.
- In general, substantial changes in axis or power are not well tolerated.
- Although most normal eyes should have a corrected acuity of 20/25 or better, it may not be possible to achieve this level of acuity in patients with high refractive errors, even with optimal refraction.
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