Farsightedness is a common condition that affects 5-10% of the population in the United States. Otherwise known as hyperopia, farsightedness makes it more difficult to see near objects than far away objects and images. Farsightedness is treated with glasses, contact lenses, or refractive eye surgery. LASIK for hyperopia can be a excellent option for those who want to minimize their dependency on glasses and contact lenses.
What Is Hyperopia?
Hyperopia is a type of refractive error. Other common types of refractive error are myopia (nearsightedness) and astigmatism. Refractive error describes a condition in which light doesn’t focus accurately on the retina, the light-sensitive tissue inside the eye, which causes images to be blurred. In individuals with hyperopia, vision is better when viewing objects in the distance versus those that are near, hence the term farsightedness. Blurry vision may interfere with the ability to read, use the computer, or thread a needle, for example. This is more of a problem in severe farsightedness versus mild farsightedness.
Who Is at Risk for Farsightedness?
Most people are born farsighted. If you measure an infant or young child’s refractive error, expect to find hyperopia. Children typically outgrow their hyperopia over time. Having said that, some people remain hyperopic. Others can even outgrow their hyperopia, but develop it again later in life. Farsightedness tends to be hereditary.
What Causes Farsightedness?
Refractive error is the result of an atypical shape of the cornea causing light rays not to refract (bend) properly. The root cause of refractive error comes from two key measurements of the eye: the power of the cornea and the length of the eye. If the cornea is not powerful enough and/or the eye is too short, light focuses behind the retina. Light rays should normally focus on the retina itself. When the light rays don’t focus where they should, vision is blurry. In hyperopia, the blur tends to be more pronounced when viewing near targets as compared to distant objects.
What Are the Symptoms of Farsightedness?
Symptoms of farsightedness may include:
- Blurry vision, especially at near
- Eyestrain
- Headaches
- Eye discomfort
Younger people may be able to compensate for hyperopia by using their accommodative (eye focusing) system, especially with mild farsightedness. When the accommodative system is stimulated, the crystalline lens inside the eye becomes more rounded, increasing its power. This helps to focus light rays where they should be on the retina. Although accommodation helps with image clarity, it can become fatiguing over the course of a day. In fact, younger individuals may complain of eye fatigue more than blurry vision. With age, the ability to accommodate diminishes and the blurred vision in hyperopia may become more prevalent.
When Should You See a Doctor?
It’s a good idea to see an optometrist or ophthalmologist if you have symptoms of blurred vision, eyestrain, or headaches. Your eye doctor can measure your vision by performing a refraction, which involves the presentation of lenses to see which lenses improve your quality of vision.
Even if you don’t have any symptoms, it’s a good idea to have regular eye exams. Not only will your eye doctor check for refractive errors like hyperopia, they will check your general eye health.
There are various guidelines by professional organizations on how often to have an eye exam. The American Optometric Association recommends the following:
Adults
Recommendations differ by risk level.
Adult risk factors include the following:
- Having a personal history of ocular disease.
- Having a family history of ocular disease.
- Belonging to certain racial or ethnic groups.
- Having a systemic health condition with potential ocular manifestations.
- Having an occupation that is highly demanding visually or has hazardous potential for the eye.
- Taking medications with ocular side effects.
- Having functional vision in only one eye.
- Wearing contact lenses.
- Having had previous eye surgery or injury.
- Having high or progressive refractive error.
- Having other eye-related health concerns or conditions.
Children & Adolescents
Recommendations by the American Optometric Association differ by risk level for children and adolescents as well.
Risk factors for children and adolescents include:
- Having a history of prematurity, low birth weight, and/or prolonged supplemental oxygen at birth.
- Having a history of prolonged labor/fetal distress.
- Having a family history of myopia, amblyopia, strabismus, retinoblastoma, congenital cataracts, metabolic or genetic disease.
- Having a history of maternal infection during pregnancy.
- Having a history of maternal smoking, alcohol use, or illicit drug use during pregnancy.
- Having cortical visual impairment.
- Having high or progressive refractive error.
- Having strabismus (eye turn).
- Having anisometropia (significantly different refractive error between the two eyes).
- Experiencing problems with academic performance.
- Having a neurodevelopmental disorder.
- Having a systemic health condition with potential ocular manifestations.
- Wearing contact lenses.
- Having functional vision in only one eye.
- Having a history of prior eye surgery or injury.
- Taking medications with potential ocular side effects.
How to Diagnose Farsightedness?
Farsightedness is diagnosed during an eye exam, your doctor may use several tools to do so.
- Phoropter: The phoropter is the device that is positioned in front of your face as you view the eye chart. It houses lenses that can be presented to you to assess their effect on your vision. As part of the process called refraction, you may be asked for feedback on which lenses you prefer to look through.
- Retinoscope: A retinoscope is sometimes used in combination with the phoropter. The retinoscope shines a light into the eye to help in diagnosing hyperopia, myopia, and astigmatism. The optimal lenses from the phoropter can then be used to measure your refractive error.
- Eye drops: Eye drops are sometimes used before refraction when hyperopia is suspected. These drops are used to temporarily disable the accommodative (focusing) system of the eye. This helps to assess the true refractive error without the influence of focusing. These drops dilate the pupil as well.
What Are Possible Hyperopia Complications?
Untreated hyperopia is especially problematic for children. In addition to experiencing symptoms of blur, headaches, and eyestrain, children may develop:
- Strabismus (eye turn)
- Amblyopia (lazy eye)
- Developmental delays
- Learning difficulties
How to Treat Hyperopia
There are several options for the treatment of hyperopia.
Glasses and Contact Lenses
Eyeglasses or contact lenses are commonly recommended for the treatment of hyperopia. The corrective lenses in eyeglasses or contact lenses help to focus light on the retina, clearing up blurred vision. If there is a large difference in hyperopia between the two eyes, contact lenses may be a better choice, especially for children. Contact lenses minimize the image size difference between the two eyes that can sometimes be problematic with glasses.
Vision Correction Surgery
Refractive surgery is another option to treat hyperopia farsightedness.
- LASIK (laser-assisted in situ keratomileusis). In LASIK, a hinged flap is created from the outer layers of the cornea. An excimer laser is then applied to deliver the necessary energy to correct the individual patient’s refractive error. The flap is then replaced.
- PRK (photorefractive keratectomy). No flap is created in PRK; rather, the epithelium is removed by gently brushing off the surface cells of the cornea. The excimer laser is applied to deliver the necessary energy to correct the refractive error. A bandage contact lens is then applied to help with healing, and will be removed once your doctor determines you are fully healed.
Your eye doctor can recommend the procedure that will provide you with the greatest level of success, while maintaining the highest level of safety. There are constraints on the levels of hyperopia that can be treated with refractive surgery. If you have severe farsightedness, schedule a consultation with your doctor to determine if refractive surgery is an option for you.
Can I Prevent Farsightedness?
Farsightedness is not preventable. However, you can keep your eyes healthy by taking the following steps:
- Wearing sunglasses
- Getting regular eye exams
- Eating a balanced diet
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