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Hyperopia, Longsighted or Farsighted – What is it?

If you know anyone with a British background they will commonly say that someone who has Hyperopia “is farsighted”.

The phrase “farsighted” however can also be used in the context of someone being able to see into what’s going to happen in a future situation, and to avoid any confusion the term “having farsightedness” is now more common, and used in the US and Australia.  Hyperopia is also known as “LongSighted”.

But whatever term is used – hyperopia, being farsighted or farsightedness or longsighted – they all refer to a condition where one or both eyes are unable to see near objects clearly, but those far away are better.

So in the same way that being nearsighted means seeing near things clearly, farsighted means someone can only see far or distant things clearer; both terms describe what’s RIGHT with the eyes – not what’s WRONG with they eyes.

Medically, hyperopia describes the condition that occurs when the lens of the eye doesn’t change shape or become curved enough to focus images on to the retina at the back of the eye correctly. The lens instead focuses to a point behind the retina so to speak (and if the eyeball itself is too short then the same thing happens) and images of distant objects are blurred.

Children often suffer from hyperopia at birth, but since their eye lenses are flexible they can often adapt to it by using their eye muscles; and normally after a while their shorter eyeballs become longer and the situation resolves itself.  This process is known as “emmetropization”.

Parents don’t often realise that their child may have hyperopia; only at an age when a child is capable of relating to picture books but can’t seem to distinguish the smaller things is it obvious there may be something wrong. Standing too close to the TV is another sign, since normally a child likes to stand back.  Similar to astigmatism this a difficult concept to explain in words.  Please see the video below for a graphic explanation, which will makes things clearer.

Symptoms

The most obvious symptom of course is blurred vision when trying to look at something up close, but this may be accompanied by headaches, especially when reading or working on a computer, and eye strain.

Children on the other hand sometimes are able to focus with significant strain reading.  To avoid the strain they will often prefer not to read but play outdoors.  Sometimes these children can not concentrate in a classroom as they cannot focus their vision efficiently.
In children hyperopia may be misdiagnosed as another eye condition called strabismus, known colloquially as “crossed eyes”. This may happen because with severe hyperopia to try and see clearly in the distance excess muscular effort is required, which to the brain is perceived as trying to read up close.  This in turn crosses the non dominant, while all visual effort is directed to the dominant eye.

Whether or not a child has hyperopia or another similar disorder will be shown up in a thorough eye examination by an optometrist or ophthalmologist, so really there is no excuse for a parent to procrastinate!

With older people who show the symptoms care must be taken again not to misdiagnose, this time for Presbyopia, which has different causes and needs to be treated differently. Presbyopia affects people over forty when the eye lens changes in flexibility making it more difficult for muscles to focus them – here treatment is by prescribing glasses to be used only to see near objects, typically reading.

Treatment

After diagnosis it depends on the severity of the hyperopia and the age of the patient whether or not to formally prescribe treatment, but if thought necessary then glasses or even contact lenses are the norm.

Laser surgery may be an option, but only usually in more mature patients whose prescriptions for spectacles lenses have not changed much of late.

See the animation below for a thorough explanation of Hyperopia:

 

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About the Author

Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He is currently a Senior Lecturer there and regular speaker to both Optometrists and Ophthalmologists in Australia and Internationally. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings.

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