Assessment for my second eye says astigmatism and they have offered a toric lens at extra cost. Worth it, or will glasses fix that anyway?

Bit thrown by this one. First eye was done with the plain standard lens, no fuss, no options offered, and it has been lovely. Went in for the second eye assessment last week and the lady doing the measurements said the left eye has "a fair bit of astigmatism" and the surgeon then asked whether I wanted to consider a toric lens, which is not covered and would mean paying for the lens on top.

I said I would think about it and have been thinking about it ever since. Nobody said anything about astigmatism in my right eye, so is it really only in one? Would the standard lens give me a blurry eye? And my glasses have always had astigmatism in them for as long as I can remember, so can they not just carry on putting it in the glasses like they always have and save me the money?

Also, and I am asking because of the halo threads on here, is a toric one of the fancy lenses that gives you rings round headlights? I do NOT want to trade a bit of blur for that. Any experience gratefully received, mine is booked for the 20th of October so I have a couple of weeks to decide.

I had a toric in my left and a plain one in my right, so I can at least tell you what it was like.

Left eye (toric) came out sharper without glasses than the right did, which surprised me because the right was supposedly the "easy" eye. The surgeon had told me the left had over two units of astigmatism, whatever the units are, and that a plain lens would have left it soft at distance. He was right. Without my glasses the left eye reads the number plates, the right eye is a touch woolly.

No extra halos on the toric side that I could ever tell. Both eyes look identical to me at night. It is still a distance only lens, mind, so readers for the crossword as ever.

No experience of toric but I would want to know the actual number before deciding anything. "A fair bit" could mean anything.

June, the direct answer is that whether a toric lens is worth paying for depends almost entirely on how much corneal astigmatism the measurements found, and Betty is right that you need that number. As a rough guide, below about 0.75 to 1.0 dioptre most surgeons would not recommend a toric lens because the gain is too small to notice; from roughly 1.0 to 1.5 dioptres upwards it starts to give a real improvement in uncorrected distance vision; and at 2 dioptres or more, which sounds like Ken's left eye, a standard lens will leave distance vision noticeably soft without glasses. Ask the unit for the figure from the biometry and the keratometry, and ask whether it is corneal astigmatism specifically.

That distinction answers your second question. Astigmatism in your glasses is the total for the eye, and part of it can come from the natural lens rather than the cornea. When the cataract is removed that lens portion goes with it, which is why some people find their new glasses have far less astigmatism than the old ones, and why the number in your spectacle prescription is not the number that matters here. Only the corneal part is left behind after surgery, and that is what a toric lens is designed to correct. It is also entirely usual for the two eyes to differ; astigmatism is measured per eye, and one eye having 2 dioptres while the other has almost none is unremarkable.

Can glasses do the job instead? Yes, and it is a perfectly reasonable alternative. A standard monofocal lens plus spectacles that carry the astigmatism will give you clear corrected vision, exactly as your glasses always have. What you are paying for with a toric lens is sharper vision without glasses at the distance the lens is set for. If you always wear glasses anyway and do not mind continuing, the case for paying is weaker; if you were hoping to be free of them for driving, television and walking about, it is stronger. Either way a toric lens is a monofocal, so it does not bring the multifocal halo and glare trade-off, and readers for close work remain likely. The site's guide to toric lenses for astigmatism sets out the same trade-offs, and premium lenses, are they worth it covers the broader question of paying extra for anything.

Two things to weigh that are specific to toric lenses. First, the lens has to sit at a precise rotation, and each degree it sits off that axis loses roughly 3 percent of its astigmatism correction, so at about 30 degrees off it does nothing. Early rotation is uncommon with modern designs, and if it happens the lens can usually be turned back in a short second procedure within the first weeks. Second, some surgeons can reduce a modest amount of astigmatism with small incisions on the cornea during the operation, which is sometimes offered when the amount sits in that grey zone around 1 dioptre. Ask whether that applies to you.

Your own measurements decide this, not a forum, so take the questions above to the surgeon who has them in front of them.

Useful thread. The bit about the astigmatism in your glasses not being the same as the astigmatism that matters for the lens is new to me, and I had both eyes done two years ago. My new glasses did end up with much less astigmatism than my old ones and I never understood why.

One more for the list, June: ask whether the price they quoted is for the lens only or includes anything else, because a friend of mine found the "toric upgrade" figure had a second consultation folded into it that nobody had mentioned.

Mr Lewis Pereira said:

ask whether it is corneal astigmatism specifically

Rang the unit and asked exactly that. Corneal astigmatism 1.75 in the left, next to nothing in the right, which explains why nobody mentioned it the first time.

Have said yes to the toric. I would rather pay once than squint at road signs on the one side for the rest of my days, and the fact that it is not one of the halo lenses settled it for me. Harold, the quote is lens only, I checked. Will report back after the 20th.