Hyperopia

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at April 13, 2016
StartDiseasesHyperopia

Hyperopia or farsightedness is a fairly common visual condition affecting about one in five people throughout the United States. The condition is also known as long-sightedness. People with hyperopia can see objects far away, but they have difficulty seeing objects up close.

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Definition & Facts

Nearly half of people wearing contact lenses or glasses have hyperopia. Farsighted people sometimes don’t know they have the condition as their eyes have gradually adjusted to the changes in their visual acuity over time. Farsightedness is a normal variation in eye shape that causes symptoms of blurry, up-close vision.

Hyperopia starts in childhood with the shape of the eyeball. Sometimes children can outgrow the condition as the eyes becomes larger. Children don't often complain about the symptoms, however, as their brains accommodate the changes in vision as their bodies grow.

Symptoms & Complaints

People affected by hyperopia complain most often of headaches, tired eyes or blurred vision. These symptoms occur when trying to focus on up-close tasks such as reading, hand crafting, or prolonged computer work. Continued concentration on near objects can cause eye strain and irritability and will increase the symptoms.

Occasionally, the ability to see things far off (near-sightedness) will also be affected as the condition progresses. Patients with hyperopia rarely have complications past the inability to see things close up. However, rare complications such as lazy eyes, crossed eyes and double vision have been reported.

Causes

Causes of hyperopia can include the shape of the eyeball, the shape of the cornea or weakened muscles around the lens of the eye. The cornea is the clear part of the eye that helps bring in and bend the light in order to focus on an image. If the cornea is not curved properly, the light is not properly focused and vision can be skewed.

The tiny, intricate muscles that pull the eye’s lens to help focus on an image can also become fatigued, causing a loss of visual accuracy on items close by. Prolonged straining or concentration on close tasks can make the problem worse and also cause headaches or eye pain.

Sometimes people are born with farsightedness because of family history. Genetic factors can play a role in the shape and size of the eyes and the progression of vision problems within a family. Rarely, another disease can affect or cause hyperopia like a tumor pressing on a muscle or a retina issue.

Diagnosis & Tests

To properly diagnosis farsightedness, an eye doctor will perform an eye examination involving a vision test and a check up of the condition of the eyes. The simple, standard vision screenings given in schools and by employers do not always diagnose hyperopia. An exam in an optometrist’s office is the best way to know if hyperopia is an issue. The doctor may decide to use drops to dilate the pupils to more easily see the entire eye. Sometimes dye is also used, but this is rare.

A slit lamp allows a powerful beam of light to shine all the way to the back of the eyeball. The doctor can then see the shape of the eye, the muscle movement, how the lens and cornea are shaped, and the optic nerve. This important test can also detect other eye abnormalities or diseases such as cataracts or macular degeneration. There is no advanced preparation needed before this test; however, the patient may want to have a ride home, as sometimes the pupils remain dilated well past the exam time, and this can make it difficult to drive.

Treatment & Therapy

Once hyperopia has been formally diagnosed, a course of treatment is offered. The easiest, most common way to treat farsightedness is with corrective lenses. Either eyeglasses or contact lenses can be prescribed from the optometrist after a thorough exam. Surgery is reserved only for the most severe cases or when one wishes to not wear corrective lenses. One kind of laser surgery, photorefractive keratectomy, or PRK, removes part of the cornea. This surgery has many complications including dry eyes, halos in the vision, scarring and can have a long recovery time.

Another surgical option is LASIK. With this procedure, the surgeon makes a flap in the cornea, removes some of the corneal material and replaces the flap. This surgery also comes with similar risks, but not as many as the PRK procedure. Both surgeries, when successful, reduce or eliminate the need to wear contact lenses or glasses. The prospective patient for either of these surgeries must need to meet qualifications prior to being considered for the procedure. The eye doctor is the best source of information for options, risks, and benefits of these procedures.

Prevention & Prophylaxis

Hyperopia cannot be prevented, as often it is the shape of the eye and genetics that play the biggest roles in the presentation of symptoms. Regular checkups with an optometrist can catch problems early and ensure proper prescription eye glasses since corrective lenses help minimize strain and headaches. A healthy diet rich in colorful fruits and vegetables along with a multivitamin for eye health is also recommended.

Sunglasses help reduce UV damage to the eyes, and eye protection during carpentry work or other such activities will protect the eyes from foreign objects. Regular breaks from close work such as reading, computer screens, sewing or writing helps to reduce muscle strain and gives the eyes a chance to recover. The use of good lighting can also help reduce eye strain and help reduce the load on the cornea.

General eye health is also affected by smoking, high blood pressure, diabetes mellitus and stress. Diabetes control is important as blood sugars that are out of control can lead to other eye diseases and even blindness. Farsightedness cannot be prevented, but quality eye care, eye hygiene and a healthy lifestyle can help protect the eyes and keep them as healthy as possible.