Astigmatism can be fixed with glasses, contact lenses, or several types of surgery, depending on how severe it is and what you’re looking for long-term. Most people have at least some degree of astigmatism, and for many it’s mild enough that correction is optional. But when it blurs your vision or causes eye strain, you have more options than ever to correct it.
Astigmatism happens when your cornea (the clear front surface of your eye) is curved more like a football than a basketball. Instead of light focusing on a single point at the back of your eye, it lands in two different spots, which makes things look blurry or stretched at any distance. Less commonly, the lens inside the eye or even the position of the retina contributes to the problem. Factors like eyelid pressure and the pull of the muscles around your eye can also influence its severity.
Eye Exercises Won’t Fix It
This is worth addressing up front because it comes up constantly online. The American Academy of Ophthalmology is clear: eye exercises are ineffective for astigmatism. No exercise program has been shown to reshape the cornea or reduce the need for glasses. The Bates Method, “vision training” apps, and similar programs lack scientific evidence. Astigmatism is a structural issue with the shape of your eye, not a muscle weakness you can train away.
Glasses and Standard Contact Lenses
The simplest fix is a pair of glasses with a cylindrical correction built into the lens. Your prescription will include two numbers beyond basic nearsightedness or farsightedness: the “cylinder” (how much astigmatism you have) and the “axis” (the angle at which your cornea is steepest, measured from 0 to 180 degrees). These values tell the lab exactly how to grind the lens so light focuses properly on your retina.
If you prefer contacts, toric lenses are designed specifically for astigmatism. Unlike regular contacts, which are the same power all the way around, toric lenses have different corrections at different angles. They need to sit on your eye in a precise orientation, so they’re weighted or shaped to resist rotating when you blink. Any rotation off-axis creates new blur, which is why some people find toric contacts slightly less consistent than glasses. Currently available toric soft lenses correct astigmatism ranging from about 0.50 to 3.75 diopters in 0.25-diopter steps, which covers the vast majority of prescriptions.
Ortho-K: A Temporary, Non-Surgical Fix
Orthokeratology uses rigid gas-permeable lenses worn overnight to gently reshape your cornea while you sleep. You remove them in the morning and see clearly throughout the day without glasses or contacts. The effect is temporary: if you stop wearing the lenses, your cornea returns to its original shape. Newer toric ortho-K designs can treat astigmatism up to about 7.00 diopters, making this a viable option even for higher prescriptions. It’s particularly popular with parents of children who want to slow the progression of nearsightedness, but it works for adults with astigmatism as well.
LASIK and PRK
LASIK is the most widely known surgical option. A laser reshapes the cornea to eliminate the uneven curvature causing your astigmatism. Current FDA-approved systems can treat up to 6.0 diopters of astigmatism when combined with nearsightedness, and up to 6.0 diopters of mixed astigmatism on its own. To qualify, your prescription needs to have been stable (changing no more than 0.50 diopters per year) for at least a year, and you need to be at least 18 for most treatments or 21 for mixed astigmatism.
PRK is an older laser procedure that works on the surface of the cornea rather than creating a flap underneath. The visual results are comparable to LASIK, but recovery takes longer because the outer layer of the cornea needs to regenerate. PRK is sometimes the better choice if your corneas are too thin for LASIK or if you’re in a profession where a corneal flap poses a risk (contact sports, military service). PRK also tends to cost less than LASIK.
The national average cost for LASIK is about $2,250 per eye, or roughly $4,500 total. Advertised discount prices usually apply only to very mild prescriptions. Most insurance plans don’t cover refractive surgery, though many surgeons offer financing.
SMILE: A Newer Laser Option
SMILE is a minimally invasive laser procedure that removes a small disc of tissue from inside the cornea through a tiny incision, rather than creating a flap. A comparative study of 159 eyes found that SMILE produced the most accurate astigmatism correction of the three procedures tested, leaving patients with an average residual cylinder of just 0.21 diopters, compared to 0.30 for LASIK. Both laser procedures significantly outperformed implantable lenses on astigmatism accuracy.
The tradeoff: SMILE and LASIK both induce slightly more higher-order aberrations (subtle optical imperfections that can cause glare or reduced contrast) than implantable lenses. For most people this is minor and resolves during healing, but it’s worth knowing if you do a lot of nighttime driving.
Implantable Lenses for High Prescriptions
If your prescription is too strong for laser surgery, or if your corneas aren’t suitable candidates, a toric implantable collamer lens (ICL) is an alternative. This is a thin lens placed inside the eye, behind the iris but in front of your natural lens. The FDA-approved version treats nearsightedness from 3.0 to 20.0 diopters with astigmatism between 1.0 and 4.0 diopters. You need to be at least 21, and the front chamber of your eye must be deep enough to accommodate the implant.
ICL surgery is reversible, since the lens can be removed or replaced. That same comparative study found that while ICLs were slightly less precise at correcting astigmatism than SMILE or LASIK, they produced significantly better overall optical quality with fewer aberrations. This means less glare and sharper contrast, especially in low light. For people with high prescriptions, ICLs often deliver a better visual experience than laser procedures can.
Lens Replacement for Older Adults
If you’re over 40 and already dealing with presbyopia (the gradual loss of up-close focusing that comes with age), refractive lens exchange may be the most practical long-term fix. This procedure removes your eye’s natural lens and replaces it with an artificial one, similar to cataract surgery but performed before a cataract develops. Toric versions of these artificial lenses correct astigmatism while simultaneously addressing nearsightedness, farsightedness, and presbyopia in one procedure. An added benefit: you’ll never develop cataracts in that eye, since the natural lens is already gone.
What Recovery Looks Like
After LASIK or SMILE, most people notice dramatically better vision within the first day. The initial weeks bring mild dryness, light sensitivity, and minor fluctuations in clarity, all of which are normal. Halos or starbursts around lights at night are common early on and typically fade as the cornea heals. Meaningful visual stability usually arrives within four to eight weeks, though complete corneal healing takes three to six months.
Extended screen time can worsen post-surgical dryness, so expect to use artificial tears frequently in the first few weeks. PRK recovery is slower, with blurry vision lasting several days to a week before gradually sharpening. ICL recovery is generally quick since the cornea itself isn’t reshaped.
Choosing the Right Option
Your best path depends on a few key factors: how much astigmatism you have, your age, your corneal thickness, and whether you want a permanent fix or are comfortable with an ongoing solution like contacts or ortho-K. For mild to moderate astigmatism (under 3 diopters), any of the options above will work well. For higher amounts, ICLs or specialty toric contacts become more relevant. For adults over 40 who also struggle with reading vision, lens replacement addresses multiple problems at once.
All surgical options require a stable prescription. If your vision is still changing year to year, corrective lenses remain the safest choice until things settle. A comprehensive eye exam with topographic mapping of your cornea is the starting point for determining which procedures you’re a candidate for.