Hyperopia long sighted treatment

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Long sighted (hyperopia) is age-related and first causes reading vision to be blurred, with distance blur following some years later

Long Sighted Laser Eye Surgery: Overview

Long sighted (hyperopia) is age-related and first causes reading vision to be blurred, with distance blur following some years later

If a patient is long sighted, 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 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 photosensitive 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 visual 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.

Progression of long-sighted 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 sighted hyperopia

Depending on your eye, long sight can be treated with either laser eye surgery or, especially those aged 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.

Long-sighted 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 a 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 short sight, where at least the near vision is in clear focus.

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