1. Myopia + Astigmatism: What exactly is going on?

Myopia: Primarily an excessively long axial length, causing the light focus to fall in front of the retina, resulting in blurred distance vision.

。

Astigmatism: It is usually because the corneal surface is not a perfect hemispherical shape but more like an ovoid, so light rays in different meridians focus at different locations, causing objects to appear distorted or double at any distance.

When both exist simultaneously, vision becomes both blurry and distorted. Many people's astigmatism is congenital and not largely related to prolonged eye use, but it can combine with myopia and accelerate the decline in visual quality.

2. There is more than one solution

Simultaneously correcting myopia and astigmatism essentially involves ensuring that light rays from different meridians all accurately focus on the same point of the retina.

1. Frame glasses

Key point: Fitting must be precise. Lenses need to include prescriptions for both myopia correction and astigmatism correction, and the axis must be measured accurately.

Suitable for: Everyone, especially children and adolescents, those with higher astigmatism, or those not suitable for contact lenses/surgery.

Note: A brief adaptation period is required for first-time wearers or after prescription changes. Those with high astigmatism may be more sensitive to image distortion at the lens edges and should choose higher-quality lens designs.

2. Contact lenses

Soft contact lenses: choose toric lenses. These lenses have a weighted design that automatically stabilizes at the correct axis in the eye, ensuring astigmatism correction. Professional fitting is required.

Rigid gas-permeable corneal lenses (RGP): an excellent choice for moderate to high astigmatism and irregular astigmatism. RGPs create a smooth new surface over the cornea, effectively correcting both myopia and astigmatism, and visual quality is often superior to spectacle lenses.

Orthokeratology lenses (OK lenses): worn at night to temporarily restore clear vision during the day. They also provide good control and correction for myopia and a certain degree of astigmatism, especially suitable for adolescents with rapidly progressing myopia.

3. Myopia surgery

Currently mainstream laser surgeries (such as femtosecond-assisted LASIK, SMILE) and ICL lens implantation can correct astigmatism concurrently while correcting myopia.

Laser surgery: uses a laser to precisely ablate the cornea, reshaping it into a more regular sphere.

ICL lens implantation: implants a refractive intraocular "miniature contact lens" into the eye; this lens can be custom-made to match your myopia and astigmatism.

Important prerequisite: A comprehensive and rigorous preoperative examination must confirm that corneal conditions, ocular status, and refractive stability meet surgical requirements, and the doctor must evaluate the most suitable plan.

3. How should you choose? A self-assessment approach

Consider lifestyle needs: If you are active in sports, value appearance and a wide field of view, contact lenses or surgery can be prioritized. If you prefer convenience, safety, and low maintenance, spectacle frames are a reliable companion.

Consider age and refractive error: For adolescents, spectacle frames or orthokeratology (OK) lenses are the first choice. Adults with stable refraction can consider all options based on examination results.

Assess the degree of astigmatism: for mild to moderate astigmatism, the above methods are all acceptable. For moderate-to-high or irregular astigmatism, priority should be given to consulting about RGP lenses or performing more detailed corneal examinations to rule out conditions such as keratoconus.

Consider visual habits: people with long-term high-intensity near work or dry eye should choose contact lenses cautiously and ensure proper eye-care practices.