Effect of uncorrected astigmatism on vision

Research output: Contribution to journalArticlepeer-review


PURPOSE: To examine the effect of uncorrected astigmatism in older adults.
SETTING: University Vision Clinic
METHOD: Twenty-one healthy presbyopes, aged 58.9±2.8 years, had astigmatism of 0.0 to -4.0 x 90?DC and -3.0DC of cylinder at 90?, 180? and 45? induced with spectacle lenses, with the mean spherical equivalent compensated to plano, in random order. Visual acuity was assessed binocularly using a computerised test chart at 95%, 50% and 10% contrast. Near acuity and reading speed were measured using standardised reading texts. Light scatter was quantified with the cQuant and driving reaction times with a computer simulator. Finally visual clarity of a mobile phone and computer screen was subjectively rated.
RESULTS: Distance visual acuity decreased with increasing uncorrected astigmatic power (F=174.50, p<0.001) and was reduced at lower contrasts (F=170.77, p<0.001). Near visual acuity and reading speed also decreased with increasing uncorrected astigmatism power (p<0.001). Light scatter was not significantly affected by uncorrected astigmatism (p>0.05), but the reliability and variability of measurements decreased with increasing uncorrected astigmatic power (p<0.05). Driving simulator performance was also unaffected by uncorrected astigmatism (p>0.05), but subjective rating of clarity decreased with increasing uncorrected astigmatic power (p<0.001). Uncorrected astigmatism at 45? or 180? orientation resulted in a worse distance and near visual acuity, and subjective rated clarity than 90? orientation (p<0.05).
CONCLUSION: Uncorrected astigmatism, even as low as 1.0DC, causes a significant burden on a patient’s vision. If left uncorrected, this could impact significantly on their independence, quality of life and wellbeing.
Original languageEnglish
Pages (from-to)454-460
Number of pages7
JournalJournal of Cataract and Refractive Surgery
Issue number3
Early online date17 Feb 2011
Publication statusPublished - Mar 2011
EventWorld Ophthalmology Congress - Berlin, Germany
Duration: 1 Jun 2010 → …

Bibliographical note

NOTICE: this is the author’s version of a work that was accepted for publication in the Journal of Cataract & Refractive Surgery. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Wolffsohn, JS, Bhogal, G & Shah, S, 'Effect of uncorrected astigmatism on vision', Journal of cataract and refractive surgery, vol 37, no. 3 (2011) DOI http://dx.doi.org/10.1016/j.jcrs.2010.09.022


  • activities of daily living
  • aged
  • Astigmatism
  • automobile driving
  • contrast sensitivity
  • female
  • humans
  • light
  • male
  • middle aged
  • presbyopia
  • quality of life
  • reading
  • radiation scattering
  • vision disorders
  • vision tests
  • binocular vision
  • visual acuity


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