Astigmatism and Military Service: The Dioptre Difference
Reviewed by the LabReadAI medical team
The short answer: astigmatism does not prevent conscription while the difference in refraction between the two principal meridians stays at or below 4.0 dioptres. That is the key detail almost everyone misses: article 34 of the Schedule of Diseases counts neither spectacle lens power nor the "degree" written in a report, but precisely the difference between meridians.
Which fitness category astigmatism yields
| Difference in refraction between the two principal meridians | Clause | Column I (conscription) |
|---|---|---|
| Above 6.0 D | «a» | D — unfit |
| Above 4.0 and up to 6.0 D | «b» | V — limited fitness |
| Above 2.0 and up to 4.0 D | «g» | B-3 — fit with restrictions |
A difference of up to 2.0 D is not mentioned in the article at all — meaning it provides no grounds for applying it.
What article 34 says verbatim
a) …or astigmatism of any type in either eye with a difference in refraction between the two principal meridians above 6.0 D
b) …or astigmatism of any type in either eye with a difference in refraction between the two principal meridians above 4.0 D and up to 6.0 D
g) …or astigmatism of any type in either eye with a difference in refraction between the two principal meridians above 2.0 D and up to 4.0 D
The phrase "of any type" recurs in all three clauses. Simple, compound, mixed, myopic or hyperopic astigmatism are assessed identically — only the dioptre difference matters. And "in either eye" means the worse eye is taken.
Compound and myopic astigmatism: counting the difference
Astigmatism is described by two values — refraction along the steep and the flat meridian. If a report says "−1.0 / −4.5", the difference is 3.5 D: clause «g» and category B-3. If it says "−2.0 / −7.0", the difference is 5.0 D — already clause «b» and category V.
This is why the cylinder in a spectacle prescription often misleads: it reflects part of the correction rather than the whole picture. The board needs refraction along both meridians, obtained by the regulation's method.
Cycloplegia: how refraction must be measured
As with myopia, the method is prescribed directly:
The type and degree of refractive error are determined by retinoscopy or refractometry under cycloplegia.
Without pharmacological relaxation of accommodation the result may differ from the true one. An optician's prescription is therefore not a document for the board — it is measured differently and for a different purpose.
When astigmatism comes with myopia
This combination is the most common, and it is assessed on both grounds at once: the degree of myopia in a meridian separately, and the difference between meridians separately. The category follows whichever leads to the more severe clause. With a refraction of "−7.0 / −9.0", for instance, the difference is only 2.0 D — not even reaching clause «g» — but myopia of 9.0 D falls under clause «b», and that is what decides. Myopia thresholds are covered on the page about eyesight and conscription.
Visual acuity and correction
Where astigmatism markedly reduces vision, article 35 applies in addition. There acuity counts with correction, and the regulation states a requirement for it:
Correction of astigmatism of any type must be carried out with cylindrical or combined lenses fully across all meridians.
Incomplete or imprecise correction therefore distorts the result, and that is taken into account.
What your records must contain
- Refractometry or retinoscopy under cycloplegia stating refraction along both principal meridians of each eye.
- The difference between meridians calculated explicitly, or at least both values so it can be derived.
- Visual acuity with and without correction for each eye.
- An ophthalmologist's conclusion with the type and degree of astigmatism.
- The chart code is H52.1 where myopia is combined.
- A preliminary bearing can come from an online astigmatism test — not a document, but it helps frame questions for the doctor.
What is usually missing
- The report states only the cylinder from a spectacle prescription, without refraction by meridian.
- There is no note of cycloplegia.
- The "degree of astigmatism" is given in words rather than dioptres.
- Data for one eye only, although the regulation takes the worse one.
- Acuity with full correction across all meridians is not stated.
Questions for your doctor
- What is my refraction along each of the two principal meridians in each eye?
- What is the difference between the meridians in dioptres?
- Was the measurement performed under cycloplegia?
- What is my acuity with full cylindrical correction?
- Is there accompanying myopia, and of what degree?
Vision at departmental boards
The above concerns assessment under Government Decree No. 565. The Interior Ministry, National Guard, Federal Security Service and Emergencies Ministry use their own schedules of diseases, with stricter vision requirements. A review under articles 34 and 35 shows how complete your records are but is not their regulation.
The short version
Astigmatism is the rare case decided by a single subtraction: the difference in refraction between the two principal meridians. Up to 2.0 D the article does not apply; 2.0 to 4.0 gives B-3; 4.0 to 6.0 gives V; above 6.0 gives D. The type of astigmatism is irrelevant. What matters is that the records state both meridians and note cycloplegia. Only the military medical board determines the fitness category.
For informational purposes only
This article is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Please consult a healthcare professional for medical guidance.