Hyperopia long-sight treatment
Long-sight or hyperopia is age-related and first causes reading vision to be burred, with distance blur following some years later
Long-sight treatment: Overview
Long-sight is a vision disorder that gets increasingly common with age. Long-sight is also known as farsight in the United States. The correct medical term is hyperopia.
If the patient suffers from long-sight, it is the 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 long-sight the close vision will always be worse than the distance vision. The name refers to the fact that it is the long 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 varifocal glasses.
Normal vision without hyperopia
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 photo-sensitive layer at the back of the eye converts the light into data that passes along the optic nerve coming from the back of the eye, taking the vision information to the occipital lobe at the back of the brain; this brain region then processes this sight information so that you get a visual perception and awareness of the world.
The cause of long-sighted blur
Hyperopia is the correct medical term for long-sightedness (farsighted in the US), and 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 combined as a ‘telescope’) is completely normal but the retinal ‘screen’ where the image is projected is too close. The image is now incorrectly behind the retina, with the light rays failing to meet at the retinal plane, leaving the image out of focus.
Progression of hyperopia – when to have treatment
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 stabilises in the early 60s.
Higher degrees of long-sight in younger patients, or all hyperopic patients after 50, will start to notice their distance vision also becoming blurry. Bifocal or varifocal 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 long-sightedness 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, long-sighted patients can be very happy with the outcome, due to the disabling nature of long-sight with every distance often being blurred.
Treatment for long-sight
Depending on your eye, long-sight can be treated with either laser eye surgery or, especially those age 50+, with refractive lens exchange (RLE).
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.
Laser surgery for long-sight
Treatment has developed greatly over the past 10 years. Using an excimer laser we can now correct up to 6 dioptres of hyperopia, with or without astigmatism, although correction works best for up to 4 dioptres.
Longsight treatment with our LASIK procedure involves creating a very thin flap using a femtosecond laser, which at Focus is the advanced Ziemer LDV, 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, compensating for the effects of long-sight.
At Focus Clinic, we prefer using LASIK rather than PRK for the correction of hyperopia. Because it is a progressive condition which continues to get worse with age, it is important for the patient to realise that this is not a permanent solution even though they will always retain benefit from having had the treatment. It may be possible to improve the vision further when the patient is older and has more farsight, with a second enhancement procedure.
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 shortsight, where at least the near vision is in clear focus.