Hypermetropia, long sightedness what exactly is it

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Optometrist Amy Ogden explains Hypermetropia or Long Sightedness  

Hypermetropia (which actually, we shorten to hyperopia), occurs when either the cornea (the clear window that covers the iris) is too flat, or the eyeball itself is shorter than normal. This means, the light rays we need to be focussed at the retina, are instead focussed behind it.

What does this mean for the hyperopic person?

Usually, unless the level of hyperopia is very high, distance objects are seen clearly, whereas near objects appear blurred.   When we view an object up close, the lens in our eye changes shape. This increases its ability to bend light, this helps focus light from the near object onto the retina. For a person with small or medium amounts of hyperopia, the lens in the eye is able to change its shape to overcome some of the correction required when looking at a distant object. But it cannot change shape enough to provide the amount of focussing power needed for a near object.  If levels of hyperopia are very high, then vision at all distances may appear blurred. This is because the lens cannot provide the focusing power required for either. Hyperopia is an eye focusing disorder (refractive disorder – it is not a disease). 

Symptoms 

Symptoms of hyperopia are specific to a person, but the ones I see most commonly are;
  • Difficulty with reading and computer work
  • Headaches after prolonged near work, or when at school (but not at the weekends)
  • Squinting to focus 
As I have mentioned above, due to children having a very flexible lens in their eye, they may not have any symptoms of blurred vision, as they are able to focus light onto their retina. In using the lens in the eye, instead of glasses, to focus light on the retina for distance objects, this causes headaches and eyestrain. This is due to the amount of extra work undertaken by the eye.

How we test for it

Hypermetropia can be picked up as part of your routine sight test. We use a comprehensive range of tests to do so. Using a retinoscope and monitoring the reflex shone back to us can give an indication on any signs of hyperopia. This will allow us to pinpoint a baseline prescription. Using techniques such as binocular refraction (if required), binocular balancing or a plus one blur test, can help us to refine the prescription further.  Due to children having a very flexible lens, it is sometimes more difficult to pinpoint the amount of hyperopia in them. This causes a problem when we are trying to prescribe glasses. We try to prevent the eye from overworking, thus stopping eyestrain and headaches.  If hyperopia is suspected, but the amount can not be determined, cycloplegic eye drops can be used to help relax the lens. This allows us to determine the full amount of prescription required. If glasses are required, your optometrist will talk you through how they work. They also also tell you what they are to be used for. However, I only use them when absolutely necessary. 

Treatment 

Once we have your prescription (the amount of refractive correction required), we can then discuss how to help correct it, and how to help with the symptoms.  For small amounts of hyperopia, we may just advise glasses for concentrated work. This can include things like homework, reading, computer, playing music, painting etc. For higher amounts of hyperopia, we would prescribe glasses for full-time wear. There is also an option of contact lenses, but this would be at the Optometrist’s discretion.  Laser eye surgery is also another form of refractive correction, but this is something that would need to be discussed depending on the prescription, patients suitability, and would ultimately be at an Ophthalmologist’s discretion.  There is no best method of correction, it varies on a patient to patient basis, depending on the circumstances. I always get asked if exercises can cure hyperopia – the answer is no, there is not enough science-based evidence supporting this, the same also applies for the suggestion that a vitamin or a tablet can “ cure” someone of hyperopia too.    

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