Astigmatism usually occurs when the front surface of the eye, the cornea, has an irregular curvature. Normally the cornea is smooth and equally curved in all directions and light entering the cornea is focused equally on all planes, or in all directions. In astigmatism, the cornea is curved more in one direction than in the other. This abnormality may result in vision that is much like looking into a distorted, wavy mirror. The distortion results because of an inability of the eye to focus light rays to a point.
If the corneal surface has a high degree of variation in its curvature, light refraction may be impaired to the degree that corrective lenses are needed to help focus light rays better. At any time, only a small proportion of the rays are focused and the remainder are not, so that the image formed is always blurred. Usually, astigmatism causes blurred vision at all distances. Some people with very high degrees of astigmatism may have cornea problems such as keratoconus.
Astigmatism is very common. Some experts believe that almost everyone has a degree of astigmatism, often from birth, which may remain the same throughout life. The exact reason for differences in corneal shape remains unknown, but the tendency to develop astigmatism is inherited. For that reason, some people are more prone to develop astigmatism than others.