Astigmatism is a type of refractive error due to rotational asymmetry in the eyes refractive power. This results in distorted or blurred vision at any distance. Other symptoms can include eyestrain, headaches, and trouble driving at night. Astigmatism often occurs at birth and can change or develop later in life. If it occurs in early life and is left untreated, it may result in amblyopia.The cause of astigmatism is unclear; however, it is believed to be partly related to genetic factors. The underlying mechanism involves an irregular curvature of the cornea or abnormalities in the lens of the eye. Diagnosis is by an eye examination, through objective and subjective refraction.Three treatment options are available: glasses, contact lenses, and surgery. Glasses are the simplest. Contact lenses can provide a wider field of vision. Refractive surgery permanently changes the shape of the eye.In Europe and Asia, astigmatism affects between 30 and 60% of adults. People of all ages can be affected by astigmatism. Astigmatism was first reported by Thomas Young in 1801. Signs and symptoms
Although astigmatism may be asymptomatic, higher degrees of astigmatism may cause symptoms such as blurred vision, double vision, squinting, eye strain, fatigue, or headaches. Some research has pointed to the link between astigmatism and higher prevalence of migraine headaches. Causes
Congenital
The cause of congenital astigmatism is unclear, however it is believed to be partly related to genetic factors.
Irregular astigmatism is quantified by a vector calculation called topographic disparity. Focus of the principal meridian
With accommodation relaxed:

Simple astigmatism
Simple hyperopic astigmatism – first focal line is on the retina, while the second is located behind the retina. Simple myopic astigmatism – first focal line is in front of the retina, while the second is on the retina. Compound astigmatism
Compound hyperopic astigmatism – both focal lines are located behind the retina. Compound myopic astigmatism – both focal lines are located in front of the retina. Mixed astigmatism – focal lines are on both sides of the retina (straddling the retina). Throughout the eye
Astigmatism, whether it is regular or irregular, is caused by some combination of external (corneal surface) and internal (posterior corneal surface, human lens, fluids, retina, and eye-brain interface) optical properties. In some people, the external optics may have the greater influence, and in other people, the internal optics may predominate. Importantly, the axes and magnitudes of external and internal astigmatism do not necessarily coincide, but it is the combination of the two that by definition determines the overall optics of the eye. The overall optics of the eye are typically expressed by a persons refraction; the contribution of the external (anterior corneal) astigmatism is measured through the use of techniques such as keratometry and corneal topography. One method analyzes vectors for planning refractive surgery such that the surgery is apportioned optimally between both the refractive and topographic components.