What should I do with my astigmatism (2.50cyl and 1.50cyl)

Hello everyone! I’m a bit confused about astigmatism and I’m not sure how to approach my case. I’ve read most posts in the forum, and I’ve experimented a lot, so much that I even got a test lens kit to reaaally understand all about glasses. The most recent vision test I had with an optometrist showed: OS: 3.75sph 2.50cyl OD: 4.0sph 1.50cyl

The approach I decided to take was:

  1. To completely remove CYL from differentials.
  2. To almost completely remove CYL from normalized (only leave 0.75cyl in my left eye).

So with the help of the test lens kit I found that the best I could see without cylinder correction was with 4.0 sph in both eyes. My vision is very clear, but not completely clear.

My main concern is that I don’t want the cyl-for-sph substitution make my myopia worse. Specially because with sph-only correction my vision is not as clear (I do see a lot clearer with the cyl correction the optometrist gave me). I can’t remember finding a lot of details about this specifically. I know Jake says astigmatism correction is, in many cases, unnecessary.

However, isn’t getting more sph as substitute for cyl a direct stimulus for more induced myopia?

Do you think is a good idea to put cyl back and only have the least amount of sph possible to give me, say 20/25 vision? What about for closeup? I’m wearing 2.75 for closeup and can “read” the text, but it’s not very clear (and it’s even a little double). So same here, wouldn’t having more sph be counterproductive just for the sake of removing cyl?

What’s better?

  1. To have all (or almost all) the cyl I “need” and only enough sph to give me a blur challenge.
  2. To remove all (or almost all) cyl and substitute it with sph correction.

Thank you all so much!

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It’s necessary after you’ve been wearing it for a while.

It’s hard to get rid of. I recently dropped all of mine, with no sphere trade, just to give my eyes some room to adjust.

I don’t recommend this for anyone else, but it seems to be working out. I just have to accept degraded vision and some additional lack of clarity, but after a week or more (two?) with it, my eyes feel comfortable, much more so than they have in the past.

I’m reconsidering adding a little cylinder back in to take the edge off in my next normalized. I don’t intend to add any in to my differentials.

There are possible third and fourth options for you.
3. Step down alternating sphere and cylinder
4. Combine reductions. I noted that 0.25D sph plus 0.25D cyl equals 0.37D of spherical equivalent. My thought was, I’ll take the acuity hit on that for one round at least, and maybe more.

I think this is all about finding a comfortable way to accomplish this goal of back to 20/20. We learn from one another’s strategies… And mistakes.

Interested to hear how it goes for you. Tagging @Ursa and @Astigmatism_Assasin because I’m guessing they’ll be interested too.

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I used strategy 4, which has worked very well for my less myopic and astigmatic right eye, but not for the left. Binocular vision compensates, and I feel perfectly comfortable driving with my norms.

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Hi Alex, it’s great to have someone on the forum with a similar starting point, in my case I have -2.25 cyl on both eyes, and like you, I dropped it all together on my differentials.

These first four weeks I’ll only worry about differentials, but I’ve already begin to have the same questions about my normalized. I haven’t found a good enough answer yet. I’ll leave you with some quotes, unfortunately these are all over the place and pretty vague if we want to answer your question.

From the “How To: Test If You Need Astigmatism Correction (for Normalized Prescriptions)” post on endmyopia:

In many cases, your first normalized prescription should only be reducing in spherical values (the straight on myopia), leaving the axis and cylinder portions of the correction as it is.

Once you have improved your vision to the point that the first normalized should be lowered again, it’s worth taking a look at adjusting the astigmatism correction. Some clients, and some cases are best served by making an alternate adjustment, where one reduction is only astigmatism, and the next only spherical – though that’s something that we want to look at on a case by case basis.

From this forum thread Jake says:

Always try to have at least 1-2 spherical reductions between cylinder reductions.

There are some other threads on the forum talking about how to reduce astigmatism, like you mentioned some people make the trade-off and substitute all (usually low astigmatism) or some of their astigmatism correction with sphere, the issue with this is being undercorrected for astigmatism and overcorrected for myopia,

It’ll be cool if we can gather some more information / experiences in this thread and make it at least less difficult to make a decision on reducing astigmatism (specially on high astigmatism). Please keep us updated.

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What line can you read on the Snellen with the -4.00’s using both eyes? Is the clarity for each individual eye roughly the same?

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I have OS: -4.0sph -0.75cyl OD: -4.0sph 0cyl

I can read the 20/25 line always, and sometimes the 20/20. My vision is pretty much the same in both eyes.

Although I can read those lines, I don’t mean they’re super clear, I can make out the letters, but they’re not completely clear.

Are those your normalized?
How about your diffs?

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These are my normalized. My differentials are both -2.75sph no cyl

A couple of points.

First, looks like you just started recently, and if that’s the case it’s probably best to concentrate on your differentials for now. Sometimes, especially if you’ve been over-prescribed, the changes in the first 90-days can happen quickly and that will impact your normalized. You can waste a lot of money buying normalized too soon that quickly became useless (guilty).

Make sure your diffs continue to give you a little bit of blur challenge at a comfortable screen distance. If you start feeling the need to grow longer arms to get some blur then it’s probably time to reduce.

Second, if you are able to achieve 20/20 then those normalized are too strong. Shoot for 20/30-20/40 on the indoor Snellen.

What Kent said here is spot on. We’re all going to be a little different and your individual pathway will depend on what you’re comfortable with. Some people are extremely sensitive to small changes, while others can get away with dramatic ones. I started out with -2.00 and -2.50 cyl but don’t correct for it. Discovered by accident that I really didn’t need it and my eyes felt much better without it. But that’s me.

Keep us posted, and good luck!

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