How is astigmatism diagnosed?

Nov 19, 2025 Source: Cainiu Health

Dr. Wang Lei

Introduction

In general, diagnosis of astigmatism requires a professional ophthalmic examination, with core methods including visual acuity testing, automated refraction, cycloplegic refraction, corneal topography, and comprehensive refractor examination. Once diagnosed, astigmatism should be corrected promptly to prevent long-term blurred vision that may lead to eye strain or decreased vision. Children and adolescents are advised to have follow-up examinations every six months, while adults should have annual check-ups.

In general, diagnosis of astigmatism requires professional ophthalmic examinations, with core methods including visual acuity testing, automated refraction, cycloplegic refraction, corneal topography, and subjective refraction using a phoropter. Detailed analysis is as follows:

1. Visual Acuity Testing: This is the fundamental step in diagnosing astigmatism, measuring both distance and near vision using standardized eye charts. Patients with astigmatism typically experience blurred vision for both distant and near objects. They may also find that lines in one direction appear clearer than those in another—for example, when reading an "E" chart, horizontal strokes may be harder to distinguish than vertical ones—providing initial evidence of astigmatism.

2. Automated Refraction: This method uses optical principles to rapidly obtain refractive data of the eye, measuring approximate astigmatism power, axis, and levels of myopia or hyperopia within seconds. While convenient and efficient, providing useful preliminary data for further evaluation, results can be influenced by eye fatigue and accommodation, so it cannot serve as the definitive diagnostic basis.

3. Cycloplegic Refraction: This involves administering cycloplegic eye drops to relax the ciliary muscle and eliminate interference from ocular accommodation. It is especially suitable for children, adolescents, and adults with strong accommodative ability. Cycloplegic refraction provides more accurate refractive measurements, helping to differentiate true astigmatism from pseudo-astigmatism caused by accommodative spasm, thus preventing misdiagnosis.

4. Corneal Topography: This technique uses optical scanning to map the surface shape of the cornea, clearly revealing variations in corneal curvature. Since most astigmatism is related to corneal irregularities, this test can precisely identify steep or flat areas on the cornea and determine whether the astigmatism is due to abnormal corneal morphology.

5. Phoropter (Subjective) Refraction: Conducted by an eye care professional using a phoropter, this subjective test involves adjusting various astigmatic lens powers and axes while asking the patient to compare clarity of vision. Based on patient feedback, the doctor fine-tunes the parameters to accurately determine the astigmatism degree, axis, and optimal correction plan.

Once diagnosed, astigmatism should be corrected promptly to prevent long-term blurred vision from causing eye strain or progressive vision deterioration. Children and adolescents are advised to have check-ups every six months, while adults should have annual exams. Correction plans should be updated timely according to changes in refractive error to maintain optimal visual health.

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How is the astigmatism axis of the eye measured?

Astigmatism axis measurement is generally performed using methods such as automated refractometry. The optometrist operates the autorefractor, instructing the subject to fixate on a target image within the instrument. Using optical principles, the device captures refractive information from the eye and quickly provides an initial measurement of the astigmatism axis and degree. This method is simple to perform and time-efficient, commonly serving as a preliminary screening tool and providing reference data for subsequent precise refraction.

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How to recover from astigmatism

Determine the degree and axis of astigmatism through professional refraction, then prescribe appropriate cylindrical lenses. These glasses can accurately correct refractive errors caused by corneal irregularities, ensuring clear retinal imaging and alleviating symptoms such as blurred vision and double vision. For individuals unsuitable for wearing eyeglasses, rigid gas-permeable contact lenses or toric soft contact lenses designed specifically for astigmatism are alternative options.

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What medication is used for astigmatism?

Commonly used medications for astigmatism generally include compound aspartic acid and vitamin B6 eye drops, sodium hyaluronate eye drops, and polyvinyl alcohol eye drops. Compound aspartic acid and vitamin B6 eye drops contain ingredients such as aspartic acid and vitamin B6, which can relieve eye fatigue symptoms associated with astigmatism, such as eye soreness, blurred vision, promote ocular blood circulation, help relax eye muscles, and improve discomfort after eye use.

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How to correct astigmatism

Astigmatism can be managed to improve visual experience and control refractive changes through methods such as fitting appropriate corrective devices, performing targeted eye exercises, maintaining a scientifically sound eye-use routine, optimizing visual environments, and regularly monitoring vision status. First, visit a qualified institution for an accurate refraction test to determine the degree and axis of astigmatism, then select the appropriate corrective device. For eyeglasses, precision-manufactured cylindrical lenses are required.