Astigmatism Management

 Frequently Asked Questions About

Astigmatism Management

(Limbal Relaxing Incision)



What is astigmatism?

It is an abnormality in which the optical surfaces of the eye are shaped like a football (oval) rather than a baseball or basketball (round). Astigmatism is the most common optical problem after myopia (nearsightedness) and hyperopia (farsightedness).


How does astigmatism affect vision?

When it is uncorrected, astigmatism blurs vision at all distances, near and far.


Is astigmatism correction something new?

No. We have been correcting astigmatism at the time of cataract surgery for years.  Medicare and private health insurance plans do not cover it.


How is astigmatism corrected?

The steepened area of the cornea is flattened by placing one or more incisions in the peripheral cornea. This is performed with a special diamond knife at the time of cataract surgery.


What if I do not have my astigmatism corrected?

If you have residual astigmatism after surgery, there is a greater chance you will need glasses to see clearly at both distance and near.


Will I need astigmatism correction in both eyes?

Probably. The two eyes are often a little different. We evaluate them independently.


Will I see 20/20 if my astigmatism is corrected?

We hope so, but as with all surgery, we do not guarantee outcomes. There are many variables that affect visual outcomes besides astigmatism (the power of the lens implant, the health of your retina and optic nerve, etc.). The odds of achieving 20/20 visual acuity for distance without glasses or contact lenses are much better if we evaluate and correct your astigmatism than if we do not.


Will it take longer to recover from surgery if my astigmatism is corrected?

Probably not. The eye may be a little more irritated the day after surgery, but recovery is fairly quick.


Should I have my astigmatism corrected if I am having surgery in one eye only?

Yes. Your overall vision without glasses will be better even if only one eye is corrected.


What if my astigmatism is not fully corrected at the time of surgery?

You will still need glasses for best distance and near vision. Even if your astigmatism is not fully corrected, the quality of your uncorrected vision will be better if your astigmatism can be reduced by any amount.


Will I need reading glasses if I have my astigmatism corrected?

Yes. Current monofocal lenses only correct for distance visual acuity. You will have a higher likelihood of being spectacle free at distance with astigmatism correction.


Are there any risks or side effects?

The only significant risk is that we will not be able to correct all of your astigmatism, and you will need glasses or contact lenses for best vision.


Can I have surgery if I decide not to have my astigmatism corrected?

Absolutely. Astigmatism management is optional and an out of pocket cost. You will however have a much higher likelihood of needing glasses for your distance vision if you choose not to have your astigmatism corrected.


Does insurance (or Medicare) pay for astigmatism correction?

No, Medicare and other health insurance plans will not pay to reduce astigmatism that exists at the time of cataract surgery.


Why doesn’t insurance (or Medicare) pay for astigmatism correction?

Your insurance will cover what is medically necessary, namely your cataract surgery. Insurance will not cover cosmetic procedures, and astigmatism correction is considered cosmetic, since it is performed only to reduce your dependence on glasses for distance.


Can I receive a refund if my astigmatism is not fully corrected?

No. As with any surgery, results are subject to individual healing patterns and a host of variables beyond our control. We cannot promise you that you will not need glasses after surgery, but we will do our best to reduce your dependence on them. However, no guarantees can be made with respect to the final result.


When do I have to decide?

We would like you to decide at the time of the scheduled preoperative visit. At a minimum, you need to let us know a few days before surgery. Additional testing and surgical planning will be required prior to your surgery.


What do I do if I want Astigmatism Management?

You should tell one of our office staff. They will have you sign a non-covered service waiver to have the astigmatism correction procedure performed at the time of your cataract surgery.