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J Cataract Refract Surg. 2011 Mar;37(3):454-60. doi: 10.1016/j.jcrs.2010.09.022.

Effect of uncorrected astigmatism on vision.

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Aston University, School of Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom.



To examine the effect of uncorrected astigmatism in older adults.


University vision clinic.


Investigational simulation.


Healthy adult presbyopes had astigmatism of 0.00 to -4.00 diopters cylinder (DC) × 90 degrees and -3.00 DC × 90, × 180, and × 45 degrees induced with spectacle lenses, with the mean spherical equivalent compensated to plano, in random order. Visual acuity was assessed binocularly using a computerized test chart at 95%, 50%, and 10% contrast. Near acuity and reading speed were measured using standardized reading texts. Light scatter was quantified with a C-Quant straylight meter and driving reaction times with a computer simulator. Visual clarity of a mobile phone and computer screen was subjectively rated.


Distance visual acuity in the 21 volunteers decreased with increasing uncorrected astigmatic power (F = 174.50, P < .001) and at lower contrasts (F = 170.77, P < .001). Near visual acuity and reading speed also decreased with increasing uncorrected astigmatism power (P < .001). Light scatter was not significantly affected by uncorrected astigmatism (P > .05); however, the reliability and variability of measurements decreased with increasing uncorrected astigmatic power (P < .05). Driving simulator performance was unaffected by uncorrected astigmatism (P > .05), although subjective rating of clarity decreased with increasing uncorrected astigmatic power (P < .001). Uncorrected astigmatism at the 45-degree or 180-degree orientation resulted in worse distance and near visual acuity and subjective-rated clarity than at the 90-degree orientation (P < .05).


Uncorrected astigmatism, even as low as 1.00 D, caused significantly decreased vision and if left uncorrected could significantly affect patients' independence, quality of life, and well-being.

[Indexed for MEDLINE]

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