We aim to provide you with the best information to make an informed decision about your vision from your suitability to the treatment options available.
Can laser fix astigmatism ?
This article summarises what astigmatism is and which laser vision correction procedures can treat it.
Can laser eye surgery fix astigmatism?
What is Astigmatism?
Astigmatism is a common focusing error of the eye that causes blurred or distorted vision. Astigmatism usually occurs when the cornea (the clear front lens of your eye) or the lens inside your eye (behind your pupil) has an irregular shape. This prevents light from focusing evenly on your retina, producing a blurred or even double image.
Symptoms of Astigmatism:
- Blurred or distorted vision at all distances
- Difficulty seeing at night including rays or elongated shapes around bright points of light such as streetlights
- Eye strain or discomfort
- Headaches, especially after prolonged visual tasks
- Squinting to see clearly
Causes:
- Irregular cornea or lens: In a normal eye, the cornea and lens are smooth and evenly curved in almost all directions. To imagine this, think of a basketball that can be spun in any direction but still presents the same single curved shape to you
- In astigmatism, your lenses may be shaped more like a rugby ball than a basketball, steep in one direction (“across the laces” ) and flat in another (“point to point”). With two curves in your lenses, light gets focused in at least two places within your eye, instead of one on your retina) so you perceive blurred vision.
- Genetics: Astigmatism often runs in families, indicating a genetic predisposition.
- Astigmatism can also be the result of systemic disease (Marfan syndrome or Down syndrome) or ocular disease such as keratoconus or pellucid marginal degeneration.
- Astigmatism can also be the result of ocular trauma or a displaced (subluxated) intraocular lens implants or natural crystalline lens
- Irregular astigmatism may result from:
- Ocular infection
- Ocular trauma
- Ocular surgery
Treatments for Astigmatism
Astigmatism very often be treated with laser eye surgery. About 97% of all patients wearing glasses are suitable for laser vision correction. It is a very common misunderstanding that astigmatism cannot be corrected by laser vision correction. This is simply not true. The most common types of laser eye surgery for astigmatism are:
SMILE Pro with OcuLign (Minimally invasive no flap laser eye surgery): The least invasive vision correction technology for myopia involves creating a and very superficial 2mm short incision in the surface of your cornea and removing a very thin amount of cornea to correct astigmatism. SMILE Pro with Oculign at LVSA costs $3,400 per eye all inclusive
OCULIGN overlays a computerised digital image of your eye taken in your initial assessment to ensure the laser astigmatism correction is placed as exactly on your eye as possible.
LASIK (Laser Assisted In-situ Keratomileusis): In LASIK for astigmatism we use laser to create a very thin (80um) layer of cornea, under which we reshape corneal tissue with a laser to correct astigmatism, and then replace the thin layer. LASIK at LVSA costs $3,200 per eye all inclusive
Clear lens extraction and intraocular lens implantation (IOL) can also correct astigmatism as can
Phakic IOL implantation by placing a lens implant that has a carefully calculated focus at a specific orientation within your eye behind your pupil to counteract the astigmatism in your eye. Think of it like placing an astigmatism correcting contact lens permanently inside your eye behind the coloured iris and dark pupil in the middle of your eye, where you wont feel it and no one will see it.
This will depend on many factors such as:
- Your age, amount and orientation of astigmatism
- The cause of your astigmatism
- Your eye’s general health
- Whether you have a preference for an external laser approach on the front of your eye or an internal lens implant
- Whether you are older than 45 years and need reading glasses
- Whether there is any irregular astigmatism in which your astigmatism is not symmetrical around the “middle” of your eye. In this case the curves may be more easily imagined as a half deflated rugby ball!
There may be sometimes a small amount of residual astigmatism after your vision correction. Many people do not notice any blur from small amounts of residual astigmatism of only 0.5 or 0.75 units (Dioptres (D)). This is because the visual part of the brain can adjust what you see. We do not see exactly the image that is focussed on the back of our eyes. A small amount of residual astigmatism shown on measurement of your prescription may not actually affect your vision. Sometimes a second treatment or “enhancement” is needed to remove remaining astigmatism if there is visually significant astigmatism remaining after the first vision correction treatment. This is rarely needed but is usually possible.
A small amount of astigmatism may recur over decades o a small extent due to pressure on your eye from your eyelids and other factors subtly changing the shape of your eyes over a long time. This has been shown to occur naturally in patients who have had no vision correction as they age over decades.
Potentially yes. Contact lenses for astigmatism must have the correct orientation on your eye relative to the specific orientation of your astigmatism. Contact lenses however can move around a little and rotate on the surface of your eye, so the orientation of the astigmatism correction in the contact lenses can vary with respect to your actual astigmatism. This can cause your vision to become a little blurry from time to time in contact lenses when they move on your eye. Laser vision correction does not move on your eye so this will not happen.
Spectacles on the other hand do not rotate with your eye as your eye does, so again the orientation of astigmatism correction in spectacle lenses can become misaligned with the orientation of your astigmatism causing variable or occasionally blurred vision.
With multifocal or progressive spectacle lenses, the optical compensation for astigmatism is a further optical complexity that can make these lenses difficult to use or adapt to for patients with astigmatism.
Vision Correction, like all procedures, has some risks, just as wearing contact lenses does. Any specific and general risks would be outlined to you by your laser vision correction surgeon and given to you in writing.
A decision to proceed with Vision Correction is usually made when you decide the value to you of the convenience of better clearer vision without glasses or contacts is greater than your concern about the risks of Vision Correction.
References
Mai Hong Phan 1, Luong Minh Huynh 1 2, Say Kiang Foo 2 Comparative Vector Analysis of Astigmatic Changes After Small-incision Lenticule Extraction versus Femtosecond Laser In -situ Keratomileusis J Ophthalmic Vis Res 2026 Jul 15:21:10.18502/jovr.v21.18010.
Tuncel İ, Ahmet S, Kandemir Beşek N, Kırgız A, Çubuk MÖ. Long-term results of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) in mixed astigmatism. Eur J Ophthalmol. 2026 Sep;36(5):1235-1243.
Topcu H, Altun M, Ocal MC, Yasa D, Durusoy GK, Kose B. Comparative effectiveness of VISUMAX 800 with keratorefractive lenticule extraction and FS-LASIK in the treatment of myopic astigmatism. J Cataract Refract Surg. 2026 Jun 1;52(6):567-573.
Zu P, Gong Y, Zhang X, Ren C, Wang X, Bi H. Clinical outcomes of femtosecond laser-assisted laser in situ keratomileusis combined with accelerated corneal cross-linking versus standard femtosecond laser-assisted laser in situ keratomileusis for the correction of myopia and myopic astigmatism. Int Ophthalmol. 2025 Nov 17;45(1):491