Counterknowledge: “Give it to me straight doc – Do I have A Stigma?”

7 02 2013

I get this question a lot from patients of every age.  It is generally accompanied by a sense of panic and fear of a debilitating ailment that threatens for very sense they rely on for a good part of daily living. What is ‘a stigma’ you may ask?  The correct question is ‘what is astigmatism?’  An the answer is as dire as one may think.  The word is derived from Greek “a” meaning without, and “stigma,” meaning point.  Without point.  Simple.  Right?  It doesn’t mean evil spirit or the devil’s eye! astigmatism Without point describes light coming into the eye.  Patient’s with astigmatism have eyes that don’t focus light onto a single point on the retina.  Put simply, the cornea is less round and shaped more like a football then like a baseball which causes light to focus within the eye at different points.  This causes distorted images rather then overall blur, which is why if you have astigmatism you may be living with it and possibly not even know it because you can ‘see just fine.’  But can you really? Looking at the 3 letters on the top compared to the bottom, although one can read them it isn’t an easy visual experience.  Consider having a learning disability where words can get jumbled or mixed up – even correcting a mild degree of astigmatism with glasses or contacts can make a huge difference.  Playing sports even in a recreational setting can become quite frustrating when a ball or a puck is your target. Astigmatism isn’t a death sentence or even a comment on your ocular health.  I have astigmatism –  studies suggest that 1 in 3 people have some measurable amount of astigmatism (National blindness and Low Vision Survey, 2003).  This doesn’t have any implication on your eye’s health however it shouldn’t be ignored because it may have a large impact on your daily performance.  In rare cases, increasing astigmatism may be a sign of an eye condition called keratoconus which is a progressive disease of the cornea.  Monitoring your refractive status is important to rule this out. Needing some form of visual correction for myopia, hyperopia and astigmatism does not mean your eye is unhealthy or that you have an impairment.  If your eye doctor tells you that your child needs glasses, don’t despair and don’t assume this will be for life.  Interestingly a parent’s reaction to a child needing glasses for the first time is a big predictor to how willing  and compliant your child will be to wear his or her corrective lenses.  If you gasp at the news then this creates anxiety about the diagnosis and is absorbed immediately by your child.  When I communicate to kids in my chair, I will speak to them directly knowing that mom or dad is right beside them listening as well.  The first thing a child does when they hear they need glasses is look at their parent for a response so I always advise parents to be excited about this and use it as an opportunity to educate and ease the anxiety. Knowing about your eyes allows you to arm yourself with the right terms to speak to your eye doctor confidently and can help you to understand that not all diagnoses are related to your ocular health status but are still important for your visual well-being.

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