Hypermetropia: Symptoms, Causes and Treatment

Hypermetropia: Symptoms, Causes and Treatment

Authored by DesiMD Doctor on 12 Apr 2016 - 15:14.

hyperopia

Hypermetropia, also known as hyperopiais the medical name for long-sightedness. It is a common vision disorder in which one can see distant (long) objects, but have problems in focusing on close-by objects. However, it can be corrected by contact lenses or glasses or sometimes can be treated with laser eye surgery. Eyesight problems like hypermetropia or myopia are also known as refractive errors.

Generally, light comes in through the lens and focuses on the retina at the back of the eye. In hypermetropia, the light is focused too far back in the eye, behind the retina, which causes things to look blurred close-up. By placing a convex (plus powered) lens in front of a hypermetropic eye, the image is moved forward and focuses correctly on the retina.  A longsighted person has difficulty in reading the chart for near reading (Jaeger eye chart), however finds it convenient to read the chart for distance (Snellen eye chart).

A study showed that the prevalence of hyperopia in India ranges from:

  • 8.4% at age 6
  • 2-3% from 9 to 14 years;
  • Approximately 1% at 15 years.

Hyperopia is often mistaken with aging vision (presbyopia). Even though hyperopia and presbyopia have similar symptoms, they are both different conditions. Presbyopia is common among people aged above 40 years. If a long-sightedness person starts having presbyopia, they will experience more trouble in seeing near objects. The American Academy of Ophthalmology indicates that if you don't wear contact lenses or glasses or experience no symptoms of eye trouble and are at a low risk of developing eye diseases, you should have an eye examination around age 40.

The causes of hyperopia include:

  • Genetic factor (hereditary)
  • An eyeball that is too short or a cornea that is too flat, because of which the distance between eye lens and retina decreases
  • Age factor (Long sightedness tend to become more noticeable for people aged above 40 years)
  • Low converging power of eye lens because of weak action of ciliary muscles
  • Infants and very young children tend to be slightly hypermetropic but normally grow out of this by about 3 years of age.
  • Rarely it may be caused due to medical conditions like small eye syndrome (microphthalmia), diabetes, problems with the blood vessels in the retina and cancers around the eye 

Some symptoms include:

  • Difficulty with near vision
  • Asthenopia (tiring of the eyes)
  • Uncomfortable vision
  • The eyes may ache and feel dry
  • Headache
  • 3-dimensional vision (Difficulty with depth perception)
  • Burning of the eyes particularly in the evenings by artificial illumination.

However, in young children there may be no symptoms as such because of the reserve capacity of the eye.

Test required for Hypermetropia:

  • Retinal examination
  • Tonometry (eye pressure measurement)
  • Slit-lamp exam of the structures at the front of the eyes
  • Refraction test, to determine the correct prescription for glasses
  • Test of color vision, to look for possible color blindness
  • Visual acuity, both at a close up (Jaeger) and distance (Snellen)

As per the American Optometric Association, Hypermetropia can be classified into 3 categories:

  • Smple hyperopia: It is caused due to normal biological variation that can be of axial or refractive etiology. 
  • Pathological hyperopia: It is caused by abnormal ocular anatomy due to trauma, ocular disease or mal-development.
  • Functional hyperopia: Functional hyperopia results from paralysis of accommodation.

Few possible complications that can occur after refractive surgery include:

  • Visible side effects like a halo, glare or starburst appearing around lights
  • Under correction or overcorrection of your initial problem
  • Infection
  • Rarely, vision loss
  • Dry eye

 

Many eye professionals including opticians, optometrists, orthoptist and ophthalmologists are involved in the management and treatment of correcting long-sightedness. According to the American Optometric Association, several treatments are available for hypermetropia-related symptoms that include:

  • Contact lenses and glasses:  Among several available treatments available for hyperopia-related symptoms, glasses and contact lenses are the most common method used for optical correction of the refractive error. Contact lenses can be daily or monthly disposable, extended wear or non-disposable. Your optometrist can suggest which type is most suitable for your eyes and prescribe accordingly. The cost of contact lenses may be higher than glasses and they require utmost care and precise hygiene because they are soft. However, lenses are best suitable for adolescents and older adults than for younger children. 

    Spherocylindrical or plus-power spherical lenses are usually prescribed to shift the focus of light from behind the eye to a point on the retina. Patients who wear contact lenses are at a greater risk for ocular complications due to infection, corneal hypoxia or mechanical irritation; however, improved vision makes contact lens wear a valuable treatment option for complaint patients. Besides contact lenses, spectacles are another alternative to correct long-sightedness.
     
  • Medical (Pharmaceutical) therapy:  A drug that causes miosis maybe suggested for patients who cannot tolerate wearing glasses. Anticholinesterase agents like echothiophate iodide (Phospholine Iodide, PI) and diisopropylfluorophosphate (DFP) have been used in some patients with accommodative hyperopia to improve alignment of the eyes and reduce a high accommodative convergence-to-accommodation (AC/A) ratio. These drugs imitate the accommodative effect of plus lenses without the use of spectacles or contact lenses.
     
  • Surgery: Hyperopia is treatable with various refractive surgeries, such as LASIK, PRK, P-IOL, RLE, Radial Keratocoagulation or Thermokeratoplasty.  Although these surgeries are expensive, they provide the chance to rejuvenate normal sight permanently. Laser surgery reshapes the cornea using the laser to remove a very thin layer. The reshaped cornea allows the refraction of the eye to be corrected. However, before proceeding upon this costly treatment you need to take advice from an eye surgeon (ophthalmologist) regarding the facts like failure rate, the procedure and the risk of complications involved.

    A review of 36 articles on studies of the safety and efficacy of refractive surgery for hyperopia discovered that surgery provides safe and effective correction for lower ranges of hyperopia. In the Laser-assisted in-situ keratomileusis (LASIK) approved by FDA, the procedure involves making a thin, circular hinge flap cut into your cornea. In Laser-assisted sub-epithelial keratectomy (LASEK) surgery, the ophthalmologist creates a flap involving only the cornea's thin protective cover (epithelium) whereas in Photorefractive keratectomy (PRK) surgery, the surgeon removes the epithelium. 

 

Reference:http://research.omicsgroup.org/index.php/Hyperopia ;  https://www.aoa.org/documents/CPG-16.pdf

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.