Hyperopia (Farsightedness): Symptoms, Causes, Treatment

What are the symptoms of hyperopia?

Hyperopia, also known as farsightedness, is a common refractive error where distant objects may be seen more clearly than close ones. Symptoms of hyperopia can vary depending on the severity and age of the individual but generally include:

1. Blurry Vision for Close Objects: Difficulty focusing on nearby objects while distant objects remain clear.
2. Eye Strain: Discomfort or fatigue in the eyes, especially after reading, writing, or other close work.
3. Headaches: Frequent headaches, particularly after prolonged periods of close-up tasks.
4. Squinting: Tendency to squint when looking at close objects to try to see them more clearly.
5. Fatigue: General tiredness or fatigue, especially after tasks requiring near vision.
6. Difficulty with Reading: Trouble reading small print or needing to hold reading material further away than normal.
7. Eye Discomfort: A feeling of burning, aching, or itching in the eyes.

In children, hyperopia can sometimes cause:

1. Crossed Eyes (Strabismus): One or both eyes may turn inward when focusing on close objects.
2. Attention Problems: Difficulty maintaining attention during activities that require near vision, such as schoolwork.

If you suspect hyperopia, it’s important to consult an eye care professional for a comprehensive eye examination and appropriate corrective measures, such as glasses or contact lenses.

What are the causes of hyperopia?

Hyperopia, or farsightedness, is a common refractive error where distant objects can be seen more clearly than close ones. The primary causes of hyperopia include:

1. Eyeball shape: A shorter-than-normal eyeball length is the most common cause of hyperopia. This shorter length means light entering the eye is focused behind the retina instead of directly on it.
2. Corneal curvature: If the cornea (the clear front surface of the eye) is flatter than normal, it can lead to hyperopia because the eye does not have enough focusing power to bring light to a sharp focus on the retina.
3. Lens shape: An abnormal shape of the eye’s lens, particularly if it is too flat, can also cause hyperopia by failing to bend light rays sufficiently to focus them on the retina.
4. Genetics: Hyperopia often runs in families, indicating a genetic predisposition. If one or both parents are farsighted, their children are more likely to develop the condition.
5. Age: As people age, the lens of the eye becomes less flexible, which can contribute to presbyopia, a form of age-related farsightedness, although this is a different condition from congenital or developmental hyperopia.

How is the diagnosis of hyperopia made?

Diagnosing hyperopia (farsightedness) involves a comprehensive eye examination conducted by an optometrist or ophthalmologist. The diagnostic process typically includes the following steps:

1. Medical history: The eye doctor will start by asking about your medical history, including any vision problems, eye conditions, general health issues, and family history of eye problems.
2. Visual acuity test: This test measures the clarity of your vision. You will be asked to read letters on a chart placed at a distance (usually 20 feet away). The smallest line of letters you can read accurately determines your visual acuity.
3. Retinoscopy: During this test, the eye doctor shines a light into your eye and observes the reflection off the retina. By moving the light and using different lenses, the doctor can estimate the refractive error and determine whether you are farsighted.
4. Refraction test: This test is more precise and involves using a device called a phoropter. The eye doctor places a series of lenses in front of your eyes and asks you to read letters on a chart. Based on your responses, the doctor determines the prescription that provides the best vision correction. This helps quantify the degree of hyperopia.
5. Ophthalmoscopy: The eye doctor uses an ophthalmoscope to examine the back of your eye (retina) and other internal structures. This helps rule out other eye conditions that might affect vision.
6. Slit-lamp examination: A slit lamp is a microscope with a bright light used to examine the front part of your eye, including the cornea, iris, and lens. This test helps detect any abnormalities in these structures.
7. Cycloplegic refraction (if necessary): In some cases, especially in children or when the initial tests are inconclusive, the eye doctor may use eye drops to temporarily paralyze the focusing muscles of the eye. This allows for a more accurate measurement of the refractive error.

After these tests, the eye doctor will review the results and determine if you have hyperopia. If you are diagnosed with hyperopia, the doctor will discuss appropriate corrective measures, such as eyeglasses, contact lenses, or possibly refractive surgery, to improve your vision. Regular eye examinations are important to monitor your vision and update prescriptions as needed.

What is the treatment for hyperopia?

The treatment for hyperopia (farsightedness) aims to correct the refractive error, allowing light to focus properly on the retina for clear vision. The most common treatments include:

1. Eyeglasses: Eyeglasses are the simplest and most common way to correct hyperopia. They use convex lenses to help focus light correctly on the retina, improving both near and distant vision. The prescription for eyeglasses is determined during a refraction test conducted by an optometrist or ophthalmologist.
2. Contact lenses: Contact lenses offer another effective option for correcting hyperopia. They function similarly to eyeglasses by providing the appropriate lens power to focus light on the retina. Some people prefer contact lenses for aesthetic reasons or for more natural vision correction. Contact lenses come in various types, including daily disposables, extended wear, and multifocal lenses.
3. Refractive surgery: For those seeking a more permanent solution, several types of refractive surgery can correct hyperopia by reshaping the cornea:

• LASIK (Laser-Assisted in Situ Keratomileusis): This procedure involves creating a thin flap on the cornea, reshaping the underlying corneal tissue with a laser, and then repositioning the flap. This reshaping allows light to focus properly on the retina.
• PRK (Photorefractive Keratectomy): In PRK, the outer layer of the cornea is removed, and a laser is used to reshape the underlying corneal tissue. The outer layer regenerates over time. PRK is an option for those with thinner corneas who may not be suitable candidates for LASIK.
• LASEK (Laser Epithelial Keratomileusis): LASEK is similar to PRK but involves preserving and repositioning the thin outer layer of the cornea after reshaping the underlying tissue with a laser.
• RLE (Refractive Lens Exchange): Also known as clear lens extraction, RLE involves replacing the eye’s natural lens with an artificial intraocular lens (IOL). This procedure is typically considered for individuals with severe hyperopia or those who are not good candidates for corneal reshaping procedures.

1. Orthokeratology: This non-surgical option involves wearing specially designed rigid gas-permeable contact lenses overnight. These lenses temporarily reshape the cornea, providing clear vision during the day without the need for glasses or contact lenses. The effect is temporary, and the lenses must be worn regularly to maintain the correction.
2. Vision therapy: In some cases, especially for children, vision therapy exercises may be recommended to improve focusing abilities and eye coordination. This approach is often used in conjunction with other treatments like eyeglasses.

The choice of treatment depends on factors such as the severity of hyperopia, age, lifestyle, and personal preferences. An eye care professional can help determine the most suitable option based on individual needs and circumstances. Regular eye exams are important to monitor vision changes and update prescriptions as necessary.