What is hyperopia? Treatment and Symptoms

What is hyperopia? Treatment and Symptoms

Hypermetropia, also known as nearsightedness, is one of the refractive errors that makes it difficult to focus on near objects. If the eyeball is shorter than normal or the cornea-lens system does not refract the light sufficiently to the retina, the image is formed behind the retina, not on it; Accordingly, while text and details cannot be seen up close, far vision is relatively preserved. Physiologically, hyperopia is common in babies; Although it disappears as most children grow up, its permanent form becomes a vision problem in adulthood. Typical complaints; blurred near vision, headache, eye fatigue and difficulty focusing in the evening. Permanent clarity can be achieved by reshaping the cornea with excimer or femtosecond laser platforms.

What is hyperopia?

Hyperopia is a vision defect known as "hyperopia" in the medical literature and causes difficulty in seeing especially near vision. If the eyeball is shorter than normal or the cornea-lens system cannot sufficiently refract the incoming light onto the retina, the image is focused a few millimeters behind, that is, behind the retina, rather than on the retina. This simple geometric shift forces the person to see the near blurry; However, far vision is generally clearer. In hyperopia, the eye constantly works the lens and ciliary muscles to clarify nearby details. This compensation works initially; But the effort that lasts throughout the day causes headaches, eye fatigue and occasional attacks of blurred vision. As the lens in the eyes of hyperopia loses its elasticity, focal support decreases and complaints become evident.

What Causes Hyperopia?

Hyperopia is a vision defect that causes difficulty in near tasks, and its basis lies in differences in the anatomical dimensions of the eye. If the eyeball is shorter than normal, the corneal-lens system cannot sufficiently bend incoming light onto the retina; the focus remains a few millimeters behind the retina. Hereditary predisposition is the first risk factor. If the parents have refractive errors, the child may develop hyperopia at a physiological level in infants; If the axis length does not increase during the growth process, a permanent defect develops. Metabolic diseases can affect the refractive index by changing the water-protein balance of the lens. Diabetes, hyperthyroidism and long-term steroid use impair lens transparency; Implantation of an underpowered intraocular lens during cataract surgery or post-traumatic lens displacement also triggers secondary hyperopia near problems.

How does hypermetropia see?

Since hyperopia is a vision problem that makes it difficult to focus at close range, the patient has the most trouble with detailed tasks such as reading, using the phone or needle and thread. Hyperopia constantly curves the intraocular lens in order to be able to distinguish letters at close range; but this temporary effort soon becomes tiring. Since far vision remains satisfactory at low degrees, the defect may not be noticed for a long time. In the evening hours, writings become shadowed, headaches and glare become evident. Especially high-degree hyperopia may experience loss of contrast in the dark; Because when the pupil expands, the focal error of the peripheral rays increases.

Symptoms of Hyperopia

• Near Vision Difficulty — At close range, letters appear shadowed, doubled, or interlaced; one feels the need to put the text at arm's length.
• Photosensitivity — Glare is evident in bright light and contrast loss is evident in dim conditions; In the evening the tables become blurry.
• Headache — Throbbing headaches in the forehead and temples in adults, and easy fatigue during classes in children are notable.
• Eye Strain — Overuse of eye muscles causes redness, stinging sensation and frequent blinking reflex.
• Blurred Vision — If complaints recur, it is critical to have individual refraction measurements taken by an ophthalmologist without delay.

How to Prevent Hyperopia?

If hyperopia is congenital, it cannot be completely prevented; However, it is possible to reduce risk factors.

• Nutrition — A diet rich in lutein, zeaxanthin and omega-three fatty acids supports eye health.
• Screen Break — It is useful to relax accommodation by looking out the window every twenty minutes while in front of the screen.
• UV Protection — It is recommended to use sunglasses that protect from UV light.
• Lighting — Homogeneous ambient light should be preferred instead of dazzling lighting.

Diagnosis of Hyperopia

The first step in reaching the correct diagnosis for someone who begins to see blurred near objects is a detailed refraction examination. This examination begins with an automatic refractometer measurement at the ophthalmologist; By analyzing refractive environments, the device determines which diopter of additional lens is required in front of the eye. When values ​​are high, confirmation is made with retinoscopy and subjective reading tests. Cycloplegic drops reveal hidden diopters by temporarily disabling accommodation, especially in the examination of children and adolescents. Keratometry and ultrasound biometry support diagnosis by precisely measuring axis length and corneal curvature.

Hyperopia Test

Hyperopia testing consists of visual acuity tables, retinoscopy and keratometry measurements. Cycloplegia is considered the critical step in determining correct diopters, especially in children. The tests are non-invasive and completed in a few minutes; The results determine the treatment algorithm.

How is Hyperopia Treated?

Hyperopia treatment is evaluated in three main steps: glasses, contact lenses and surgical methods. The aim is to focus the image on the retina by carrying the refracted light to the retina, thus providing permanent clarity. The first step of treatment is glasses with convex (plus) lenses at low diopters. For patients leading active lives, soft silicone hydrogel contact lenses offer aesthetics and a wide field of vision. Refractive surgery methods come to the fore for those looking for a permanent solution for hyperopia; LASIK, PRK and SMILE techniques increase the refractive power by removing micron-level tissue from the corneal surface. Phakic IOL implantation may be preferred in individuals with limited corneal thickness, and clear lens exchange (refractive lens exchange) may be preferred in patients aged 50 and over.

Eye Laser Surgery for Hyperopia Treatment

• LASIK — A thin flap is created in the cornea with the femtosecond laser, and Excimer energy reshapes the stroma. The recovery rate is high; Most people stop seeing blurry near vision the next day.
• PRK — The epithelial layer of the cornea is gently removed, and the Excimer laser is applied directly to the stroma. It is safe in patients with thin corneas or at risk of trauma; The epithelium is renewed in three to four days.
• LASEK — It is done by softening the epithelium with alcohol solution, laying it aside and covering it back after the procedure. Nerve cuts are minimized and the duration of pain is shortened.
• SMILE — With the femtosecond laser, a thin lenticule is created in the cornea; The lenticule is removed through an incision of only three millimeters. Since it does not require a flap, the nerve network is largely protected and the risk of dry eye is lower.

Frequently Asked Questions