You have probably spent years having to wear glasses first thing in the morning, or wrestling with contact lenses that never quite feel comfortable, frustrated by blurry vision that corrective lenses only partially address. If astigmatism is behind your blurry or distorted vision, you may have wondered whether LASIK for astigmatism could change that.
The answer depends on your eyes specifically. LASIK can correct astigmatism for many patients, but not everyone is a candidate, and the procedure carries risks that are worth understanding before making any decisions. This page explains how LASIK works as an astigmatism treatment, what affects eligibility, and what alternatives exist when LASIK is not the right fit.
Quick Overview
- LASIK is one of several laser vision correction procedures that can treat astigmatism by reshaping the cornea so that light focuses correctly on the retina.
- Many patients with corneal astigmatism are suitable candidates, though eligibility depends on factors like corneal thickness, prescription range, and overall eye health.
- LASIK is an elective procedure and, like any invasive procedure, carries potential risks that require careful assessment and informed discussion before proceeding.
- Where LASIK is not appropriate, alternatives such as photorefractive keratectomy (PRK) or refractive lens exchange may be considered.
Below, we outline how LASIK corrects astigmatism, how candidacy is assessed, and what the procedure involves.
What Astigmatism Does to Your Vision
In a normal eye, the cornea has a smooth, even curve that bends light entering the eye to a single point on the retina. The result is a clear, sharp image. In an eye with astigmatism, the cornea or lens inside the eye has an uneven curvature that results in impaired vision across most distances. Light enters the eye at different angles and focuses at more than one point, rather than landing cleanly on the retina. The result is blurred vision and distorted vision that affects most distances, not just near or far.
Astigmatism is a refractive error. Corrective lenses, whether glasses or contact lenses, compensate for this uneven curvature by bending light before it reaches the eye. What laser vision correction does differently is alter the shape of the cornea itself, correcting vision at the source rather than compensating for the refractive error with external lenses.
How LASIK Corrects Astigmatism
LASIK surgery, which stands for Laser-Assisted In Situ Keratomileusis, is a refractive procedure that uses a laser to reshape corneal tissue. The process involves two stages.
Creating the corneal flap
In the first stage, a thin corneal flap is created on the surface of the eye using either a microkeratome blade or a femtosecond laser. This flap is gently lifted to expose the tissue underneath, allowing the laser to work on the deeper layers of the cornea without affecting the outer surface.
Reshaping with the excimer laser
In the second stage, an excimer laser removes precise amounts of corneal tissue according to a treatment plan mapped to your individual prescription and corneal shape. For astigmatism specifically, the laser reshapes the irregularly shaped cornea so that it curves more evenly, correcting the unevenness that has been causing the refractive error. Once reshaping is complete, the corneal flap is repositioned and self-seals without stitches.
The excimer laser works with a level of precision measured in fractions of a micron. Treatment times vary, but the laser application itself typically takes under a minute per eye. Most patients notice improved vision within the first day or two following the procedure, though full stabilisation of vision can take several weeks.
Who Is a Candidate for LASIK for Astigmatism?
Not everyone with astigmatism is suitable for LASIK. A comprehensive pre-surgical assessment is required to determine whether the procedure is appropriate for your individual situation. Several factors influence this assessment.
Corneal thickness
LASIK involves removing corneal tissue. The cornea must be thick enough to accommodate this without compromising its structural integrity after the procedure. Patients with thinner corneas may not be suitable for LASIK but could be candidates for other laser vision correction procedures such as photorefractive keratectomy, which does not require creating a corneal flap.
Prescription range
LASIK can treat a range of refractive errors, but there are limits. Very high degrees of astigmatism may exceed what laser reshaping can reliably correct in a single procedure. Your eye surgeon will assess your prescription against the treatment range to determine whether LASIK is appropriate for your level of uncorrected astigmatism.
Stable prescription
Before undergoing any elective refractive procedure, the prescription should be stable for at least 12 months. A prescription that is still changing is a signal that the eye has not yet settled, and surgery performed before stability is reached may not deliver lasting results.
Overall eye health
Conditions such as keratoconus, dry eye disease, or other corneal abnormalities can affect both candidacy and outcomes. Your optometrist can diagnose astigmatism during a routine eye exam, but a routine eye exam is not sufficient for a pre-surgical workup. A dedicated refractive assessment includes corneal topography, measurement of corneal thickness, assessment of tear function, and review of the overall health of the eye. Patients are also assessed for conditions such as cataract that may affect vision independently of the refractive error.
Age and lifestyle
Patients are generally required to be at least 18 years old, and waiting until the mid-twenties is often recommended to allow the prescription to stabilise fully. Dr Roufail will also consider overall health, current medications, and lifestyle factors, including occupation and contact sports involvement, as part of the eligibility assessment.
LASIK vs Other Laser Vision Correction Procedures
LASIK is not the only laser option for correcting astigmatism, and for some patients, an alternative laser vision correction procedure will be more appropriate.
Photorefractive keratectomy (PRK)
PRK is an older laser refractive procedure that reshapes the cornea without creating a flap. Instead, the outer layer of the cornea is removed before the excimer laser is applied. The recovery period is longer than LASIK because the surface cells need to regenerate, but the end result is comparable. PRK is often recommended for patients with thinner corneas or those who participate in contact sports where a flap dislodgement could pose a risk.
Refractive lens exchange
Where laser surgery is not appropriate, refractive lens exchange replaces the eye’s natural lens with an artificial intraocular lens. This is more commonly considered for patients with prescriptions outside the range that laser correction can address, or for those with early lens changes who may develop cataracts in the future. Refractive lens exchange is a more invasive procedure than laser surgery and involves risks similar to cataract surgery. Lens exchange surgery is not suitable for everyone and requires thorough assessment by a specialist.
What to Expect Before and After LASIK
Before the procedure
A pre-surgical assessment with your eye surgeon covers corneal topography, wavefront analysis, prescription measurement, and a full eye health review. Contact lens wearers are usually asked to stop wearing lenses for a period before the assessment, as contact lenses can temporarily alter corneal shape and affect the accuracy of measurements.
The day of surgery
LASIK is performed under topical anaesthetic eye drops. Most patients experience little to no discomfort during the procedure. The entire process typically takes under 30 minutes for both eyes, though you will be at the clinic for longer for preparation and post-procedure instructions.
Recovery
Vision is often noticeably improved within 24 to 48 hours, though it may fluctuate as the eye heals. Most patients can return to normal daily activities within a few days. Activities such as swimming and contact sports require a longer break. Follow-up appointments allow your surgeon to monitor healing and assess the outcome against the treatment plan.
Taking the Next Step
LASIK for astigmatism is a considered decision, not a quick fix. For patients who are suitable candidates, it can meaningfully reduce or eliminate the need for glasses or contacts. For those who are not, there are other forms of vision correction worth exploring.
Dr Edward Roufail offers specialist refractive surgery assessment and laser vision correction in Melbourne for patients with astigmatism, short-sightedness, long-sightedness, and combined refractive errors. A thorough consultation is the starting point for understanding whether LASIK or another refractive procedure suits your eyes and situation. To arrange a consultation with Dr Roufail, please call us at (03) 9071 0180 or book an assessment online.
Frequently Asked Questions
Can LASIK fully correct astigmatism or only reduce it?
For many patients, LASIK can correct astigmatism to a degree where glasses or contact lenses are no longer needed for most activities. Whether correction is full or partial depends on the degree of astigmatism, corneal characteristics, and how the eye heals after the procedure. Some patients achieve vision that no longer requires correction at all. Others see significant improvement but may still need prescription glasses for specific tasks. Individual outcomes vary and are discussed in detail at the pre-surgical consultation.
Can LASIK treat astigmatism alongside short-sightedness or long-sightedness?
Yes. Astigmatism frequently occurs alongside myopia (short-sightedness) or hyperopia (long-sightedness), and LASIK is able to address combined refractive errors in a single procedure. The treatment plan is mapped to the full prescription, including both the spherical component and the astigmatic component. Your pre-surgical assessment will confirm whether your combined prescription falls within the treatable range.
What happens if LASIK does not fully correct the astigmatism?
In some cases, the initial procedure does not achieve the full intended correction. This is called an undercorrection and can occur due to individual healing responses or small variations in tissue removal. If the residual refractive error is clinically significant and the cornea has sufficient remaining thickness, an enhancement procedure may be possible. This is assessed at follow-up appointments once the eye has stabilised, typically several months after the initial procedure. Your surgeon will discuss the likelihood of enhancement and the conditions under which it would be considered before you proceed with the original surgery.
How long does the pre-surgical assessment take?
A comprehensive pre-surgical assessment typically takes one to two hours. It involves multiple measurements of the cornea, assessment of the prescription, tear function testing, and a full eye health review. Contact lens wearers are usually asked to remove soft lenses for at least one to two weeks before the assessment, and rigid or gas-permeable lens wearers for longer, to allow the corneal shape to return to its natural state before measurements are taken.
Is LASIK covered by Medicare or private health insurance?
LASIK is an elective procedure and is not covered by Medicare in Australia. Some private health insurance policies include a benefit for laser eye surgery under extras cover, but the amount and eligibility criteria vary between funds. It is worth checking with your health fund before booking a consultation. A written quote from your surgeon’s practice will help clarify the out-of-pocket costs involved.
Note: Surgical or invasive procedures carry inherent risks. As part of our standard practice, we thoroughly discuss these risks during the consent process before any surgical procedure. Your understanding and comfort are our utmost priority.
References
https://www.urmc.rochester.edu/news/publications/health-matters/what-is-astigmatism-and-can-lasik-fix-it
https://www.healthline.com/health/eye-health/lasik-for-astigmatism
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