Hyperopia – Accommodation, spasms and blurred vision
Hyperopia (farsightedness) is a refractive error. It is characterized by an eye that is too short, requiring it to accommodate (strain) in order to focus. This constant effort leads to accommodative spasms, eye strain, and blurred vision that worsens at the end of the day. It is treated with corrective glasses, contact lenses, or laser surgery (refractive surgery). It should be detected early in children because it increases the risk of amblyopia (lazy eye).
What is hyperopia?
Hyperopia is a common vision disorder that allows you to see distant objects clearly, but close objects may be blurry.
This is a refractive error, that is to say a focusing disorder, and not a true eye disease.
It indicates an eye that is too short; the image is focused behind the retina, and the eye is forced to accommodate (force) to bring the image back onto the retina.
People with severe farsightedness can only see objects clearly at a great distance, while people with mild farsightedness can see closer objects clearly.
Hyperopia is usually present at birth and tends to be hereditary.
This condition can be corrected with glasses or contact lenses. Another treatment option is surgery.
Symptoms
The symptoms that should make you suspect hyperopia are:
You are suffering from eye strain, including burning eyes and pain in or around the eyes.
You experience general eye discomfort or a headache after performing close-up tasks, such as reading, writing, computer work, or drawing, for a period of time.
Nearby objects may appear blurry.
You have to squint to see clearly.
When should you consult a doctor?
If your degree of farsightedness is severe enough to prevent you from performing a task as well as you would like, or if the quality of your vision prevents you from enjoying your activities, consult an ophthalmologist.
He will be able to determine the degree of your hyperopia and advise you on the possibilities of correcting your vision.
Causes
Hyperopia indicates an eye that is too short or too weak.
It occurs when your eyeball is shorter than normal or your cornea is not curved enough. The effect is the opposite of myopia.
The farsighted eye must force (accommodate) in order to bring the image into focus on the retina.
Hyperopia has no predisposing factors other than heredity.
Basic principles of ametropia
Your eye is composed of two parts that ensure the focusing of images:
The cornea is the clear, dome-shaped front surface of your eye.
The crystalline structure is a transparent structure the size and shape of an M&M's candy.
In a normally shaped eye, each of these focusing elements has a perfectly smooth curvature, like the surface of a ball.
A cornea and lens with such a curvature bend (refract) all incoming light to produce a very sharp image directly on the retina, at the back of the eye.
Diagnosis of hyperopia
Your ophthalmologist can diagnose and prescribe correction for farsightedness during the consultation. They will use a standard vision chart and ask you to read letters on a board placed at the other end of the room.
Your ophthalmologist will use certain examination devices to assess the degree of hyperopia.
An automatic refractor projects a special light into your eyes, which is reflected onto your retina. This allows for an approximate determination of whether a person is nearsighted or farsighted.
A phoropter (dynamic eyeglasses) allows for precise adjustment of your refractive error. It also helps determine the appropriate prescription to correct your vision.
Accurately quantifying hyperopia – Cycloplegic refraction: Skiacol and Atropine
Some patients, especially children, are so used to straining their eyes that the ophthalmologist cannot reliably assess the degree of hyperopia.
In this case, drops that relax accommodation, also called cycloplegic drops, can be used.
Correction and processing
There is no cure for hyperopia. However, it is possible to correct refractive errors medically or surgically.
Glasses and contact lenses
A pair of glasses or contact lenses with concave lenses can correct hyperopia.
In patients who have never worn glasses, correcting all of the hyperopia may not be comfortable.
In this case, the ophthalmologist corrects the hyperopia to the maximum level of comfort.
Soft contact lenses also give excellent results in patients accustomed to wearing optical correction.
Correction not supported – Overcorrected hyperopia
Prescribing glasses is not a mathematical algorithm; your ophthalmologist adapts to your visual needs, your glasses-wearing habits, and adjusts their prescription accordingly.
If you experience intolerance to glasses, they are likely too strong. A follow-up appointment to adjust the prescription may be necessary.
Opticians benefit from a return insurance policy for lenses; it is advisable to consult an ophthalmologist after 15 days of diligent wear if the glasses are not tolerated.
Although less common than for myopia, refractive surgery gives excellent results in well-selected patients.
Visual recovery often takes a little longer, with a decrease in distance vision in the first few weeks, and sometimes even the first few months.
LASIK is currently the surgical technique of choice.
SMILE is currently being evaluated and should be validated in Europe before the end of 2022.
PRK, on the other hand, can be used due to a regression of hyperopia during the healing phase.
Prelex is a lens replacement procedure. The technique is generally used in cases of associated presbyopia.
Phakic implants are sometimes used in carefully selected patients.
All refractive surgery carries a minimal but real risk of complications. A pre-operative assessment and consultation will allow us to determine the best course of action to meet your visual needs.
Complications
Hyperopia can be associated with several problems, such as:
Strabismus – Some children with farsightedness may develop misaligned eyes due to constant effort at focusing. Glasses specially designed to correct some or all of the farsightedness can treat this problem.
Impact on quality of life – If you have uncorrected farsightedness, you may not be able to perform tasks as well as you would like. And your limited vision may prevent you from enjoying your daily activities.
Eye strain – Uncorrected farsightedness can cause you to squint or strain your eyes to maintain focus. This can lead to eye strain and headaches.
Narrow-angle glaucoma – Hyperopia (farsightedness) indicates a short eye, or one lacking space. The adhesion of the different ocular structures can obstruct the trabecular meshwork, the network that regulates intraocular pressure. When the trabecular meshwork malfunctions, the pressure increases and damages the optic nerve; this is narrow-angle glaucoma.