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Farsighted

Farsightedness is a vision disorder that gets increasingly common with age. The correct medical term for farsighted is hyperopia.

If a patient is farsighted, it is their close vision that is first affected. Near objects become blurry, such as reading a newspaper or seeing a text or number appear on a mobile phone. This blur for near objects gets worse as the patient ages, and eventually even the far vision can also become blurry.

With farsightedness, the close vision will always be worse than the distance vision. The name refers to the fact that it is the far sight which is always the better. The patient normally simply wears glasses for reading, particularly in the early stages. Later, the person may graduate to wearing bifocal or progressive glasses.

In a normal, healthy eye, light rays enter via the cornea, pass through the entrance pupil (the natural opening in the iris) and continue through the lens located just posterior to the iris. If there is no focusing error (glasses prescription), the cornea and lens bend the parallel light rays to converge together to make a sharp image on the retina. This photosensitive layer at the back of the eye then converts the light into data that passes along the optic nerve to the brain; which processes this sight information so that you get a visual perception and awareness of the world.

 NORMAL EYE: IMAGE FOCUSED ON RETINA

Hyperopia is the correct medical term for farsightedness, which is most commonly caused by the eye being shorter from front to back than a normal length eye. Typically the front focusing section of the eye, the cornea and lens, are unable to focus the light directly on the retina . The light is now incorrectly focused behind the retina, leaving the image out of focus.

 FARSIGHTEDNESS – HYPEROPIA: IMAGE CANNOT BE FOCUSED

Myopia typically begins in the teenage years, and gradually progresses with worsening distance vision over the next 10-15 years. With higher levels of nearsightedness, the condition may begin before the age of 10. Some children do not realize at first that their sight is not as good as it could be. They may be able to read books and do close work without difficulty. However, seeing distant objects such as the board at school may become hard. They may think this is normal and not tell anyone. Schoolwork may suffer for a period before the condition is identified and treatment provided.

Myopia typically stabilizes in the early 20s and you no longer need regular increases in the strength of their glasses to see. That is correct time to consider laser vision correction. Most patients are ready to have laser eye correction between 25 and 30, although some may be ready earlier, depending on, e.g. when they first needed glasses.

Hyperopia can often occur in childhood, before the age of 10, but which then improves as the eye grows. The child will no longer need glasses, often for many years.

When long sight develops in adults, it is often in the 20s or 30s, initially just affecting reading vision. Because this is an age-related problem, it will naturally progress as the person gets older. This process continues until it finally stabilizes in the early 60s.

Higher degrees of hyperopia in younger patients, or all hyperopic patients after 50, will start to notice their distance vision also becoming blurry. Bifocal or progressive glasses, or simply two pairs of different strengths (one for TV and driving or day to day living, the other for reading), will usually be necessary.

Laser surgery can improve farsightedness but the patient needs to be aware that the condition does progress with age, so a long-term cure is often not possible. The exception to this rule is those patients age 55 and above with mild to moderate degrees of hyperopia, which can get a long-lasting improvement when having their far vision (e.g. driving and TV) vision corrected.

However, farsighted patients can be very happy with the outcome, due to the disabling nature of farsightedness which can cause every distance to be often blurred.

Depending on your eye, farsightedness can be treated with either LASIK eye surgery or, especially for those age 50+, with refractive lens exchange (RLE).

Lens replacement surgery can usually provide an effective cure as the results are permanent, due to the natural lens inside the eye (the cause of the condition worsening with age) being removed. You can learn more about lens implants on our comprehensive refractive lens exchange surgery page.

Treatment has developed greatly over the past 10 years. Using an excimer laser we can now reliable correct up to 4 diopters of hyperopia, with or without astigmatism.

Farsightedness treatment with our LASIK procedure involves creating a very thin flap using a femtosecond laser, which at Anaheim Eye is the advanced Ziemer Z6 Laser, and then using the WaveLight Allegretto excimer laser to remove tissue in the outer part of the cornea so steepening the central zone. This central steepening makes the cornea into a more powerful lens, allowing it to focus light directly on to the retina instead of behind it.

Hyperopic patients are often the happiest after treatment. This is because higher degrees of this refractive error is a very unpleasant condition, because vision is blurred at every distance. This compares to nearsightedness, where at least the near vision is in clear focus.

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