Hyperopia – symptoms and treatment


Hyperopia – symptoms and treatment

Hypermetropia is the result of a discrepancy between the optical function of the visual apparatus and the length of the eyeball. Moreover, these factors – the insufficient refractive power of the cornea and / or the lens and the shortening of the PZO (anteroposterior axis) of the eye – can occur both individually and in combination with each other.

Physiological hyperopia within + 2 + 4 diopters is characteristic for all newborn babies – their eyeballs have a length of 16-17 mm. It is noteworthy that if this index deviates from the norm in the smaller direction, hypermetropia is often combined with other congenital eye pathologies (microphthalmos, lentikonus, aniridia), as well as fetal malformations (hare lip, wolf mouth).

By As the child grows and grows up, the size of the eyeballs of his eyeballs reaches 23-25 ​​mm, and the change in physiological far-sightedness is accompanied by emmetropia – a healthy one-hundred-percent vision, which is usually set to 12 years. However, already at the age of seven, the parameters of the length of the eye PZO should approach the norm. If this does not happen, you need to seek professional advice from an ophthalmologist. Since at 7 years old children go to school, before the start of the first school year it will be superfluous to check the sight of the child, especially if one of the parents suffers with congenital hyperopia.

Important: at the age of 15-16 years, the human visual apparatus completes and by that time about 50% of young people have some degree of farsightedness, and half of them are shortsighted among the remaining 50% of young men and women, and half are healthy.

What is the reason for such a wide spread of hypermetropia? Scientists still can not accurately answer this question – eyeballs for no reason begin to lag behind in growth, and something, other than a genetic predisposition, to explain this pathology is difficult. Separately, mention should be made of birth defects or the complete absence of the cornea or lens – these developmental anomalies are extremely rare and almost always lead to blindness.

However, in most cases, provided the patient’s youth and low degree of farsightedness, it can be is compensated by the accommodation mechanism. Therefore, the most acute problem of hypermetropia rises in adulthood, after 40 years, when the eyes gradually wear out. First of all, it is customary to distinguish between natural physiological far-sightedness in children, as well as congenital and acquired, which includes “senile vision “, That is, presbyopia.

Depending on the causes and mechanism of development, doctors distinguish the following types of hypermetropia:

  • Axial or axial – is associated with the shortening of the eyeball’s OPO.

  • Refractive is caused by a weakening of the refractive ability of the cornea and / or the lens.

    Based on the possibility of compensation for the violation, we speak of two main types of farsightedness: is eliminated by accommodation of stress, but with age it almost always turns into an explicit one.

  • Explicit – can not be eliminated by independent efforts of the visual the device requires wearing glasses or contact lenses. In terms of the degree of severity, hypermetropia is divided into three types:

    • Weak – up to +2 Dpt.

    • Average to +5 Dp

    • High Symptoms of hyperopia

      The severity of symptoms and the duration of their manifestation depends on the severity of the disease: An easy degree of hypermetropia of at a young age does not appear in any way, since the reserves of accommodation are sufficient for self-correction of sight. The first signs of impairment will become visible after 40-45 years, when the eyes can no longer cope with the constant stress. But another scenario is even more likely: if a person actively uses the visual apparatus, knowing nothing about the presence of an easy degree of farsightedness, the disease will worsen, go on to the next stage of development and begin to manifest itself at the age of 30-35.

    • The average degree of hypermetropia is characterized by fairly clear long-range vision, but with a long focus on the nearby objects, the eyes will quickly get tired and watery. After several hours of continuous reading, the letters will begin to grow dull and merge with each other. This condition can be exacerbated by aching and burgeoning painful sensations in the forehead, overhead, bridge of the nose and eyeballs themselves. Often there is photophobia after a person tries to strengthen the lighting of the workplace in order to better see. As a rule, adults who have an average degree of farsightedness are tempted to “blink” and rub their eyes after 30-60 minutes of active near vision.

    • High degree of hypermetropia differs in the inability to clearly see both near and far, as well as the severity of the asthenopic syndrome – headache, very fast eye fatigue, a feeling of “sand” in the eyes, and this causes people to rub them often, which is fraught with corneal damage, infection and the development of inflammatory diseases s: blepharitis, conjunctivitis, keratitis, barley, chalazion. In elderly patients, hyperopia becomes one of the causes of glaucoma. Therefore, in the presence of the above symptoms it is extremely important to contact the ophthalmologist as soon as possible and undergo a complete examination.


    The first step to the standard check of visual acuity – visometry becomes the detection of this ailment. It is carried out either at all without any correction, or with the use of trial “plus” lenses with different diopters, if the suspicion of hypermetropia already exists. The procedure for visometry is very simple and familiar to all from childhood: a person is located at a certain distance from a large poster, which shows rows of letters – the largest on top and the smallest at the bottom. Depending on what the last distinctive series will be, the degree and nature of the visual impairment – myopia or hypermetropia – is established. With astigmatism, the image of the letters is distorted and fuzzy in any series.

    If the results of the visometry revealed hyperopia, the next step will be the study of eye refraction by the method of skiascopy or computer refractometry. To detect and confirm the latent farsightedness in children and young patients, refractometry is carried out after instillation of atropine sulfate in the eyes for the artificial creation of cycloplegia (ciliary muscle paralysis) and mydriasis (dilated pupil). In the framework of the diagnosis of hyperopia and associated pathologies the doctor at his discretion can be involved in additional techniques:

    • ultrasound of the eyeballs

    • Echobiometry

    • Perimetry

    • Tonometry

    • Ophthalmoscopy

    • Biomicroscopy with the Goldman lens.

    Treatment of farsightedness

    If a person does not have unpleasant asthenopic symptoms and the acuity of both eyes is not less than one subject to a stable binocular vision, then no treatment is shown to him, selection of glasses or contact lenses is also not required. But this does not mean that hidden farsightedness should be ignored. The reserve of accommodation is exhausted, therefore, every effort should be made to save it. Vision should be protected: give the eyes rest after every 2-3 hours of work at the computer, with small items or documents. It is very useful to perform special gymnastics for the eyes and use relaxing exercises – for example, palming. It does not damage the intake of vitamin-mineral complexes and biologically active food additives intended for feeding the eye tissues, maintaining the process of their regeneration and maintaining visual acuity. But on this occasion it is necessary to consult separately with a specialist.

    With more pronounced hyperopia, treatment is required:

    • Conservative methods – wearing glasses and contact lenses.

    • Laser correction – LASIK (laser keratomies), SUPER LASIK (the same, but using a wavefront analyzer), LASEK (laser epitheliokeratoectomy), PRK (photorefractive keratectomy), etc.

    • Surgical operation – thermokeratocoagulation, lenseectomy, hyperfacia, hyperartiphakia, etc.

    With farsightedness over +3 diopter for preschoolers are selected glasses. If by the age of 6-7 there are no signs of amblyopia or strabismus, the glasses are canceled. If such complications do arise, you will have to continue to wear glasses that will need to be changed regularly as the disease develops. It is also recommended that the course hardware treatment (“Rucheyk”, “Amblyocor”, “Amblyotrener”, “Sinoptofor”), massage, physiotherapy, eye gymnastics, vitamins and supplements to maintain vision. As for adult patients, they at high degrees of hypermetropia may need so-called bifocal glasses, which allow correcting myopia and hyperopia at the same time.

    Laser correction is available from the age of 18 years and is relevant in the case deterioration of visual acuity to +6 diopters. With more pronounced abnormalities, such procedures may not be useful. Despite the variety of names (LASIK, LASEK, EPI-LASIK, intraLASIK, Super LASIK), the essence of all these techniques is reduced to the formation of an optically correct surface of the cornea with the help of a laser beam around the periphery. After such a procedure, the cornea contracts and acquires the necessary refractive force.

    The most common methods of surgical treatment of hyperopia are called keratomy (the creation of radial incisions along the outer edge of the cornea) and thermokeratocoagulation (using the thinnest glowing needle for this purpose). Potent keratoplasty (transplantation of the donor cornea), implantation of the phakic lens directly on the lens (hyperfakia) or its complete removal (lenseectomy) with subsequent replacement with an artificial analogue (hyperartiphakia).

    Video: 10 effective exercises for visual improvement Prophylaxis and prognosis

    To avoid the development of age-related farsightedness, you must follow simple rules:

    • Be sure to take breaks in the process prolonged operation of near vision. Every few hours, you need to get up, warm up, massage eyeballs with circular circular movements, and keep your eyes closed for a couple of minutes. If you know the special exercises for relaxing the eyes, do them regularly – this is the most simple and reliable way to prevent hyperopia.

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      The workplace should be well lit but not excessive. From bright light with hypermetropia, vision grows tired no less rapidly than from darkness.

    • Keep track of your diet. Eyes – the most complicated mechanism, which constantly needs food. Chronic deficiency of some vitamins, minerals and amino acids leads to accelerated wear of the visual apparatus.

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      Give up harmful habits – smoking, alcohol abuse.

    • Maintain an active lifestyle, avoid repetitive monotonous loads on the eyes. Unfortunately, the prevention of hyperopia will be useless if the anteroposterior ocular axis in humans is shorter than 23.5 mm. The only way to slow down the progression of the disease in this case is the timely and correct selection of glasses or contact lenses.

      It is desirable to move as far away as possible from the moment when congenital hypermetropia becomes uncorrected, that is, it will not be compensated by accommodation. This will not only worsen both near and far vision, but also lead to serious complications, for example, glaucoma. Therefore, the resources of the adaptive mechanism of one’s eyes should be treated with diligence, following all the recommendations and prescriptions of the attending physician, and immediately seek help in case of new anxiety symptoms or a sharp drop in visual acuity. / / P

      The forecast of age-long farsightedness is also disappointing – it will quickly deteriorate without the use of high-quality optics and careful attitude to their visual apparatus. Older people who do not see well near, usually develop an extremely negative habit of rubbing their eyes, which are constantly watering and sore, as if sand was poured into them. The immune defense of the body, meanwhile, is weakening, and all this in combination leads to the development of inflammatory diseases – conjunctivitis, blepharitis, keratitis. Against their background, the cornea suffers, and hyperopia is even more progressive. That’s why you need to reduce the risk of eye damage and infecting the infection to a minimum, and if this happens, immediately go to the doctor and undergo a course of treatment. Take care of your eyes, and be healthy!


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