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Farsightedness (Hyperopia): Causes, Symptoms & Treatment

Farsightedness (hyperopia) is a common refractive error in which nearby objects appear blurry. It is caused by a too-short eyeball or a cornea with insufficient curvature.

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Things worth knowing about "Farsightedness"

Farsightedness (hyperopia) is a common refractive error in which nearby objects appear blurry. It is caused by a too-short eyeball or a cornea with insufficient curvature.

What is Farsightedness?

Farsightedness, medically known as hyperopia or hypermetropia, is one of the most common refractive errors of the eye. In individuals with farsightedness, light rays entering the eye are focused behind the retina rather than directly on it. This causes nearby objects to appear blurry, while distant objects – especially in mild cases – may still be seen relatively clearly.

Causes

Farsightedness results from an optical focusing error of the eye. The most common anatomical causes include:

Short eyeball: The eyeball is shorter than average, causing the focal point to fall behind the retina.
Flat cornea: The cornea has insufficient curvature, reducing its ability to refract light properly.
Lens irregularities: The eye's lens does not bend light adequately.

Farsightedness is often present from birth and can be hereditary. A mild degree of hyperopia is considered physiologically normal in young children and often resolves as the eye grows.

Symptoms

Symptoms vary depending on the severity of the refractive error and the age of the affected person. Common symptoms include:

Blurred vision when reading or performing close-up tasks
Frequent headaches, especially after prolonged reading or screen use
Eye fatigue and burning eyes
Squinting (strabismus), particularly in children
Difficulty focusing on nearby objects

In younger individuals, the eye can partially compensate for farsightedness through a process called accommodation – the active adjustment of the eye's lens. However, this compensatory ability decreases with age, which is why symptoms often become more pronounced in adulthood.

Diagnosis

Farsightedness is diagnosed by an ophthalmologist or optometrist using the following methods:

Visual acuity test: Measurement of sharpness of vision using standardized eye charts.
Refraction test: Objective or subjective measurement of the refractive error using instruments such as an autorefractor or trial lenses.
Retinoscopy (skiascopy): Objective assessment of the eye's refractive power.
Slit-lamp examination: Evaluation of the anterior eye structures.

The degree of farsightedness is measured in diopters (D). Up to +3 D is considered mild, up to +6 D is moderate, and above +6 D is classified as severe hyperopia.

Treatment

Treatment options depend on the severity of the condition and the impact on quality of life:

Eyeglasses

The most common and straightforward treatment involves convex lenses (plus lenses), which increase the refractive power of the eye and allow for clear vision at all distances.

Contact Lenses

Soft or rigid contact lenses with the appropriate positive power are a popular alternative to glasses for many patients.

Refractive Surgery

For adults with a stable prescription, surgical correction is an option:

LASIK / LASEK / PRK: Laser procedures that reshape the cornea to correct the refractive error.
Lens implantation: Insertion of an artificial intraocular lens, particularly suitable for high degrees of hyperopia.

Considerations in Children

Early diagnosis and treatment in children is essential to prevent the development of amblyopia (lazy eye) or strabismus. Prescription glasses are typically the first line of treatment in pediatric cases.

References

World Health Organization (WHO): Vision impairment and blindness. Fact Sheet, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment
American Academy of Ophthalmology (AAO): Farsightedness (Hyperopia) - Clinical Guidelines, 2023. Available at: https://www.aao.org/eye-health/diseases/farsightedness
Kanski, J.J., Bowling, B.: Clinical Ophthalmology: A Systematic Approach. 8th Edition. Elsevier, 2016.

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