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Hyperopia

Hyperopia: definition

Hyperopia is a common optical defect, characterized by the existence of a too short look. The image formed on the retina by a farsighted eye at rest is blurred, because from the observed target light rays converge in a plane located behind the retina.  If the distance between the cornea and the retina is too short compared to the focus distance of the cornea-crystalline couple, Visual symptoms of hyperopia are variable and depend on the age of the farsighted subject, on its degree of farsightedness, and the existence of an associated with presbyopia. In all case, the farsighted sees even more unclear that the objects he sees are close together.

Distance vision (10 meters and in the past) is sometimes preserved, and some hypermetropes are happy with their long-range vision, while objects located a few meters, as in an office room, seem more or less blurred.

On the optical plan hyperopia is mainly related to a insufficient axial length of the eye, which is that the image of a distant object is de-focused spontaneously behind the retina. The image projected in the plan of the retina is blurred.

Hyperopia is corrected by lenses of glasses or convex lenses: these features make rays converge retinal plan. The degree of farsightedness in diopter (ex: + 2 D) corresponds to the power of the glass required to refocus the image on the retina.

hyperopia

Hyperopia: the sharper image is formed behind the retina. The eye is too short (the axial its failure) with respect to the focal length of the cornea and the crystalline lens

 

In some case, much rarer, hyperopia is mainly related to corneal power (vergence) insufficient. The cornea is not curved enough, not quite fast after refraction by the corneal diopter incident rays converge.

corneal hyperopia

In this example, hyperopia is corneal original. It is linked to a much lower than average central keratometry (37.5 D to the left eye and right eye), while the axial length (measurement by optical biometry) is close to normal (about 23 mm). The depth of the anterior Chamber of the eye is relatively large (3 mm). A biometric calculation formula using the keratometry to predict the position of an implant of cataract (as the SRK - T formula) would predict a position relatively close to the cornea. Hyperopic eyes biometric calculation is deemed less accurate for the eyes normalsighted and short-sighted, because the relative size of the refractive elements of the hyperopic eye (keratometry, report between the respective lengths of the anterior and posterior segments) are subject to a larger variability.

Signs associated with hyperopia

There are two types of hyperopia: farsightedness low and moderatewhich is often well tolerated (hyperopia latent) and does not require the patient to correct permanently (at least until the installation of presbyopia to 40 years), and hyperopia strongwhich requires a fixed permanent, generally appears in early childhood, and is often associated with disorders of binocular vision (strabismus) or amblyopia. The border between these two types of hyperopia is located around 2 to 3 dioptres.

Moderate farsightedness

If hyperopia is moderate, theaccommodation (normally reserved for near vision) may be jeopardized in order to re - focus the image of the object away on the retina. Distance vision is corrected, but at the cost of an effort signals more or less permanent. However, this effort is well tolerated in young subjects (see the) page dedicated to the hyperopia and presbyopia). Vision away from the weak hypermetropia is paradoxically excellent, because a focus on the retina is perfect and can be adjusted to an optimal perception ("principle of the" auto focus"). The moderate hypermetropia more often judge their far excellent vision, especially for 'very remote' targets: road signs, etc.  The notion of 'distance' differ substantially among the farsighted with respect to the short-sighted; a farsighted considers remote targets tens of meters, while for the myopic, an array of Visual acuity 5 meters is part of the domain of the distant.

If the vision of "far away" is good, to be clear, near vision requires farsighted patients an extra effort which can, especially if it is extended (reading, nearly painstaking work, ect.), induce a various symptoms "Visual fatigue": light-sensitive and easily irritated eyes, headache, vision is blurring by intermittent, intermittent eye redness, ect.

The "moderate" hypermetropes have often received in childhood or adolescence of a so-called eyeglass prescription "to rest", they wore for homework or watch TV. A large proportion of the moderate hypermetropies unnoticed and not to unmask that around the age of presbyopia.

Thus, moderate hyperopia is often very well tolerated (because of the accommodative compensation), appears relatively late, in is "décompensant" sometimes during installation of presbyopia. The power of the compensatory accommodative effort decreases, allowing more patients to see net far without correction in a comfortable way. Patients, who have never worn glasses, must, to the quarantine, to equip themselves not only for vision closely, but also sometimes for the vision by far. except for undemanding activities and targets very far away (because of the optical defect involved,) and clinical factors as the diameter of the pupil, the moderate hypermetropes see their vision of far relatively satisfactory for distant objects, to several tens of meters, while the measure of their Visual acuity uncorrected 5 metres is less than 10/10.

Hyperopia medium to high

If hyperopia is more important (or already well installed at a medium hypermetropic presbyopia), it will induce an important gene in vision closely from afar, accommodation no longer sufficient in total compensation.

Unlike the 'weak' hypermetropia in which Visual disorders begin after 40 years, the 'strong' hypermetropia are usually corrected as a child and often present a history of strabismus was sometimes the subject of surgery.

Strongly farsighted eyes setting usually involves external rotation marked with respect to the optical axis of the eye, and an increase of theKappa angle. These considerations are important in refractive surgery to perfect centering of the laser corrections.

Secondary hyperopia

This type of farsightedness is observed after surgery of myopia by the technique of radiaire keratotomii; in some patients, there is a prolonged effect of surgery, which leads to a correction and a secondary hyperopia. One correction by PKR for hyperopia post radial keratotomy is possible in most of the case.

A strong farsightedness is also result of a cataract surgery where it has not been placed implant)aphakia). The removal of the lens corresponds to the withdrawal of a biconvex lens, whose power in the eyewear plan is equivalent to 12-to-15 D (20 D about in terms of the lens). The placement of an implant of artificial lens is intended to so to compensate for this loss of optical power and correct a farsightedness which would not reduce vision and force the patient to wear thick convex glasses in case of non-pose of implant.

A secondary hyperopia can be observed in a patient operated on cataract who received an implant of power lower than that which would have been necessary to obtain the emmetropia (from afar clear vision without glasses).

Correction of hyperopia

Lens correction

Hyperopia is corrected by the use of glasses or lenses glasses convex to refocus the image of an object far closer to the retina. The power of these glasses, expressed in Diopter, is positive (ex: + 3 D).

hyperopia correction

Correction of hyperopia in glasses: the positive vergence of convex glass brings the li plan' net mage in the retina.

More farsightedness is important, more corrective glass will be curved and so thick in the Center (like a magnifying glass). In addition to the unsightly side, such glasses can induce a magnification of images and a narrowing of the peripheral Visual field.
Contact lenses will avoid these problems subject to their tolerance and acceptance.

Surgical correction

The most effective refractive corneal surgery for the correction of Hyperopic is LASIK, which uses the excimer Laser to induce a bulge of the central part of the anterior face of the cornea. After LASIK, the vision becomes clear without any effort of accommodation, and visual fatigue can disappear. In case of early cataract, or high hyperopia in the subject of quarantine and more (> + 6 D), the removal of Crystalline lens with the installation of an artificial Crystalline lens implant can be Indicated.

The correction of hyperopia low and medium is made elective way by the technique of the LASIK. It has some features that are discussed in the following pages:

Learn more about: hyperopia surgery –  the hypermetropique LASIKhypermetropiques photoablations

 

The hyperopic eye biometrics

 

The hyperopic eye is an eye on average shorter than the Emmetropic eye, and of course the myopic eye.

The Visual setting of the hyperopic eye usually results in a slight external rotation of the eyeball towards its optical axis (centerline). THEVisual axis an angle relatively more great with thepupillary axis the Emmetropic and the myopic: increase of thekappa angle. The reflection of a light target set by the patient is thus formed in a nasal portion of the entry pupil.

 

Biometrics longsighted eye

Study of the dimensions of a farsighted eye thanks to a last generation biometer (Interferometry). An eye is considered to be short when its axial length (of the cornea to the fovea) is less than 22 millimeters.

The anterior segment (cornea, room earlier, crystalline) is statistically shorter, but the proportion of shortening is usually smaller and relatively little commensurate with that of the posterior segment. This can cause some problems with respect to the calculation of cataract surgery implant. Formulas adapted to short eyes are Holladay 2 formulas, and Hoffer Q Haigis.

 

Following biometrics has been obtained for a nanophtalme look. The nanophthalmia is an impairment of ocular development, is a rare congenital malformation. The growth of the eyeball is hampered, but the volume of the lens remains significant with respect to that of the entire eye. The wall of the eye (sclera) is usually thickened. This reduction in the volume of the anterior and posterior segment exposes to various complications, such as by angle closure glaucoma, uveale effusion syndrome, etc.

Biometrics eye nanophtalme

Biometrics in one eye nanophtalme, axial length is lower than 20 mm.

31 answers to "Farsightedness"

  1. Julien Michael says:

    Hello

    I was operated by Dr Gatinel on Thursday, March 24, 2016 to the hyperopia and astigmatism in both eyes. The right eye was much more affected than the left eye - which I considered pretty good - to the point that I was more comfortable with the right eye closed with both eyes open.
    I hesitated for a long time to have an operation of this left eye that seemed to hold the road, but I crossed the step for both eyes, absolutely without regret.

    On the left eye, probably because that the correction was weak, the vision was net, from far away, the next day. And the recovery has been very fast, almost imperceptible.
    As for the right eye, despite a blur beyond 50-60 cm, reading – which is no longer a chore – and computer screen work was greatly improved. As an example, six months ago, with glasses, I had to lower the resolution of my laptop 17 "from 1900 × 1200 to 1280 × 1024. Four days after the surgery, I went to 1900 × 1200. Amazing thing: Despite the difference in vision between the two eyes, I didn't make any effort to compensate.

    But the surprise - also amazing that unexpected - on which I want to stress is the total disappearance of headaches, of feeling heavy head - like wearing a caseque - and eyestrain, which were part of my daily life despite wearing glasses. Just for that, I am happy to have done (and it is not finished, the eye having not finished to progress). I sleep and wake up better, I don't feel more continuously tired. The loss of balance and blunders standing disappeared also, thanks to a much better depth perception. I feel more comfortable today by car than before with my glasses.

    A few words on medical assistance: Professional, reassuring, clear in explanations and very nice.

    Hoping that my testimony can be used by others.

  2. John Paul says:

    I have a question.
    When I was younger, I was told that since I am hyperopic, I have difficulty estimating the distance between me and an object. Is that true?
    For example, when my brother asks me how far he is from me and I tell him 1.5 meters, he replies that he is actually at least 3 meters away from me.

  3. Dr. Damien Gatinel says:

    This difference in perception can be induced by the effect of the hyperopia correction goggles, which are "magnifying" glasses, and can thus make the objects appear more "coarse" and "nearer". Uncorrected, the hyperopia is not a source of error for the assessment of a priori distances.

  4. Mike Lee says:

    Hello, it's amazing to read all these comments. That of Julien Rinaldy encourages me. I'm Hyperopic + 5.5. My ophthalmologist chose the Panoptix lenses for both eyes. I read that one could put another lens as a SBL in the dominant eye to reduce the night halos. Is that true and advantageous? My intermediate and close vision is very important to me.
    http://www.focusoncontacts.ca/publication/?i=288016&article_id=2375296&view=articleBrowser&ver=html5#{« issue_id »:288016, »view »: »articleBrowser », »article_id »: »2375257″}

  5. Dr. Damien Gatinel says:

    The choice of inserting an intra-ocular lens in your situation requires removing the Crystalline lens (surgery at any point similar to that of cataract). You may have a beginner cataract, or an age at which it is better to anticipate a little this surgery to correct the hyperopia and the presbyopia. Panoptix implants provide intermediate vision a priori a little closer to the close vision than competing trifocal implants (ex; Finevision or AT Lisa Tri). If you do not have cataracts and/or less than 45/50 years, it may be more interesting to consider a correction in LASIK (less invasive surgery and that has made a lot of progress in the case of the strong hyperopia with some recent laser).

  6. Ikram says:

    Hello
    I'm hypermetrope. I have a question
    I had a correction there is 2 years of (+ 1.5 OG and + 0.75 OD).
    I just consulted the ophthalmologist 5 days ago and gave me a correction (+ 2 OD and + 2 OG) I just wear my glasses today and with my right eye I see blurry from afar but with the og I'm fine. And it bothers me.
    are c normal or not?
    Thank you

  7. Dr. Damien Gatinel says:

    You have to remake the point with your OPH. The total correction of hyperopia is often poorly tolerated in patients. It is possible that the right eye is slightly overcorrected...

  8. Kaci says:

    Must be systematically refractiond under Cycloplegic ex: Skiacol in a patient over 18 years of age who presents a hypermetropie, and are given the total correction found under Cycloplégie or the one that gives the best visual acuity; Thank you

  9. Dr. Damien Gatinel says:

    It is not necessarily necessary to carry out a skiascopie for the prescription of glasses in adult hyperopic. In my experience, it is necessary to prescribe the best subjective correction (without dilation), generally being rather under correction. Total correction (or skiascopique) is rarely well tolerated in farsighted.

  10. Jaime Rajput says:

    I did a consultation with an ophthalmologist who informed me that I am hyperopic and he gave me a vision bezel from afar + 1.00 for every eye but when I used it I noticed that I see blurring even things a 1m from me or more thanks to me in Train what do I have to do

  11. Dr. Damien Gatinel says:

    The weak farsighted often experience difficulties in wearing the correction, especially for least vision, which for a defect at + 1.00 D is probably judged (subjectively) as quite satisfactory by you. It is not necessary to wear this correction, except for more static activities (work on screen, reading) where it may be useful in order to avoid symptoms related to eye fatigue.

  12. Mr. Martin says:

    Hello sir, following a strong correction of my myopia by Lazik (-7 to both eyes) carried out 2 months ago. I am today Hypermetrope at + 1.00 on my right eye. Is it necessary to carry out a retouching? Or will I end up getting used to this discomfort? Thank you for your expertise
    Good to you

  13. Dr. Damien Gatinel says:

    This degree of hyperopia (overcorrection after correction of high myopia in LASIK) should slightly regress/and or less hinder you. Wait a few more months to judge.

  14. Hyper says:

    Hello
    I have 23ans and am hyperopic with the following correction:
    Right eye: + 2 (-0.25) 25
    Left Eye: + 4.25 (-0.25) 165
    My hyperopia was detected in 16ans following migraines. I started by wearing glasses with little corrections exclusively to read or when using a screen. Very quickly, I felt the need to wear them constantly. Then at 17yrs, my correction rose a little. At 18ans, my correction has risen again, noticeably this time. I was feeling visual fatigue. Eight months ago, my correction was again increased to be the one announced above. In spite of everything, I am handicapped in my daily life by visual fatigue. I work much of my time on screens. So I have to sleep at the minimum 8h to succeed in holding the day and still I have to fight not to fall asleep during the afternoon. I did some sessions to correct my convergence at a orthoptist this year, which relieves me a little. But I still have this feeling of having to accommodate closely (to have to force) and that is the cause of my fatigue. I sometimes have red eyes, which might suggest a lack of hydration or blinking but I guess that doesn't explain everything. The various ophthalmologists think that I have strongly accommodated up to my 16ans and that my eyes have not finished "releasing" even today, they prefer not to "overcorrect", which could affect my vision from afar. So I wonder if you've ever had case like mine of young men, with a "brutal" appearance of hyperopia accompanied by annoying visual fatigue for everyday life.
    Thanks in advance.

  15. Elisa Gauthier says:

    Hello
    I've been hypermetrope since I was 6 years old
    Today I have 24 years and a correction of 2.50 left eye and 2.00 glass right eye from afar.
    I always wear my glasses (to see near or far because otherwise I can not concentrate on an object or text because my vision is blurred and I end in the evening by having headaches)
    I've been wanting to wear lentils for four years. I have done several ophthalmologists, several lens tests, (different brands like Acuvue Oasys, Air Optix night and day (bets as day), as well as Comphilcon A Asphère. As you can see, I have tried several different materials. I also tried several different correction and nothing to do I see blurry from afar in the little bright spaces and in the areas too bright as the shops, I see bisaarly too. On the other hand in natural light and with the lenses air Optix night and day, I see well, almost as well as with my glasses.
    I noticed that confilcon A and Acuvue Oasys had an anti-UV filter that air Optix night and day does not have. Besides, the radius and also different.
    I would like to know if you have any idea of the problem? What is the role of the diameter/radius in the lenses and does the UV filter can change the vision?
    Otherwise do you think I have to turn to rigid lenses? Where else? Knowing that I'm tired of putting on my glasses and that my ophthalmologists (even specialized in lenses) find that my lenses behave well on my eye.

    Thank you for reading me. I hope you can put me on a new track..

  16. Dr. Damien Gatinel says:

    In your situation it would be appropriate to carry out a corneal topography, as well as a aberrométrique examination: These explorations may be to detect a reason why your vision is sometimes considered blurred (e.g. presence of astigmatism Irregular). The UV filter does not alter the vision (the eye is not sensitive to these radiations which do not penetrate much the cornea and the Crystalline lens). The lenses that correct the hyperopia "magnify" the perceived images, and the farsighted tend to find that the details are better perceived in glasses than in lenses (this is the opposite in myopic). But for a 2d correction, this effect is not important. Rigid lenses can be a solution to increase the quality of your eyesight, if it is actually a little altered by the presence of a slight irregularity of the cornea.

  17. Dr. Damien Gatinel says:

    This kind of situation is not uncommon, and is sometimes related to problems underlying ocular dominance. A priori, your right eye is dominant (lesser correction), and there is a notable difference in correction between the two eyes. This could also promote some eye fatigue. There is no obvious solution, but I would recommend to try various corrections, or to wear different glasses depending on the activities to be performed (e.g. screens).

  18. Rob James says:

    Hi Dr. Ganeshan,
    I was given L + 1.25-0.25 R + 1.00 glasses at the age of 39 and told to wear them when ever I was pulled at the computer or reading. I did have another prescription when I was about 32 but it was very low L + 0.75 R + 0.5 and it did not get glasses.
    Now Age 51 I need the glasses for all near work although I can still drive and watch TV I get a headache but the glasses I now have are blurry in the distance.
    Do you think this will get worse?

  19. Dr. Damien Gatinel says:

    Often, after age 50, mild hyperopes undergo such visual disturbances. Near vision gets dramatically worse, and there is also a decrease in distance uncorrected visual acuity. At some point, you may need both near and distance correction for daily activities.

  20. HERBET Lily says:

    Hi, I'm hyperopic and astigmatism. I have + 1.00 d (-0.75 to 170 ° astigmatism) on the right eye and + 0.75 D (-0.75 to 165 ° astigmatism) for the left eye.
    My eyes burn regularly and, as you can imagine, I do not see closely. My eyes sometimes take a long time to accommodate. So I wanted to ask you. Do you think that have such problems it is better that I wear all the time my glasses or only in the moments of readings, on computer and when I am tired?
    Thank you very much!

  21. Dr. Damien Gatinel says:

    To relieve the vision, it is necessary to wear your glasses, as often as you want/can.

  22. Chris B says:

    Hello doctor,

    My son just turned 18, he has a strong hyperopia and is also astigmatism, his correction is: OD (95 ° + 2.25) + 6.00 and OG (80 ° + 2.5) + 7.25

    After a complicated adolescence, he can no longer have his glasses glasses "magnifying effect" although we make them thinner to the maximum... He has been wearing rigid lenses since last year, but he is increasingly struggling to support them despite a very strong motivation... In the face of its evil to be I do not know what to do, do you think an operation would be possible in a few years? Thank you in advance for your answer.

  23. Dr. Damien Gatinel says:

    An intervention in LASIK, carried out with a modern laser platform (eg: Wavelight FS200/EX500 with which it is possible to obtain optimal surgical parameters for the correction of the strong hyperopia) is conceivable, even if a certain Degree of under correction can be expected. A strong reduction in hyperopia is potentially beneficial in young patients as they enjoy good accommdation and are less prone to dry eye. Indications should be discussed at the case By case After a careful checkup.

  24. Jérôme says:

    Hello
    I came out of my first ophthalmological consultation and here is the result:
    OD: + 1.75
    OG: + 1.25
    So I'm hyperopic!
    I am 25 years old, I consulted because I work on screens all day and I feel fatigue at night.
    Should I wear my glasses only for work, reading and in front of the screens or continuously all day long?
    I do not have the impression of seeing evil except visual fatigue when I am on the screens.
    In advance thank you for your help
    (I'm depressed at the idea of having to wear glasses constantly)
    Kind regards

  25. Dr. Damien Gatinel says:

    You can totally wear these glasses on demand when you feel the need. It is not dangerous not to wear anything in the daytime if you are not embarrassed: In general, the hyperopia is only a problem for reading or working closely prolonged (screens, etc.). By far, your acuity is certainly excellent. However, over the years, it is unfortunately certain that your eyeglass dependence will increase. In the Fifties, you will need glasses constantly for vision from afar or near... Sorry for these pessimistic predictions! :)

  26. heulin says:

    Hello my daughter is 14 years old and she has a strong hyperopia + 9 and + 8
    She was operated from a stabisme she is very sporty what evolution in her case She's more and more hurting her big glasses? in advance thank you

  27. Dr. Damien Gatinel says:

    It may be advisable to adapt contact lenses to correct this strong hyperopia, thus avoiding the unsightly and impractical aspect of the sport of the matching lenses.

  28. Chris V says:

    Hello doctor,
    I am 38 years old and I am hypermetrope astigmate, with the following prescription glasses:
    – right eye: (125 °-1.25) + 4.50
    – left eye: (50 °-1.25) + 5.50
    Is it possible in my case to do a surgical procedure? And if so the result would be perfect in the long run?
    By thanking you in advance for your return,
    Cdlt
    Nicolas

  29. Dr. Damien Gatinel says:

    The degree of your astigmatism and your hyperopia is available for LASIK correction. A detailed pre-operative assessment must be carried out to confirm this in your case particular.

  30. Julien says:

    Hello
    I am amblyopic due to a small medical error.
    Left eye not corrected 4/10 corrects 6/10. Correction of +3.75
    Right eye not corrected 8/10 corrected 12/10, correction +3.75 100-.
    Is an operation recommended? I would like to, but I'm afraid I'll lose my right eye if it reacts badly to the operation...
    Knowing that in 1 year I lost +0.50 on each eye...
    thank you for your help and advice.

  31. Dr. Damien Gatinel says:

    LASIK is a surgical technique that has reached maturity, and it could be offered to you a priori, despite your slight amblyopia, if the preoperative check-up is free of contraindications.

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