Hyperopia

What Is Hyperopia (Farsightedness)? Symptoms, Causes, Diagnosis, Treatment, and Prevention

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Updated on May 11, 2023
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Hyperopia, or farsightedness, is a relatively common vision problem in which close objects appear blurry, even as distant objects remain clear.

Most infants are born farsighted, but by age 1, less than 4 percent of children have hyperopia, which continues fading as adulthood progresses.

In middle age, adults tend to develop presbyopia, which makes it more difficult to see close-up. This condition may be described as farsightedness, but it’s different from hyperopia.

Signs and Symptoms of Farsightedness

If you’re holding your reading material farther and farther away from your eyes in order to see it more clearly, and squinting or straining to see, you may be exhibiting signs of farsightedness.

Without even being aware of it, you may be exerting more effort to maintain the perfect distance between your eyes and the object you’re trying to see. That can cause the following problems:

  • Eyestrain
  • Burning eyes
  • Headaches
  • General eye discomfort
Mild farsightedness may not cause any noticeable symptoms, but this is why it’s important to have regular eye exams.

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Causes and Risk Factors of Farsightedness

In a person with normal eyesight, the eyes focus light directly on the retina (which is like a screen at the back of your eye).

Most commonly, farsightedness is caused by a cornea (the clear layer at the front of the eye) that isn’t curved enough or by an eyeball that’s too short. These two problems prevent light from focusing directly on the retina. Instead, light focuses behind the retina, which makes close-up objects look blurry.

Most people with hyperopia are born with it, though it may not become apparent or cause vision problems until they’re older.

While there’s no clear pattern of direct inheritance, your risk for farsightedness is greater if you have a first-degree relative (such as siblings or parents) with the condition.

How Is Farsightedness Diagnosed?

A complete eye exam by an optometrist can easily detect hyperopia.

Common vision tests, such as those done in schools, may not diagnose the problem. That’s because these tests usually evaluate distance vision, not your ability to see close objects.

During a comprehensive exam, an eye doctor will use an instrument called a retinoscope to see how light reflects off your retina, which can indicate hyperopia or myopia (nearsightedness). Another instrument, called a phoropter, measures the amount of refractive error you have and determines the strength of prescription lenses.

Even if you have no symptoms of farsightedness, it’s a good idea to get an eye exam around age 40.

After that, the American Academy of Ophthalmology (AAO) recommends getting an eye exam at the following intervals if you have no risk factors for eye disease:

  • Every two to four years between ages 40 and 54
  • Every one to three years between ages 55 and 64
  • Every one to two years starting at age 65
If you’re at high risk for certain eye diseases, such as glaucoma, or if you have diabetes, your eyes should be checked more frequently and every one to two years starting at age 40.

The AAO recommends that children have their eyes screened when they’re newborn and again between 6 and 12 months. Between ages 3 and 5, vision and eye alignment should be checked, and visual acuity should be tested as soon as a child is able to read an eye chart. At age 5, screening for visual acuity and alignment should be performed. If a child fails a vision screening test, a comprehensive eye exam may be in order.

Prognosis of Farsightedness

For most farsighted people, wearing glasses or contact lenses will suffice.

Annually, tens of thousands of people in the United States experience good results from laser eye surgery for hyperopia.

Duration of Farsightedness

As noted above, most people are born farsighted, but by age 1, less than 4 percent of children have hyperopia.

Most adults begin losing their close-up vision around age 40 because of presbyopia, a condition in which the lens of the eye becomes less flexible.

Presbyopia progressively worsens until people are in their late sixties, at which point it tends to stabilize.

People with hyperopia are at risk of developing premature presbyopia.

Treatment and Medication Options for Farsightedness

The simplest treatment for farsightedness is wearing corrective lenses, either eyeglasses or contact lenses.

Another option for treating farsightedness is surgery. Although most corrective surgeries are done to treat nearsightedness, they can also be performed to correct farsightedness. Common surgeries include these procedures:

LASIK (Laser-Assisted In Situ Keratomileusis) An ophthalmologist (eye doctor) cuts a round, hinged flap in your cornea. Then, using an excimer laser (which, unlike other lasers, produces no heat), the doctor removes layers from the center of your cornea to change its shape and improve your vision.

LASEK (Laser-Assisted Subepithelial Keratectomy) The doctor works only on the cornea’s thin outer layer (epithelium). After creating a flap, the doctor uses an excimer laser to reshape the outer layer of the cornea.

Following this procedure, your doctor may insert a temporary contact lens to protect your eye for a few days.

PRK (Photorefractive Keratectomy) The doctor removes the entire epithelium and, using a laser, changes the shape of the cornea. The doctor doesn’t replace the epithelium, which grows back on its own and conforms to the reshaped cornea.

Surgery may include these complications:

  • Under- or overcorrection of your original vision problem
  • New vision problems, such as halos or other effects around bright lights
  • Dry eye
  • Infection
  • Corneal scarring
  • Vision loss (in rare cases)

Medication Options

Research has shown that two types of eye-drops may temporarily reduce presbyopia.

 One of these, pilocarpine HCl ophthalmic solution, was approved to manage presbyopia by the U.S. Food and Drug Administration in 2021. The drops must be used every day to be effective, and potential side effects may include headache and eye redness or irritation.
But these eye-drops are only effective for the age-related vision challenges of presbyopia. For now, farsighted people still need to rely on glasses or contact lenses to improve their vision.

 

Alternative and Complementary Therapies

Eye exercises are not a proven effective alternative therapy for farsightedness.

When eyes feel tired, it’s a good idea to stop reading or doing other close-up work. This may delay needing glasses or contacts for hyperopia.

Prevention of Farsightedness

There’s no way to prevent farsightedness.

 But certain behaviors and practices can help protect your vision and eyes.
Protective measures include regular eye exams and protecting your eyes from the sun. You can reduce eye strain by looking away from a close-up task (like reading or computer work) and looking at something 20 feet away for 20 seconds every 20 minutes.

Complications of Farsightedness

Possible complications include:

  • Crossed Eyes Children with hyperopia can sometimes develop crossed eyes (strabismus), but eyeglasses may help treat the issue.
  • Eyestrain Without correction, farsightedness can cause people to squint or strain their eyes, which can lead to headaches and eyestrain.
  • Safety Impairment When farsightedness goes uncorrected, it can interfere with people’s safety, such as while driving.

Research and Statistics: Who Has Farsightedness?

In the United States, almost 14.2 million people age 40 or older are farsighted, representing 8.4 percent of that population.

Black and Hispanic Americans and Farsightedness

According to data from the National Eye Institute, Black Americans are about 50 percent less likely than white Americans to develop farsightedness at any age. By age 70, only about 8 percent of Black Americans will be farsighted.

Hispanic Americans also have a lower risk of farsightedness, compared with white Americans.

Related Conditions of Farsightedness

According to research, 4- and 5-year-olds with uncorrected moderate hyperopia may struggle to focus their attention and face challenges with early literacy.

Children with a severe degree of hyperopia are at a greater risk for developing eye conditions such as strabismus (crossed eyes or eyes that don’t look in the same direction) and amblyopia (also known as “lazy eye”).

Resources We Trust

EDITORIAL SOURCES
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