The answer is yes!

Astigmatism – that eye condition that blurs your vision at all distances – affects millions worldwide. At SHARPEVISION, we’ve found that some degree of astigmatism is present in about 84% of our glasses or contacts lens wearing patients presenting for vision correction. Yet, a stubborn myth persists: that vision correction options like LASIK, PRK, EVO ICL, RLE (refractive lens exchange) or cataract surgery with premium toric IOL lenses can’t correct it. This couldn’t be further from the truth. In fact, LASIK and PRK, collectively called “laser vision correction,” have been effectively treating astigmatism since 1998. I want to dispel this myth, so that we give people who want to see clearly without glasses or contacts the correct information.

What is Astigmatism?

The term “Astigmatism” refers to an aberration, or irregular shape of the cornea, the round clear front part of your eye that covers the iris, the colored part of your eye. This irregular shape is the same as if you took half of a tennis ball, and gently squeezed the edges between your thumb and index finger. It can also occur in the lens of the eye, which is located directly behind the colored part of the eye. Astigmatism is perceived as blurred or distorted vision. It can cause headaches, eye strain, and difficulty with night driving. Astigmatism can be congenital or develop from as our bodies mature. Importantly, it’s incredibly common. Studies show that astigmatism prevalence in the general population is as high as 62%, with rates climbing higher among those over 70. Among glasses wearers, it’s even more prevalent; for instance, in children requiring prescriptions, a significant portion – often over 80% in some analyses – have astigmatism components like with-the-rule astigmatism. This means that if you’re relying on glasses to see clearly, astigmatism is likely playing a role, yet many hesitate to explore surgery due to outdated beliefs.

The myth that astigmatism can’t be treated with laser eye surgery or implants is one of the most pervasive in ophthalmology.

Sources across eye care websites and patient forums highlight this as a top misconception, often stemming from early limitations in technology. In the past, some procedures were indeed restricted to nearsightedness or farsightedness, but long ago, those restrictions were eliminated. All modern lasers and lenses are designed specifically to address the irregular shape of the eye known as astigmatism. Educating our patients is crucial because they may go years enduring uncomfortable and inconvenient glasses and contact lenses rather than seeking life-changing vision correction procedures. As one clinic notes, “individuals with astigmatism are not suitable candidates” is flat-out wrong.  All the above procedures yield outstanding results for astigmatic patients. Let’s explore each treatment option to see how they eliminate astigmatism. Astigmatism is not a big deal, and can be corrected with any of the technologies listed in the title of this blog post.

Why Does This Misconception Persist?

How exactly does each vision correction procedure work? In this blog post, I’ll explain how we treat astigmatism surgically, eliminate the confusion, and empower you to make informed decisions about your eye health.

LASIK

Starting with LASIK (Laser-Assisted In Situ Keratomileusis), this popular procedure has been a game-changer since its FDA approval in 1999 for treating nearsightedness, farsightedness, and astigmatism. LASIK works by creating a thin flap in the cornea using a femtosecond laser, then reshaping the underlying tissue with an excimer laser to decrease (in nearsightedness) or increase (in farsightedness) the curvature of the cornea. For astigmatism, the laser precisely ablates more tissue in the flatter meridians, smoothing out the football-like shape into a more spherical one. The flap is then repositioned, and healing begins almost immediately. Success rates are high: Over 95% of patients achieve 20/20 vision or better, with astigmatism correction being particularly effective for up to 6 diopters-which is a lot. I’ve treated up to 8 diopters with success. Full FDA approval for LASIK for nearsightedness and astigmatism came in 1999, building on earlier trials. Pros include quick recovery (often within 24 hours), minimal discomfort, and long-lasting results. However, it’s not for everyone – those with thin corneas or severe dry eye might need alternatives. Risks like flap complications are rare but worth discussing with your surgeon.

PRK

Closely related is PRK (Photorefractive Keratectomy), often called the precursor to LASIK. Approved by the FDA in October 1995, PRK was the first laser procedure for vision correction and included astigmatism from the start, albeit with initial limitations on degree. Unlike LASIK, PRK doesn’t create a flap; instead, the outer epithelial (skin) layer is removed, and the same excimer laser reshapes the cornea directly, with the same results as LASIK. The epithelium regenerates over 3-5 days. This makes PRK ideal for patients with thinner corneas or those in high-contact professions, like athletes or military personnel, where flap risks are a concern. Astigmatism treatment mirrors LASIK’s precision, correcting irregularities by customizing the laser pattern. Recovery takes longer – usually 2.5-3 days to be comfortable and function. It can take 6-8 weeks for full sharpness. One myth debunked here: PRK isn’t outdated; it’s often preferred for its safety profile in certain cases. Both LASIK and PRK have treated astigmatism reliably since the late 1990s.

EVO ICL (EVO Visian Implantable Collamer Lens)

The EVO ICL offers a reversible alternative that has become my primary recommendation for vision correction for those who are candidates. The 5 minute per eye procedure consists of placing a biocompatible collamer lens between the iris and natural lens, adding corrective power without altering the cornea. The toric version specifically addresses astigmatism by incorporating a cylindrical component to align with the eye’s axis. FDA approval for the EVO ICL, including its toric model for astigmatism, came in March 2022, marking a significant advancement in the US. While earlier ICL versions were approved in 2005, the EVO’s main innovation is that there are tiny holes in the lens, so that fluid can flow normally throughout the eye. It’s FDA approved for ages 21-45 with moderate to high nearsightedness and astigmatism (up to 4 diopters in toric models). Benefits include no increase in dry eyes, no flap created, no tissue removed, no postop pain, UV protection, better night vision (less glare, haloes) than contact lenses, and removability if needed. Surgery is quick (about 5 minutes per eye), with most having functional vision the next day. Potential downsides? The correct lens sizing is important to prevent lens rotation. In my hands, the risk of needing to exchange the lens is less than 1 in 400. As of the posting, SHARPEVISION is the #1 EVO ICL clinic in the nation.

Premium Cataract and RLE Surgery

Finally, premium toric IOLs (Intraocular lenses) in cataract surgery or refractive lens exchange (RLE) to eliminate glasses for near and distance vision is typically recommended for those over age 45. These lenses replace the eye’s natural lens, correcting astigmatism via built-in toric optics that counteract corneal astigmatism. History traces back to 1992, when the first toric IOL was designed, evolving from rigid PMMA models to foldable ones insertable through tiny incisions. They’ve been in widespread use for decades, with multifocal toric options now combining astigmatism correction with presbyopia treatment for reading vision. During surgery, the lens is precisely rotated to match the astigmatic axis, often guided by advanced imaging. Up to 90% of patients achieve uncorrected distance vision of 20/25 or better. For those over 50 years of age with astigmatism and cataracts, this is transformative, reducing glasses dependence. Myths here include rotational instability, but modern designs lock in place effectively. Risks mirror cataract surgery: infection (about 1 in 15000) or posterior capsule opacification (which can be cleared with a 2 minute painless laser in office), but benefits far outweigh risks for qualified candidates.

Persistent Internet Myths

Why does the myth persist? Early procedures had limits on astigmatism degrees, and word-of-mouth from outdated experiences fuels doubt. Consider the numbers: With astigmatism so common among glasses wearers (one study found 81%), ignoring surgical fixes means missing freedom from glasses and contact lenses. Patient stories abound: A 35-year-old with 2 diopters of astigmatism post-LASIK reports crystal-clear vision for sports; a 60-year-old with toric IOLs reads without bifocals. I had a cataract patient recently in tears because she opted for the standard Medicare lens, not the toric lens, and as expected, and as we advised her beforehand, she will need glasses for the rest of her life. My advice: get all the information, and make a decision to improve your quality of life through paying more for the higher level of technology. Nothing is perfect, but the modern lenses indeed offer the possibility of freedom from glasses, and much better outcomes than we had a generation ago.

In conclusion, yes – we absolutely can treat astigmatism with LASIK (since 1999), PRK (since 1995-96), EVO ICL (toric since 2022 in the US), and premium toric IOLs (since the 1990s)! These aren’t experimental; they’re proven, with millions of successful cases. If the myth has held you back, consult an ophthalmologist for a personalized assessment. Factors like age, prescription stability, and eye health determine the best fit. Vision correction isn’t just about seeing better – it’s about living better. Don’t let misconceptions blur your future; clear vision awaits, and adds so much value to your life.