Hyperopia or Hypermetropia

Hyperopia is a defect in the eye’s refraction that occurs when images are focused behind the retina and not directly on it, resulting in blurred or unclear vision at intermediate and close distances. This usually occurs because the cornea or crystalline lens (or both) are weak or the eye is shorter than usual. Thus, people with hyperopia may experience problems reading or watching television, but not in distinguishing road signs when driving. Hyperopia is also often accompanied by astigmatism.

Causes

Hyperopia has, in many cases, a hereditary component, so it occurs more often in people with a history of hyperopia in their family. Nevertheless, other factors can also play a role.

Most newborns are hyperopic, a defect that is corrected as the eye develops, until it disappears, in many cases, in their teens. Even so, if during this period the infantile hyperopia is not corrected in an adequate way it can trigger other visual alterations, such as lazy eye or strabismus. In cases where hyperopia is not very high, young people usually compensate for it by accommodating the ocular muscles, but with age this capacity is lost, and the hyperopia that they had during childhood and had disappeared in adolescence reappears, requiring the use of optical correction.

How to detect Hyperopia?

The most common symptoms suffered by people with hyperopia are:

• Blurred vision of close objects: this symptom is the most common, although sometimes it can go unnoticed or be attenuated in children or teenagers due to their eyes’ ability to accommodate.
• Eye pain or fatigue: these usually appear after a long time of doing activities that require good close vision such as reading, working with the computer, etc.
• Headache: especially after a long period of effort to accommodate, i.e. excessive close-up work.
• Eye redness: especially at the end of the day. It may be accompanied by tearing, stinging and excessive blinking.
• Strabismus or exotropia: (deviation of the eye outwards ) can sometimes appear as an involuntary reaction to the accommodation the eyes make to focus correctly.

How can hyperopia be corrected?

Hyperopia can be corrected by laser refractive surgery (LASIK) or by an intraocular lens implantation. Both options are a quick and effective solution, which also allows for the simultaneous correction not only of hyperopia but also of other refractive defects, such as astigmatism and presbyopia (eyestrain).

• Laser refractive surgery: is recommended for people who want to do without optical correction and fulfill a series of requirements. The technique used in the correction of hyperopia is LASIK.
• Intraocular lens implant: in cases of high hyperopia, or that do not fulfill criteria for laser surgery another option is the intraocular lens implant. Either phakic lenses (ICL) a lens that is placed between the cornea and the crystalline lens, reserved for young hyperopes; while in older patients, who also have presbyopia (eyestrain) is corrected by a lens that replaces the crystalline lens, pseudo-phakic lenses.

In order to choose the most suitable treatment, the particular needs of each patient (work, hobbies, etc.) will be considered and a complete preoperative study will be carried out to assess the characteristics of the eye, including tests such as corneal topography, pupillometry, aberrometry, biometry, etc. The execution of all these tests does not usually take more than a few hours. Considering both things, the best technique for that particular patient will be determined.

 

People who are not yet considering surgery or who are not yet suitable because their grading is not stable have other options for correcting hyperopia:

• Eyeglass correction: This is the easiest and most common way to correct hyperopia. Even if the number of dioptres is low, it is recommended to use them to avoid the symptoms associated with this defect, such as headaches or eye pain.
• Contact lens correction: people who do not want to wear glasses also have the option of using contact lenses. There are a variety of options for correcting hyperopia with contact lenses as well as other refractive errors. The CL can be soft, RGP (semi-rigid) or even if it fulfills a series of criteria orthokeratology lenses, these last ones are contact lenses that the patient puts on at night, managing to mold the cornea varying its power so that the patient during the day obtains a good vision without the need to use another correction system during the day.

In the end, it will be the ophthalmologist who will evaluate each case and recommend the most appropriate option for each patient.

Frequently Asked Questions

Is hyperopia hereditary?

Hyperopia has, in many cases, a hereditary component, so it occurs more often in people with a history of hyperopia in their family. However, other factors can also play a role.

What is Childhood Hyperopia? Can it be cured?

Most children have hyperopia in childhood, but in many cases the accommodation (focusing) capacity of their eye is usually sufficient to compensate for low vision and allow them to see close objects. Still, having to make this accommodation effort can lead to eye strain, discomfort or headaches.

Childhood hyperopia is usually corrected as the eye develops, and decreases, until it disappears, by the teenage years. If by then, hyperopia has not been completely corrected, the defect is likely to persist for the rest of one’s life.

Can hyperopia be prevented?

No, hyperopia cannot be prevented, but it is recommended to treat it as soon as possible to avoid its consequences and to control possible related problems.

How do I know if I am a candidate for laser surgery for hyperopia?

In theory, any person over 21 years of age with a stable prescription of no more than 5 diopters can have laser surgery. Before that, a complete ophthalmological examination with the necessary refractive tests will be required to confirm its suitability.

Besides hyperopia, can I have another refraction defect?

People who have hyperopia can also have both astigmatism and, at a later age, presbyopia or eyestrain. However, a person cannot have both hyperopia and myopia at the same time.

Is it possible to have cataract and hyperopia surgery at the same time?

Cataract surgery consists of the extraction of the opacified crystalline lens (cataract) and its replacement by an intraocular lens. Thanks to current technology, we can customize this intraocular lens to correct in the same operation the refractive defects of the eye: myopia, hypermetropia, presbyopia (tired sight) and astigmatism.

Is it possible to have cataract surgery after a hyperopia operation?

Yes, in fact, it is common. A person may have had surgery in the past to correct his or her hyperopia and later, due to the natural evolution of the eye, develop a cataract that requires removal. In this case, it is necessary to inform the ophthalmologist so that he or she can consider it when carrying out the tests prior to the intervention of the cataract for the calculation of the intraocular lens.