What causes vision deterioration with astigmatism?

Hello,

Welcome to icliniq.com.

I can understand your concern.

Thanks for sharing all of that it gives a clear starting point. Based on what you have described, here is a detailed breakdown of what might be going on and why your situation deserves more attention. Your prescription is currently +5.50 in the right eye and +5.75 in the left eye, which is considered moderate to high hyperopia (farsightedness). You also have astigmatism 180 degrees in the right eye and 160 degrees in the left eye, which indicates regular corneal shape issues. The main concern is that your vision has never corrected to 20/20, even with updated lenses, and your prescription continues to progress by +0.25 every year. You started losing vision around the age of eight, and it has never fully corrected.

This may suggest a few possibilities. One is uncorrected hyperopia in childhood, which can lead to amblyopia (lazy eye). In amblyopia, the eye itself is healthy, but the brain does not fully process visual input from that eye, meaning vision will not reach 20/20 even with the best glasses. It is often subtle and can be missed unless specifically tested in childhood. Another possibility is latent hyperopia or accommodative strain.

Some farsighted individuals use their eye muscles (accommodation) to focus, especially at near distances, and over time, this can cause eye strain, blurred vision, and difficulty reaching 20/20 if the muscles become fatigued. Latent hyperopia can also hide the full extent of your prescription, especially in younger years. Additionally, astigmatism like yours can blur vision if it is not fully corrected, and even small mismatches in the cylinder axis or power can prevent perfect clarity.

Some people are very sensitive to small amounts of uncorrected astigmatism, especially in hyperopic prescriptions. Less commonly, other causes could include keratoconus a progressive corneal thinning condition that usually involves increasing astigmatism and myopia, though it is less likely in your case but still worth ruling out genetic or developmental refractive errors, or macular or retinal development issues, especially if you have never had clear vision even with correction.

To move forward, you should consider a comprehensive eye examination with an optometrist or ophthalmologist. Ask for dilated refraction and a check for amblyopia, and have them rule out lazy eye, macular abnormalities, or early degenerative conditions. A cycloplegic refraction, which temporarily paralyzes the eye’s focusing ability using special drops, is especially important to reveal true hyperopia that may be masked by muscle compensation.

An OCT scan (optical coherence tomography) may also be helpful if your vision cannot reach 20/20 with lenses, as it gives a highly detailed, non-invasive view of the retina and optic nerve. In summary, your visual development may have been impacted early on, and your condition might not have been fully explored. If you have never been given a clear diagnosis, it is worth requesting a referral to a specialist, such as a neuro-ophthalmologist or pediatric ophthalmologist. Let me know if you would like help drafting questions for your appointment or interpreting any test results they can be tricky.

I hope this helps.

Thank you.