Definition

Hypermetropia (hyperopia) or farsightedness is a vision condition in which a person cannot see close objects clearly but can see distant objects clearly. Hypermetropia can be corrected using plus lenses. The severity of hypermetropia can affect one's ability to focus on objects.

Mild hypermetropia may cause nearby objects to appear slightly blurry, while severe hypermetropia only allows for clear vision at a distance. Hypermetropia varies greatly among individuals. In younger sufferers, the condition is often not noticeable.

Hypermetropia can be classified into three groups based on its severity:

• Mild hypermetropia (low): requiring lenses with a strength of +2.00 D (diopters) or less
• Moderate hypermetropia: requiring lenses with a strength between +2.25 D and +5.00 D
• Severe hypermetropia (high): requiring lenses with a strength greater than +5.00 D

Causes

To see clearly, the eye needs to focus the image of an object directly on the retina. The eye achieves this by thickening or thinning the lens, regulating light entry with the pupil, and maintaining a clear cornea. In hypermetropia, the image of an object falls behind the retina. This causes objects to appear blurry. Causes include an eyeball that is too short and/or a cornea that is too thin. To adjust, a hypermetropic eye must accommodate the image by engaging the muscles around the eye, which often leads to discomfort and eye strain.

Risk factor

Both men and women can experience hypermetropia. Living in rural areas compared to urban areas affects the incidence of hypermetropia. Factors that increase the risk of hypermetropia include:

• Family history of hypermetropia
• Mother smoking during pregnancy
• Premature birth
• Low birth weight
• Having diabetes mellitus

Symptoms

You might have hypermetropia if you have difficulty seeing close objects, like reading a book or newspaper, but no issues with distant objects. Other symptoms include:

• Frequent squinting or closing eyes to see nearby objects
• Sensation of eye strain around the eyes, frontal head
• Eyes become sensitive or glare when exposed to light
• Frequent headaches after engaging in close-up activities like reading, writing, using a computer, or drawing for long periods
• In some cases, strabismus (crossed eyes) can occur

Diagnosis

An eye doctor can diagnose hypermetropia through a vision sharpness test, such as using a Snellen Chart. This test involves reading numbers or letters pointed out by the doctor.

If you are at high risk for eye diseases, such as having a family history of glaucoma, you should have regular eye exams every 1-2 years starting at age 40. If you do not wear glasses, or contact lenses, or have a family history of eye diseases, start eye exams at age 40 as follows:

• Initial examination at age 40
• Every 2-4 years between ages 40-54
• Every 1-3 years between ages 55-64
• Every 1-2 years after age 65

Management

If the degree of your hypermetropia interferes with daily activities, see a doctor immediately.

Lenses

The standard and safest treatment for hypermetropia is using glasses. Mild hypermetropia may not require further treatment. Hypermetropia can be corrected with glasses, contact lenses, and refractive surgery. The lenses used to correct hypermetropia are convex or plus lenses that bring the eye's focal point back to the retina. Lenses are better tolerated by children and infants. Contact lenses are not recommended for hypermetropia, but if you are comfortable using them and can maintain hygiene, you can use them.

Surgery

Refractive surgery can be used to treat hypermetropia by correcting the curvature of your cornea. Types of refractive surgery include:

• Laser-assisted in situ keratomileusis (LASIK): This procedure uses a laser to reshape your cornea to correct hypermetropia. Recovery from LASIK is generally faster and more comfortable.
• Laser-assisted subepithelial keratectomy (LASEK): This surgery corrects the outer part of the cornea (corneal epithelium).
• Photorefractive keratectomy (PRK): Similar to LASEK, but involves removing the corneal epithelium to reshape the cornea. The corneal epithelium naturally regrows.

Complications

Complications from hypermetropia include:

• Strabismus: If a child experiences hypermetropia at a young age, they are at risk of developing crossed eyes to compensate for the blur.
• Reduced quality of life: Due to the inability to perform activities well.
• Persistent headaches and eye strain: Caused by eye muscles working to focus the image on the retina.
• Safety risks: When driving or walking.

Prevention

You cannot prevent hypermetropia, but you can protect your eyes in several ways, including:

• Regular eye exams
• Controlling conditions like diabetes and hypertension that can affect vision
• Preventing eye trauma: Use eye protection during sports, mowing the lawn, painting, and using chemicals
• Eating a healthy diet: Increase intake of fish and vegetables
• Not smoking
• Using good lighting when reading or viewing
• Relieving eye strain

When to see a doctor?

Visit a nearby doctor if you experience blurry vision. See a doctor immediately if blurry vision is accompanied by severe pain and red eyes.

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