Hyperopia (long-sightedness)

About Hyperopia

Hyperopia is the most common eye condition in Australia and is also called long-sightedness or far-sightedness. If you are long-sighted, nearby objects look blurry or you might be able to focus clearly but get tired eyes or headaches. You can see distant objects very well but have difficulty seeing clearly when doing things up close, such as reading books or looking at the computer screen. For people with significant long-sightedness, vision can be blurry for things in the distance as well.

Hyperopia happens when the eyeball grows too short from front to back, or when there are problems with the shape of the cornea or lens. These problems make light focus behind the retina, instead of on it.
People with long-sightedness are usually born with it. If not corrected, they often experience eyestrain and headaches and may feel tired at the end of the day.

Hyperopia is very common and is, in fact, the most common vision problem in Australia, with one in four people or more than 7.2 million Australians having the condition. The Australian Institute of Health and Welfare’s Eye Health web report, dated August 30, 2019, revealed the latest data and trends on vision impairment and blindness in Australia. It showed that the prevalence of hyperopia is increasing as it rose from 25 to 28 per cent in the ten years from 2007-2008 to 2017-2018. The information is based on reported data from the Australian Bureau of Statistics 2017-2018 National Health Survey.

Hyperopia is a type of refractive error. Refractive errors are the most common type of vision problem.

They happen when the shape of your eye keeps light from focusing correctly on your retina (a light-sensitive layer of tissue in the back of your eye). Many people have a refractive error but do not know that they could be seeing better which is why eye examinations are so important. If you have a refractive error, your optometrist can prescribe glasses or contact lenses to help you see clearly.

The four types of refractive error are near-sightedness (myopia) which makes far-away objects look blurry; long-sightedness or far-sightedness (hyperopia) which makes nearby objects look blurry; astigmatism which can make far-away and nearby objects look blurry or distorted; and presbyopia which makes it hard for middle-aged and older adults to see things up close.

Females are more likely to be affected by hyperopia, with 60 per cent of reported cases in 2010 being among females and 40 per cent in males, according to American data.

Long-sightedness is also one of the most common eyesight problems in children. But often children’s long-sightedness improves over time. This can mean that some children are less long-sighted in the pre-teen and early teenage years than they were in early childhood.

https://www.aihw.gov.au/reports/eye-health/eye-health/contents/how-common-is-visual-impairment

Trends in prevalence of long- and short-sightedness from 2007-08 to 2017-18

Image Credit: Australian Institute of Health and Welfare

Causes Of Hyperopia

The size and shape of the eye largely causes long-sightedness and you have a slightly higher chance of having hyperopia if either of your parents is long-sighted.

When light enters the eye, it is bent by the cornea (the clear layer on the front of the eye) and the lens. This is called refraction.

In people with normal vision, rays of light are brought into focus on the retina, the layer at the back of the eye. But in long-sighted people, the cornea is not sufficiently curved or the eye is too short. This means light rays from close objects focus behind, rather than on the retina when the eye is resting and not actively focusing.

Many people are slightly long-sighted and the lens corrects for the refractive error by adjusting the focus to get a sharp image.

But those who are more long-sighted or who do a lot of near-focus activities such as reading, need more adjustment. This means their eyes can get tired by the end of the day and they might get headaches.

 

Long-sightedness causes light to focus behind the retina when the eye is resting – rather than directly on it – so close objects appear blurred. 

Image Source: www.healthdirect.gov.au

Symptoms Of  Hyperopia

Mild long-sightedness can be hard to detect because the lens corrects focus to make close objects clear.

But if you have strained or aching eyes, a headache or tiredness after periods of close work, this may be an indicator that you have hyperopia.

If you have more severe long-sightedness, you might find it hard to focus on close objects.

Hyperopia And Children

Depending on how old your child is, the symptoms of long-sightedness can vary. If your child is younger, you might notice that they squint or blink when looking at close things, or rub their eyes a lot. Young children often don’t realise they have poor vision, so your child might not say that they cannot see well.

If your child is older, they might tell you that they can see things in the distance more easily than close things, or they might need to strain their eyes to see close things clearly. They may also complain of sore eyes, headache or fatigue or might not be interested in reading because of the eye strain it causes, and you might notice issues with their schoolwork.

Long-sighted children might also have a squint, when the eyes seem to be looking in different directions.

If you think that you or your child might be long-sighted, see your optometrist for an eye examination. To find an optometrist near you, use our Find an Optometrist search function.

What causes blurry vision and what can we do to bring our world into better focus?

Video Credit: www.allaboutvision.com

Detecting The Condition

Your optometrist will be able to detect if you or your child have hyperopia. All children should have an eye examination before starting school as children often do not know if they have vision problems or something is wrong with their vision and may think everyone sees like them.

The optometrist will perform a series of tests, such as using special equipment like a retinoscope and placing different lenses in front of your eyes. Retinoscopy is a good technique to find refractive error, especially so in young children who are non-verbal or cannot yet recognise alphabets on a vision chart. They will also use a slit lamp to magnify and light your eye so that they can see it in much closer detail to check your eye health. 

These examinations can be conducted without using eye drops to determine how the eyes respond under normal seeing conditions. In some cases, such as for patients who can't respond verbally or when some of the eye's focusing power may be hidden (such as in children), an optometrist may use eye drops, called Cyclopentolate, which temporarily keep the eyes from changing focus during testing.

The optometrist will be able to diagnose if you have hyperopia and the extent, whether mild, moderate or severe. The optometrist can then advise what management and treatment options would be best to help treat the condition and alleviate symptoms such as blurriness, headache, eye strain and tired eyes.

Treating Hyperopia

Children or young people with mild long-sightedness might not need treatment because their eyes may naturally adjust over time to see clearly. However, children with more severe long-sightedness might need glasses. If your child is younger or also has a squint, they may need to use glasses all the time.

If moderate to severe long-sightedness is not corrected, the extra focusing effort required may increase the likelihood of children developing lazy eye (amblyopia) or turned eyes (also called a squint or strabismus).

If older, they may only need glasses for close activities such as reading or schoolwork.

Contact lenses might also be an option for older children or teenagers.

The most common treatment for hyperopia is glasses, especially for reading and other near work, but sometimes also for distance. 

Long-sighted adults will also need reading glasses at a younger age, often around 30 instead of in their 40s. They may eventually need glasses or contact lenses for distance vision also, as the ability of the lens to change its shape gradually declines. 

In hyperopia, the eye muscles, through accommodation – (the ability of the eye to change its focus from distant to near objects and vice versa) - alter the lens shape and glasses are often not needed initially. Close objects are also seen clearly because of increased accommodation. But as the lens loses its flexibility, largely due to the aging process, this increased accommodation cannot be achieved, requiring the person to seek vision correction via glasses or contact lenses. 

Another option for adults requiring correction of long-sightedness is refractive surgery, such as laser refraction surgery and clear lens exchange surgery. These approaches may be suitable for some adults. Refractive surgery is not recommended for children. Laser surgery, for example, uses a laser (beam of light) to correct vision by reshaping the cornea. In some cases this removes the need for glasses or contact lenses but like all eye surgery, it has risks and possible complications. Refractive surgery for hyperopia is performed by specialist eye doctors (ophthalmologists). Your optometrist will be able to perform preliminary tests to assess your suitability and chat with you regarding the pros and cons of these techniques. Your optometrist will then refer you to an ophthalmologist for further assessment of your suitability.

 

People with hyperopia often need glasses to see things more clearly up close such as reading or computer work

Photo Credit: Photo From Unsplash By Kevin Lehtla

Commonly Asked Questions

What causes hyperopia?

The size and shape of the eye is largely responsible for this condition, which is usually hereditary. If the cornea, the clear window at the front of the eye, is not sufficiently curved or your eye is too short, the light that enters your eye will not focus correctly on the retina at the back of the eye.

Can hyperopia be cured?

Properly prescribed glasses or contact lenses will make tasks much easier by improving how clearly you see and making it more comfortable for your eyes, but hyperopia cannot be cured.

Will I have to wear glasses? 

Your optometrist will tell you if you need to wear glasses all the time or some of the time, according to your prescription and lifestyle. You are likely to need glasses when you are reading books or using computers or performing other tasks that require you to focus up close. Glasses are a good option for vision correction. They make a fashion statement and come in many shapes, sizes and colours. Contact lenses worn on the eyes are also a great option and may provide better vision, particularly if you lead an active lifestyle.

Is it better to wear weaker glasses and make my eyes work harder?

No, this is not true. Long-sighted people have trouble reading because the muscles in their eyes over focus. Properly prescribed glasses or contact lenses from your optometrist will help your eyes to focus normally. They will also help stop the muscles in your eyes from over-working, easing eye-strain and headaches. 

Can contact lenses correct long-sightedness?

Contact lenses are a great option for both adults and children with high levels of hyperopia, as they can provide clear, comfortable vision all day. 

Are contact lenses better than glasses?

It often comes down to personal preference. Many long-sighted people use both glasses and contact lenses to treat their long-sightedness. Contact lens wearers should always have a pair of glasses as well, and alternate use between both, to give their eyes a break from wearing contact lenses. 

How can I tell if I’m longsighted and how will it affect me?

Long-sighted people can often see clearly when looking at distant objects and may not realise that they need glasses or contact lenses. It is important to have an eye examination with your optometrist who will be able to examine how well you see up close by placing different lenses in front of your eyes, so he or she can then prescribe the lenses that give you the clearest and most comfortable vision.

How does hyperopia affect me?

If you have mild hyperopia, you may not notice any problems but in other more moderate or severe cases your optometrist can prescribe glasses or contact lenses that will help enhance your vision and reduce symptoms of eye-strain and headache.

Where do i go for more advice?

We recommend making an appointment with an optometrist for a comprehensive eye examination. Comprehensive eye examinations, at regular intervals starting from childhood, ensure that most eye conditions can be prevented or corrected. Eye examinations can also be an important tool for determining your overall health.

Use our Find an optometrist search function if you do not have an optometrist, or would like to find an optometrist close to where you live.

Published date: 01 September 2016 Reviewed date: 17 April 2020

Luke Arundel

Author: Luke Arundel, BAppSci (OPtom) Hons, FIACLE, FCCLSA, FBLSA, FBCLS, AdjAssProf University of Missouri St Louis, GCOT, CASA CO

Bio: Luke Arundel is Chief Clinical Officer of Optometry Australia. He graduated with Honours in Optometry from Queensland University of Technology in 1998 and has worked extensively in Australia and Ireland. He currently holds fellowships with the BCLA, CCLSA and IACLE and became an Adjunct Associat Professor of the University of Missouri, St Louis, USA in 2008. His professional interests include keratoconus, post-graft and scleral lens fitting, dry eye, ortho-keratology and paediatric contact lenses. He has worked in specialty contact lens practices in Brisbane and Melbourne and in the contact lens manufacturing field along with time in the public health and education sectors. Luke’s role at Optometry Australia sees him provide professional services assistance to members in audits, investigations and medico-legal matters along with leading development of resources and special projects.

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Disclaimer: No information provided on the Good vision for life website is intended to constitute or substitute advice from visiting an optometrist. Many factors unknown to us may affect the applicability of any information on this website. You should seek appropriate personalised advice from a qualified optometrist about any eye health and vision conditions.