Jewelry designer’s rapidly worsening astigmatism traced to keratoconus, restored to 20/20 vision with precision glasses

A jewelry designer who needs to read the fine cuts and reflections of gemstones struggled with vision that shifted between clear and blurred. Her astigmatism rose rapidly in both eyes, reaching 600 degrees in the left eye and 400 degrees in the right.

Repeatedly changing her glasses did not solve the problem. A detailed examination at National Taiwan University Hospital Hsinchu Branch found that the 33-year-old woman had keratoconus, a condition in which the cornea gradually thins and bulges forward.

Ophthalmologist Ko Mei-lan said early keratoconus can look like ordinary nearsightedness or worsening astigmatism. As the condition progresses, patients may develop irregular astigmatism, distorted images or double vision. Standard glasses may not provide consistently clear sight, while some patients cannot adapt to soft or rigid contact lenses.

Ko worked with Chen Ya-yu, an assistant professor in the Department of Optometry at Mackay Medical College, to assess both-eye visual function, analyze the optical system and design individualized glasses. The process first improved the image in each eye, then adjusted the prescription according to how the eyes worked together.

After the assessment and new prescription, the designer’s corrected vision returned to 1.0 in both eyes. She could again use both eyes steadily for detailed jewelry design. Ko said the non-invasive approach may also help patients with stable keratoconus, severe astigmatism and complex refractive errors. The research team plans to present its findings at the 2026 midyear ophthalmology conference.

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If astigmatism increases rapidly over a short period, glasses become less clear with each replacement, or vision becomes distorted or doubled, people should seek a detailed eye examination as soon as possible.