Hyperopia is a type of refractive error, meaning that the eyes cannot bend or refract light correctly to form a clear image. Hyperopia is also known as farsightedness – this means that hyperopic people are typically able to see far away rather than up close.
People with hyperopia have eyes that are either too small or too weak, resulting in the light that focuses behind the retina. The retina is what allows our eyes to see images, so when light is not focused properly on the retina, we see a blurred image. Glasses and contacts are able to bend the light differently, so a clear image forms on the retina, and vision is no longer blurry for hyperopic individuals.
Symptoms of Hyperopia
One of the most common symptoms of hyperopia is blurry vision, usually up close rather than far away. However, some hyperopic people will experience distance and near blur, while others will never experience blurry vision at all!
Additional symptoms include trouble focusing or concentrating on near images, headaches or brow aches, eye fatigue or eye strain, or aching and burning eyes.
Many patients do not become symptomatic for their hyperopia until their eyes muscles can no longer compensate for their prescription, so it is not uncommon for a person with hyperopia to not need glasses until later in life.
How is it diagnosed?
Hyperopia is diagnosed through a comprehensive eye examination with a certified eye doctor. The doctor will check a patient’s vision at distance and up close to see if it is reduced. The doctor will also complete a refraction, which is the classic “Which is better, 1 or 2?” test for which eye doctors are infamously known.
The refraction will reveal what type and amount of prescription you have and whether or some kind of treatment is warranted.
Treatments for farsightedness
Treatments for farsightedness include prescription glasses and contact lenses. The lenses for hyperopia will have a plus prescription, meaning that they will have a “+” sign at the beginning. A plus lens has a convex shape, pictured below, which helps to bring light forward onto the retina and allows a clear image to form.
Additional treatment options might include refractive surgery procedures such as LASIK and PRK, which are described below.
What kind of doctor can treat hyperopia
Optometrists are able to treat hyperopia with glasses or contact lenses. Ophthalmologists are also able to treat hyperopia the same way and might be able to correct hyperopia with refractive surgeries such as LASIK or PRK.
When should you see a doctor
As an adult:
It is suggested that adults receive a comprehensive eye examination yearly even if their vision is adequate, just to rule out any additional ocular health concerns. It is especially important to see an eye doctor if you are experiencing any of the symptoms explained above such as blurry vision, eye strain, or issues focusing as these can be signs of hyperopia.
As a child:
Because many children are able to accommodate and compensate for their hyperopia early on, many of them are not initially symptomatic. It is important to have your children screened early on to ensure that they are not masking or hiding a high hyperopic prescription that can lead to potentially permanent vision loss.
The American Optometric Association (AOA) suggests that infants should have their eyes examined within 6 months of age. A program called InfantSee through the AOA helps to provide a no-cost comprehensive eye examination for all infants from 6 months in age to a year.
If your child is not found to have any eye conditions at their initial visit, they can be seen for their next visit at age 3, and then again before entering kindergarten at age 5 or 6.
Causes of Hyperopia
Hyperopia is caused by an eye that is either too short in length or too weak and flat at the front surface of the eye called the cornea. These two issues will result in light focusing behind the back surface of the eye, the retina, and results in a blurry image.
There can also be a hereditary component to hyperopia, so it is important for children with parents who have high hyperopic prescriptions to get their eyes checked early on.
Risk factors for Hyperopia
The only major risk factor for hyperopia is a family history. There is no age, gender, race, or ethnic influence to hyperopia.
What are other types of refractive errors?
Other types of refractive errors include myopia, presbyopia, and astigmatism.
Myopia is the opposite of hyperopia. It is also known as nearsightedness, and myopic people are able to see up close well but have blurry distance vision. Myopia is caused by eyes that are too long in length or have too much power and steepness on the front surface. This causes light to focus in front of the retina. Myopia is corrected with minus “-” glasses and contact lenses.
Presbyopia translates to “old eyes” meaning that this is typically not seen until middle age. The eye loses its ability to focus easily at near, and many patients have to use reading glasses to see up close. This is a normal part of the aging process and all people over the age of 65 will have some degree of presbyopia. They make contact lenses specially designed for presbyopia.
Astigmatism occurs when a person’s eye is shaped more like a football, rather than a perfect spherical soccer ball. This shape change causes light to focus on two separate spots on the back of the eye, which results in a blurry image. This is corrected by glasses and contacts for astigmatism that contain a cylindrical prescriptions, allowing the light to focus on just one location on the back of the eye. A person can have both hyperopia and astigmatism at the same time.
Are there any complications associated with farsightedness?
Complications can occur if hyperopia is not corrected. In young children with uncorrected hyperopia, amblyopia can occur which is permanent vision loss that cannot be corrected by glasses and contact lenses. This is why it is important for young children to have their eyes examined early on!
Does LASIK or PRK fix farsightedness?
LASIK and PRK are two types of refractive surgeries that can be a treatment option for hyperopia. However, it depends on how much hyperopia a patient has. If a patient has more than 5 diopters of hyperopia, they may not be a good candidate for refractive surgeries. Other ocular health factors can also play a role in limiting the success of LASIK and PRK for hyperopic patients. Your eye care professional will be able to assess your prescription and ocular health to determine if you would be a candidate for LASIK and PRK.
Can you be a pilot if you are farsighted? Are any other jobs off-limits?
As long as you are able to correct your hyperopia and have clear vision that meets the criteria for this job, you are able to become a licensed pilot. Hyperopia as long as it is correctable and achieves a suitable visual acuity, will not limit you from obtaining any particular occupations.
If you are interested in becoming a pilot, firefighter, policeman, or other visually demanding occupations, it is important to get a comprehensive eye examination prior to pursuing these careers. Many of these jobs require a certain visual acuity, functional color vision, and proper depth perception, and a comprehensive exam with a certified eye care professional will test for all of these potential limitations.
Dr. Olivia Burger, O.D. is an optometrist who graduated from the Pennsylvania College of Optometry. She is pursuing a 1-year residency at the UC Berkeley School of Optometry in Vision Science in Primary Care / Contact Lens. Her optometric areas of interest include private practice, contact lenses, and optometric service organizations such as VOSH. In her free time, she enjoys live music and is a freelance concert photographer.