Hyperopia (Farsightedness)

How hyperopia works

To see clearly, the cornea and lens must focus light exactly on the retina at the back of the eye. In hyperopia:

• the eyeball is too short from front to back, or
• the cornea or lens is not curved enough

So light focuses behind the retina. The eye can partly correct this by tightening its focusing muscle (accommodation), which changes the lens shape. This works for young people with mild hyperopia, but it is tiring. As focusing power declines with age, hyperopia becomes noticeable at near and then at distance.

Hyperopia vs myopia vs presbyopia

Hyperopia and presbyopia are often confused because both affect near vision. Hyperopia is a matter of eye shape and can be present at any age; presbyopia happens to everyone with age.

Symptoms

• blurry vision for reading, phones and close work
• eye strain, aching or burning eyes
• headaches, often around the forehead, after reading or screen use
• tired eyes and trouble concentrating on close tasks
• needing to squint
• in higher degrees, blurry distance vision as well

Hyperopia in children

Most babies are mildly farsighted, and this usually lessens as the eye grows. Significant hyperopia in children can cause:

• avoiding reading or losing interest in close tasks
• eye rubbing and headaches
• accommodative esotropia: one eye turning inward, usually between ages 2 and 4, from the extra focusing effort (strabismus)
• amblyopia (lazy eye): if one eye is much more farsighted than the other or turns in

Children often do not complain, so vision screening is important.

Causes and risk factors

• inherited eye shape
• some conditions that cause small eyes (microphthalmia)
• rarely, tumors or swelling behind the eye that push the retina forward
• in adults with diabetes, blood sugar changes can temporarily shift focusing

Diagnosis

A comprehensive eye exam by an optometrist or ophthalmologist includes vision testing at distance and near and a refraction to measure the prescription. In children and young adults, cycloplegic drops relax the focusing muscle so that hidden (latent) hyperopia can be measured. The eye doctor also checks eye alignment and the drainage angle, since farsighted eyes have a narrower angle and a higher risk of angle-closure glaucoma.

Treatment

• Glasses with plus (convex) lenses. Some people need them only for close work; others full-time.
• Contact lenses, including soft, rigid and multifocal designs.
• Refractive surgery: LASIK or PRK reshape the cornea, best for low to moderate hyperopia. Results can be less stable than for myopia.
• Lens surgery: refractive lens exchange or implantable lenses for higher hyperopia, especially after 45.
• Children: glasses, sometimes with patching or eye drops for amblyopia. Glasses often fully straighten an inward-turning eye caused by hyperopia.

Frequently asked questions

What does farsighted mean?

Being farsighted means you can see distant objects more clearly than close ones. Light focuses behind the retina because the eye is slightly short, so near objects look blurry and the eyes strain to focus.

Is hyperopia the same as presbyopia?

No. Hyperopia is caused by the shape of the eye and can be present from birth. Presbyopia is age-related stiffening of the lens that affects everyone from about 40 onward. Both blur near vision and are corrected with plus lenses.

Can farsightedness get better?

In children, mild hyperopia often lessens as the eye grows. In adults, hyperopia does not improve on its own and often becomes more noticeable with age as focusing ability declines.

Can hyperopia cause headaches?

Yes. The constant effort to focus, especially during reading and screen work, can cause eye strain and headaches. Correct glasses or contact lenses usually relieve them.