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Astigmatism – Smorawski Okulistyka

Astigmatism

Why is astigmatism the most bothersome vision defect?

Astigmatism is associated with an asymmetrical structure of the cornea. It occurs when different corneal meridians have different curvatures. In such cases, the cornea takes on an ellipsoidal rather than a spherical shape (resembling a rugby ball more than a football). This irregular shape causes light to refract more weakly in flatter meridians and more strongly in steeper ones. As a result of these changes in the cornea’s refractive power, the patient’s vision is not only blurry but also distorted in shape—flattened in one axis and slightly elongated in the perpendicular one. The most challenging situation occurs when the axes that distort the object’s shape are not aligned vertically or horizontally. This type of astigmatism is known as oblique astigmatism. Astigmatism can occur in isolation or alongside hyperopia or myopia. When it exceeds 2–2.5 diopters, it presents a significant challenge for optical correction, especially when part of a more complex refractive error (e.g., astigmatism in a patient with high hyperopia and presbyopia). In such cases, laser vision correction appears to be the ideal solution.

Astigmatism: The "double" vision defect – decreasing visual acuity and distorting object shapes.

Astigmatism – a burdensome defect you can be free from. What are the symptoms of astigmatism? Spatial disorientation, headaches, dizziness, difficulty seeing fine details, and a significant decline in vision quality in the evening and in poor lighting. Astigmatism is usually associated with myopia and hyperopia. It is also often an element of presbyopia

How is astigmatism treated ?

Vision Correction Methods for Astigmatism

FemtoLasik

Who is FemtoLasik for?

  • Patients with farsightedness (hyperopia) up to +6.0 diopters.
  • Patients with astigmatism up to 6.0 diopters, with an accompanying spherical error up to -10.0 diopters.
  • Patients with near vision impairment (presbyopia).
  • The procedure can also be used for shortsightedness (minus errors), although this is less common due to the availability of the SMILE technology alternative.

Why choose FemtoLasik?

  • High EMO (Effective Modifying Power) coefficient:
    This method is highly effective for treating vision impairments that are more resistant to correction, such as farsightedness (hyperopia), hyperopic astigmatism, and complex astigmatism.
  • Easy access for future adjustments: Due to the ease of accessing the treatment zone (laser area), this method is an excellent choice for patients who may require re-correction in the future (those with farsightedness developing after age 40 or presbyopia)
  • Combined correction protocols: FemtoLasik allows for the simultaneous application of protocols designed to correct both distance and near vision, such as Presbyond and Presbymax.

Shortsightness (Myopia), Astigmatism, Myopic Astigmatism, Hyperopic Astigmatism, Presbyopia

Who is Trans-PRK for?

  • Patients with shortsightedness (myopia) up to -3.5 diopters, possibly with accompanying astigmatism.
  • Patients with farsightedness (hyperopia) up to +2.5 diopters.
  • Patients with astigmatism up to ±2.5 diopters.

Why choose Trans-PRK?

  • Trans-PRK is a surface procedure in which the corneal epithelium is removed non-contact using an excimer laser. The acronym Trans-PRK stands for transepithelial PRK.
  • Using a laser for epithelial removal ensures that the stroma is free from minor irregularities before the corrective procedure. The stromal bed is perfectly even before the vision correction process begins, maintaining uniform humidity and temperature conditions across its entire surface.
  • Since there is no need to create a corneal flap or use the epithelium as a “masking substance,” this method can be carefully applied to corneas with minor irregularities, as well as in selected cases of keratoconus.

Mild Nearsightedness (Mild Myopia) and Myopic Astigmatism, Mild Farsightedness (Mild Hyperopia) and Hyoperopic Astigmatism, Mild Astigmatism

Who is EBK for?

  • Patients with shortsightedness (myopia) up to -3.5 diopters, including those with accompanying astigmatism.
  • Patients with farsightedness (hyperopia) up to +2.5 diopters.
  • Patients with astigmatism up to ±2.5 diopters

Why choose EBK?

  • EBK is a surface procedure where the corneal epithelium is removed mechanically—without the use of alcohol.
  • The absence of alcohol in this method ensures a faster regrowth of the corneal epithelium, making the post-operative recovery period significantly milder and more comfortable.
  • Since there is no need to create a corneal flap, EBK is an excellent option for patients with thin corneas

Mild Shortsightedness (Mild Myopia) and Myopic Astigmatism, Mild Farsightedness (Mild Hyperopia) and Hyperopic Astigmatism, Mild Astigmatism

Read our patient testimonials

aa profile picture
aa
13:26 02 Apr 26
I recommend it 100%. Thanks to specialists like you, I regain my faith in the medical profession. 10/10. KK
Bartosz Bober profile picture
Bartosz Bober
11:48 24 Sep 25
I had the SMILE procedure and I'm delighted. The doctor is a true professional – everything was thoroughly explained to me before the surgery, and I felt safe and at ease during the procedure. The procedure itself was quick and painless, and the results exceeded my expectations – my vision is excellent, better than ever before. Post-operative care was also top-notch; I could always count on answers to my questions and support.

I wholeheartedly recommend him to anyone considering vision correction – it was one of the best decisions of my life!
Renata profile picture
Renata
19:12 10 Jul 25
Very good doctor. Friendly staff. Thanks to the correction, I have a new life. I highly recommend it.
Olena Shmanko profile picture
Olena Shmanko
12:52 06 Mar 25
I highly recommend Dr. Marcin as a top eye surgery specialist in Warsaw.
The procedure was totally painless and the service l have gotten was great.
Now, l can see this World properly thanks to the Doctor. My sincere recommendation to everyone.
Monika K profile picture
Monika K
08:53 23 Dec 24
I had a lot of concerns about vision correction. I was afraid something would go wrong and I'd have to deal with the consequences. Ultimately, I went for a consultation with Dr. Smorawski on a recommendation, as he had performed the procedure on a family member a few years ago. And that was the moment I believed him. Dr. Smorawski is full of empathy and patience, personally greets and gets to know each patient, answers all questions honestly, is extremely knowledgeable and professional, and his personalized approach makes you feel completely cared for. This isn't a chain store where you have to wait for a hotline to be connected, so in case of an emergency, you can count on him.

Ms. Agata, who supports the doctor, also inspires great trust, offers advice, and patiently answers questions. 😉
I've been having my vision correction done for a few weeks now, from -3 to 0, and my quality of life has improved significantly. I can only say that I regret waiting so long. I would choose the same place again, and only Dr. Smorawski.
I recommend it 100%.
Catherine Jofi profile picture
Catherine Jofi
09:43 20 Aug 24
If you are looking for an ophthalmologist I highly recommend the Smorawski Okulistyka clinic.

Dr. Marcin Smorawski performed my SMILE procedure lately, and I had the pleasure of receiving his excellent care. From the very first consultation, Dr. Smorawski impressed me with his professionalism. He patiently answered all of my questions and took the time to thoroughly explain every step of the process. His ability to make complicated medical concepts understandable gave me the confidence to feel well-informed and secure in my choice.
The results of the LASIK surgery have been life-changing, and I owe it all to Dr. Smorawski’s expertise.

Laser Astigmatism Correction
- consultation with a specialist

Are you struggling with astigmatism and want to effectively eliminate this vision problem? Contact us to determine the treatment method best suited to your case.

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Hyperopia, hyperopic astigmatism, and astigmatism are the most resistant refractive errors to correct. To eliminate farsightedness, a change is required that results in increased corneal steepening. Steepening the corneal dome is significantly more challenging to achieve with laser correction than flattening it. This creates the need for a procedure with a higher EMO (Effective Modifying Power), which is more effective at reshaping the tissue. Femto-LASIK is such a procedure. It is a two-stage treatment. The first stage, which involves creating a corneal flap, simultaneously reduces the rigidity (softens) of the cornea. Once prepared this way, the cornea becomes much more pliable and susceptible to reshaping during the second stage. In the second stage, an excimer laser is applied to the corneal stroma exposed under the flap. In the treatment of presbyopia, we take advantage of the practicality and easy access provided by the presence of the corneal flap. As we age, the demand for visual power for near-distance work increases. To meet this growing need, we can compensate for the increasing near-vision impairment through a minimally invasive and simple method: a flap lift.

Why is Trans-PRK correction more predictable?

The epithelium covers the corneal stroma and is its outermost layer. In surface methods (EBK, Trans-PRK, Topo-guided-PRK), the first step is the removal of the corneal epithelium. Due to the specific way the laser operates, removing the epithelium with a laser leaves the cornea highly uniform in terms of surface texture and hydration levels. The correction stage follows immediately after the epithelial removal phase, making the overall result significantly more predictable compared to manual removal.

What does it mean that the epithelium can be used as a masking substance?

The human eye is not perfect; minor irregularities often occur on the corneal surface. These are frequently compensated for by the overlying epithelium. Thus, the epithelium acts as a tissue that masks imperfections in the corneal stroma. When removing the epithelium manually, these surface imperfections are exposed rather than eliminated. However, by using an excimer laser for epithelial removal, we eliminate corneal irregularities along with the epithelium, achieving an optically ideal surface.

EBK and PRK are surface vision correction methods in which the first, preparatory stage is the removal of the corneal epithelium. In PRK, the epithelium is removed manually using a special solution that loosens the connection between the epithelium and the corneal stroma. In EBK, also a manual method, a specialized device called an epikeratome is used to remove the epithelium.
The corneal epithelium regenerates—or regrows—within several dozen hours, forming a perfectly smooth and even surface. The epithelium has a massive impact on visual quality, and even microscopic irregularities on its surface can drastically impair vision.

The epithelium is a fascinating structure with the ability to mask any imperfections of the underlying stroma. This characteristic is very often utilized in the treatment of corneal irregularities and keratoconus.