Hypermetropia: Everything you need to know

Hypermetropia: Everything you need to know

According to a worldwide report on vision conducted by the World Health Organisation (WHO), 2.2 billion people currently suffer from vision impairment or blindness [1]. That’s 29% of the population. Moreover, their report found that 1 billion cases of vision impairment or blindness could have been prevented or are untreated. Refractive error is a major cause of vision impairment and blindness worldwide, and in this article, we explore all you need to know about a type of refractive error called hypermetropia (far-sightedness).

all you need to know about hypermetropia

What is a refractive error?

Amongst these cases of vision impairment, the most common cause is a refractive error. Refractive error occurs when the shape of your eye prevents light from focusing onto your retina properly, resulting in a blurred image. The retina is the light-sensitive tissue at the back of your eye. Refractive error is the first cause of visual impairment and the second cause of sight loss worldwide [2], with 43% of visual impairment caused by refractive errors.

There are 4 main types of refractive error:

  1. Myopia (near-sightedness) – When near objects appear clear, but distant objects appear blurred.
  2. Hypermetropia (far-sightedness) – When distant objects appear clear, but near objects appear blurred.
  3. Presbyopia – Age-related stiffness of eye lens, specifically loss of the ability to focus on near objects.
  4. Astigmatism – When vision is blurred or distorted.

What is hypermetropia?

Hypermetropia occurs in around 10% of the world population [3]. The refractive error caused by hypermetropia, also known as hyperopia, happens because the axial length (the distance from the cornea to the retina) is shorter than normal. Hypermetropia can also be caused by the surface of the cornea being too flat. The cornea is the transparent part of the eye that covers the front of the eye. Because of these physiological (something normal, not resulting from illness) differences in the shape and size of the eye, the light rays that enter the eye have a focal point that is behind, rather than on the retina. Hypermetropia is normally present at birth and tends to be a hereditary vision problem.

Along with physiological hypermetropia, the more common type of hypermetropia, there is also pathologic hypermetropia. Pathologic, within medicine, means something that is indicative of disease, or the result of disease or external injury. Something that is not naturally occurring. Pathologic hypermetropia can be the result of injury to the eye, or damage induced by eye diseases like glaucoma. Glaucoma is a condition where your eye’s optic nerve, which is responsible for transmitting messages from the retina to the brain, is damaged by increased pressure in the eye. It often leads to the gradual loss of vision and is most common in people 70 years and older.

all you need to know about hypermetropia

Symptoms of hypermetropia

Often, the main symptom that is associated with hypermetropia is a blurry vision when viewing near objects. This is more noticeable when you are doing near work, like reading, writing, or working on a device. But as well as the blurring of near objects, people who suffer from hypermetropia can also experience eye strain and general eye discomfort or headaches, especially after doing those tasks that require near work. Eye strain feels like a burning and aching sensation in and around the eyes.

While not directly a symptom of hypermetropia, the American Academy of Ophthalmology notes that strabismus can be an indicator of hypermetropia. Strabismus is the abnormal alignment of the eyes, often caused by one eye being weaker than the other. In patients with strabismus (lazy eyes) the visual axes of the eyes are not parallel, and the eyes do not appear to be facing the same direction.

If you experience any of these signs and symptoms, schedule an appointment with an eye health professional to get your eyes checked. It is also important to note that the development of eye conditions may even start before symptoms appear, which makes going for regular and timely eye checks that much more essential.

How is hypermetropia diagnosed?

If you are concerned that you or someone you know might have hypermetropia it is best to book an appointment with your optometrist. The diagnosis process for hypermetropia is fairly hassle-free. The most common method of diagnosis is through a visual acuity test (VAT) that your optometrist will conduct. Visual acuity refers to the measurement of how well you can make out small details and your overall quality of vision. These tests can be made up of a series of tests to see how good your visual acuity is, and what if any intervention is needed.

The visual acuity examination’s main component is a chart that has letters of varying sizes that your optometrist will ask you to readout. There are several different versions of this chart, but the Snellen Chart is the most common. While you are looking at the Snellen Chart your optometrist might place a series of different lenses in front of your eyes and ask you questions like, “Is the image clearer with one or two?” This is called a retinoscopy and is a way of determining which lens strengths could help correct any refractive error you might have. There is another method called cycloplegic refraction, where the optometrist places eye drops in your eye that momentarily relax the muscles, allowing them a clearer image of your eye and any refractive error present.

If your child goes to have a visual acuity test, it is more likely that the optometrist will use a retinoscopy. This is because, even if your child cannot properly communicate their symptoms, the optometrist can understand their symptoms, and what prescription they need, based on their responses during the test [4].

Even if you aren’t particularly concerned about your eye health, it is important to get your eyes checked by an optometrist regularly. Regular eye checks can catch asymptomatic eye diseases before they are a risk to your vision.

Treatment options for hypermetropia

In most cases of patients with hypermetropia, their refractive error is corrected with lenses. In some cases, these are convex lenses that adjust the paths of the light when it enters the eye so that the focal point is on the retina rather than behind it. These lenses can come in the form of either eyeglasses, or contact lenses.

There are also several refractive surgeries that can correct hypermetropia. But they prefer for surgeries like thermal laser keratoplasty (TLK) not to be done until the eye has stopped growing, which usually happens in your 20s.

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The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

[1] World Health Organization. WHO launches first World report on vision. Geneva, WHO. 2019.

[2] D Pascolini, S.P. Mariotti. Global Estimates of Visual Impairment: 2010. British Journal of Ophthalmology. 2012.

[3] J D Trobe. The Physician’s Guide to Eye Care. San Francisco, CA. American Academy of Ophthalmology. 2006.

[4] B D Moore, A R Augsburger, E B Ciner, D A Cockrell, K D Fern, E Harb. Optometric Clinical Practice Guideline: Care of the Patient with Hyperopia. St. Louis, MO. American Optometric Association. 1997.

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