The relation between anterior corneal astigmatism and total refractive astigmatism is poorly defined in India. The prevalence of astigmatism in especially young patients and those un-co-operative adult patients is a topic of interest and big challenge for an optometrist to correct it properly from avoiding refractive amblyopia in young patients as well as to help them for better vision for comfortable lifestyle. Astigmatism one of the defects of the optical system, has a great effect on the development of visual acuity. Astigmatism is a common optical defect prevails in human eyes. Refractive astigmatism and anterior corneal astigmatism is a different type of astigmatism. Total refractive astigmatism was received by subjective manifest refraction. Anterior corneal astigmatism power different b/w the steep and flat meridians on the anterior corneal surface. Refractive astigmastism is both myopia and hyperopia. Astigmatism are evenly distributed with the axes of higher level of astigmastism close to the horizontal and vertical axes rather than oblique,therefore possibly reducing the risk of astigmatism amblyopia.

Keywords : Total refractive astigmatism,anterior corneal astigmatism internal astigmatism,manual keratometry Retinoscope,Anterior corneal toricity