Treatment for Farsightedness
Warsaw · Krakow · Vienna · Zurich
Hyperopia (farsightedness) causes the image to form behind the retina, resulting in blurry vision – both up close and at a distance. This can be caused by an eyeball that is too short or insufficient refractive power of the cornea or lens.
Modern correction methods effectively restore clear vision and comfort in daily life – without constant visual strain.
What is Hyperopia (Farsightedness)?
Hyperopia (also known as hypermetropia, farsightedness) is a refractive error where parallel light rays entering the eye, after passing through the optical media, refract not on the retina but behind it, causing the image formed on the retina to be blurry. This condition can be caused by an eyeball that is too short or insufficient refractive power of the cornea or lens. Although it is said that a farsighted person – unlike a nearsighted person – has difficulty seeing objects clearly up close, they most often have trouble perceiving objects clearly at any distance.
Depending on the degree of the defect, hyperopia is classified as:
- low (up to +2.5D)
- moderate (+2.5D to +6.0D)
- high (over +6.0D)
Farsightedness in Children vs. Hyperopia in Adults
In children up to 3 years of age, so-called physiological hyperopia occurs, but it should resolve as the eyeball grows (the eyes should undergo emmetropization, meaning they should lose hyperopia to achieve a state without refractive error). If this does not happen, the defect does not disappear but deepens, requiring correction. It is estimated that about 90% of the youngest children are hyperopic, and this percentage decreases to 40–50% by 8–10 years of age.
Due to significant accommodative capabilities, it can remain undiagnosed for a long time. Parents should therefore pay attention to symptoms such as reluctance to read and look at books, rapid eye fatigue, or strabismus (squinting). The latter symptom appears when, for example, the defect differs in both eyes (anisometropia) or when one eyeball has an underdeveloped optic nerve. The weaker eye stops working and is excluded from the visual process because the brain “chooses” the stronger, more efficient, better-seeing eye. We may then observe one eye drifting.
A prompt visit to an ophthalmologist is necessary, as such a situation can lead to disorders of binocular vision and/or spatial vision (stereopsis). In the case of strabismus, the sooner ophthalmological intervention occurs, the greater the chance of avoiding monocularity (seeing with only one eye), which in the future can result in the inability to perform many professions, such as a driver.
Between the ages of 25 and 40, a typical symptom of hyperopia is poorer near vision. After the age of 40, hyperopia manifests as poor vision for both distance and near (due to weakened accommodation). A separate ophthalmological problem is so-called presbyopia (age-related farsightedness), which is not a refractive error but a set of changes that occur with age in the human eye. It can also appear in individuals who have never been diagnosed with any refractive error.
How is Hyperopia Diagnosed?
For children, diagnosing farsightedness requires temporary paralysis of the ciliary muscle, i.e., paralysis of accommodation (the so-called cycloplegic state). An ophthalmologist or optometrist instills an appropriate preparation (e.g., tropicamide or atropine) into the eye and performs skiascopy (which involves manually projecting a beam of light rays onto the fundus of the eye and observing the direction of movement of the red reflex from the fundus within the pupil; special rulers/strips or a Hess screen with embedded lenses of various powers are used for the examination) or refractometry (the principle of the examination is the same, but it is performed by a computer). In adults, paralysis of accommodation is not necessary.
Methods for Correcting Farsightedness
Farsighted individuals are prescribed glasses with convex lenses, or “plus” lenses, which are thicker in the center than at the edge. This type of lens converges light, shifting the focal point onto the retina. Contact lenses also yield good results; for farsighted individuals, they do not narrow the field of vision, which glasses do. A similar phenomenon also occurs in nearsighted individuals. In both cases, the greater the defect, the better the patient sees with contact lenses.
Hyperopia can also be corrected with laser procedures.
Considering the severity of the condition, the degree of farsightedness can be considered low when the diopter value does not exceed +2.0, and high when its value exceeds +5.0. The treatment method depends on the number of diopters and is determined individually during the preliminary examination and consultation with a doctor. During laser treatment for farsightedness, a greater curvature is created, which increases the eye’s refractive power, thereby improving comfort and visual acuity.
Laser Treatment Methods for Hyperopia
LASIK
Two-stage technique: the cornea is incised with a scalpel (microkeratome), and then the corneal surface is reshaped so that it can properly focus the image onto the retina.
FemtoLASIK
Using a precise femtosecond laser, the surgeon makes an incision in the cornea, creating a thin flap 0.1 mm thick. An excimer laser is then used to reshape the exposed cornea for a few seconds, after which the flap is repositioned; it adheres and forms a protective barrier for the cornea.
Alternative Vision Correction Methods
Individuals who do not qualify for laser vision correction may opt for phakic lenses (special lenses made of Collamer (ILC) material, which allow for the correction of astigmatism and severe vision impairments with diopter values greater than -8 and +3). For severe farsightedness, intraocular implants are also used.
Refractive Lens Exchange (RLE)
Refractive Lens Exchange (RLE) involves the aspiration of the natural lens through a small incision in the cornea, and its replacement with a lens made of compatible plastic (acrylate).
