In a vision sense relative to normal pistol sights, your problem is not astigmatism, a football shaped lense/eye rather than a normal round. It is more on the order of:
1) your distance vision begins to focus clearly farther in front of your eye-hands-pistol sights than your arms are long, and
2) the relative invisibility of black on black or even three white dot pistol sights.
3) a side issue is the prescription quality. Astigmatism makes lense prescription "rotation indexing" critical. Specs are 5 degrees rotation on axis, BUT I can tell the difference in vision between perfect axis rotation and one degree off. The doc has to make sure the lenses correctly fit the frames.
A workable solution without optics hung on a pistol for me and some old friends has been to:
1a) find an eye doctor, take your gun or a substitute, with discussion demonstrate what you have trouble with, and have the doctor "pull" the distance vision prescription correction back just a little so that the sights enter your distance focus correction at arms length, and
2a) use some sights that are bright AND large so that you can see them AND by their nature align much easier than black on black. To me, it means HiViz light pipes or something like that from Ameriglo. Bright green dots side by side are easy to align. Or the big Ameriglo square fronts.
3a) the doc has to send the lenses back unless they are close to zero.
Done correctly, these are wearable full time. Not a switch at the range or Zombie time. Distance vision stays almost perfect but close things at arms length become seeable.
These things work for near sightedness. I think you have the normal age related far sightedness. The translation is beyond my limited knowledge, but the idea is there.
See the photos in the following posts:
https://www.ar15.com/forums/handguns/Glock-21-The-Real-Deal/13-178333/
https://www.ar15.com/forums/handguns/Shield-Sights-HiViz-and-AmeriGlo-Combination-Follow-up-to-an-archived-thread/16-177728/
https://www.ar15.com/forums/handguns/Glock_19_and_SandW_Shield_9mm___Use_and_Shooting_Comparison/4-162813/
The stories don't much matter. Its the photos of sights.