Farsightedness

Overview

Farsightedness (hyperopia) is a common vision condition in which you can see distant objects clearly, but objects nearby may be blurry.

The degree of your farsightedness influences your focusing ability. People with severe farsightedness may be able to clearly see only objects a great distance away, while those with mild farsightedness may be able to clearly see objects that are closer.

Farsightedness usually is present at birth and tends to run in families. You can easily correct this condition with eyeglasses or contact lenses. Another treatment option is surgery.

Symptoms

Farsightedness may mean:

• Nearby objects may appear blurry
• You need to squint to see clearly
• You have eyestrain, including burning eyes, and aching in or around the eyes
• You have general eye discomfort or a headache after doing close tasks, such as reading, writing, computer work or drawing, for a time

When to see a doctor

If your degree of farsightedness is pronounced enough that you can't perform a task as well as you wish, or if your quality of vision detracts from your enjoyment of activities, see an eye doctor. He or she can determine the degree of your farsightedness and advise you of options to correct your vision.

Since it may not always be readily apparent that you're having trouble with your vision, the American Academy of Ophthalmology recommends the following intervals for regular eye exams:

Adults

If you're at high risk of certain eye diseases, such as glaucoma, get a dilated eye exam every one to two years, starting at age 40.

If you don't wear glasses or contacts, have no symptoms of eye trouble, and are at a low risk of developing eye diseases, such as glaucoma, get an eye exam at the following intervals:

• An initial exam at 40
• Every two to four years between ages 40 and 54
• Every one to three years between ages 55 and 64
• Every one to two years beginning at age 65

If you wear glasses or contacts or you have a health condition that affects the eyes, such as diabetes, you'll likely need to have your eyes checked regularly. Ask your eye doctor how frequently you need to schedule your appointments. But, if you notice problems with your vision, schedule an appointment with your eye doctor as soon as possible, even if you've recently had an eye exam. Blurred vision, for example, may suggest you need a prescription change, or it could be a sign of another problem.

Children and adolescents

Children need to be screened for eye disease and have their vision tested by a pediatrician, an ophthalmologist, an optometrist or another trained screener at the following ages and intervals.

• Age 6 months
• Age 3 years
• Before first grade and every two years during school years, at well-child visits, or through school or public screenings

Causes

Your eye has two parts that focus images:

• The cornea is the clear, dome-shaped front surface of your eye.
• The lens is a clear structure about the size and shape of an M&M's candy.

In a normally shaped eye, each of these focusing elements has a perfectly smooth curvature, like the surface of a marble. A cornea and lens with such curvature bend (refract) all incoming light to make a sharply focused image directly on the retina, at the back of your eye.

A refractive error

If your cornea or lens isn't evenly and smoothly curved, light rays aren't refracted properly, and you have a refractive error.

Farsightedness occurs when your eyeball is shorter than normal or your cornea is curved too little. The effect is the opposite of nearsightedness.

Other refractive errors

In addition to farsightedness, other refractive errors include:

• Nearsightedness (myopia). Nearsightedness usually occurs when your eyeball is longer than normal or your cornea is curved too steeply. Instead of being focused precisely on your retina, light is focused in front of your retina, resulting in a blurry appearance for distant objects.
• Astigmatism. This occurs when your cornea or lens is curved more steeply in one direction than it is in another. Uncorrected astigmatism blurs your vision.

Complications

Farsightedness can be associated with several problems, such as:

• Crossed eyes. Some children with farsightedness may develop crossed eyes. Specially designed eyeglasses that correct for part or all of the farsightedness may treat this problem.
• Reduced quality of life. With uncorrected farsightedness, you might not be able to perform a task as well as you wish. And your limited vision may detract from your enjoyment of day-to-day activities.
• Eyestrain. Uncorrected farsightedness may cause you to squint or strain your eyes to maintain focus. This can lead to eyestrain and headaches.
• Impaired safety. Your own safety and that of others may be jeopardized if you have an uncorrected vision problem. This could be especially serious if you are driving a car or operating heavy equipment.
• Financial burden. The cost of corrective lenses, eye exams and medical treatments can add up, especially with a chronic condition such as farsightedness.

Diagnosis

Farsightedness is diagnosed by a basic eye exam, which includes a refraction assessment and an eye health exam.

A refraction assessment determines if you have vision problems such as nearsightedness or farsightedness, astigmatism, or presbyopia. Your doctor may use various instruments and ask you to look through several lenses to test your distance and close-up vision.

Your eye doctor likely will put drops in your eyes to dilate your pupils for the eye health exam. This may make your eyes more light sensitive for a few hours after the exam. Dilation enables your doctor to see wider views inside of your eyes.

Treatment

The goal of treating farsightedness is to help focus light on the retina through the use of corrective lenses or refractive surgery.

Prescription lenses

In young people, treatment isn't always necessary because the crystalline lenses inside the eyes are flexible enough to compensate for the condition. Depending on the degree of farsightedness, you may need prescription lenses to improve your near vision. This is especially likely as you age and the lenses inside your eyes become less flexible.

Wearing prescription lenses treats farsightedness by counteracting the decreased curvature of your cornea or the smaller size (length) of your eye. Types of prescription lenses include:

• Eyeglasses. This is a simple, safe way to sharpen vision caused by farsightedness. The variety of eyeglass lenses is wide and includes single vision, bifocals, trifocals and progressive multifocals.
• Contact lenses. These lenses are worn right on your eyes. They are available in a variety of materials and designs, including soft and rigid, gas permeable in combination with spherical, toric, multifocal and monovision designs. Ask your eye doctor about the pros and cons of contact lenses and what might be best for you.

Refractive surgery

Although most refractive surgical procedures are used to treat nearsightedness, they can also be used for mild to moderate farsightedness. These surgical treatments correct farsightedness by reshaping the curvature of your cornea. Refractive surgery methods include:

• Laser-assisted in situ keratomileusis (LASIK). With this procedure, your eye surgeon makes a thin, hinged flap into your cornea. He or she then uses a laser to adjust the curves of the cornea that corrects the farsightedness. Recovery from LASIK surgery is usually more rapid and causes less discomfort than other corneal surgeries.
• Laser-assisted subepithelial keratectomy (LASEK). The surgeon creates an ultra-thin flap only in the cornea's outer protective cover (epithelium). He or she then uses a laser to reshape the cornea's outer layers, changing its curve, and then replaces the epithelium.
• Photorefractive keratectomy (PRK). This procedure is similar to LASEK, except the surgeon completely removes the epithelium, then uses the laser to reshape the cornea. The epithelium is not replaced, but will grow back naturally, conforming to your cornea's new shape.

Talk with your doctor about the possible side effects of refractive surgery.

Lifestyle and home remedies

You can't prevent farsightedness, but you can help protect your eyes and your vision by following these tips:

• Have your eyes checked. Do this regularly even if you see well.
• Control chronic health conditions. Certain conditions, such as diabetes and high blood pressure, can affect your vision if not treated.
• Protect your eyes from the sun. Wear sunglasses that block ultraviolet (UV) radiation.
• Prevent eye injuries. Wear protective eyewear when doing certain things, such as playing sports, mowing the lawn, painting or using other products with toxic fumes.
• Eat healthy foods. Try to eat plenty of leafy greens, other vegetables and fruits. And studies show that your eyes benefit if you also include in your diet fish high in omega-3 fatty acids, such as tuna and salmon.
• Don't smoke. Just as smoking isn't good for the rest of your body, smoking can adversely affect your eye health as well.
• Use the right corrective lenses. The right lenses optimize your vision. Having regular exams will ensure that your prescription is correct.
• Use good lighting. Turn up or add light to see better.
• Reduce eyestrain. Look away from your computer or near-task work, including reading, every 20 minutes — for 20 seconds — at something 20 feet away.

See your doctor immediately if you have any of these symptoms: Sudden loss of vision in one eye with or without pain; sudden hazy or blurred vision; double vision; or visual flashes of light, black spots or halos around lights. This may represent a serious medical or eye condition.

Preparing for your appointment

There are three kinds of specialists for various eye conditions:

• Ophthalmologist. This is an eye specialist with a doctor of medicine (M.D.) or a doctor of osteopathy (D.O.) degree followed by a residency. Ophthalmologists are trained to provide complete eye evaluations, prescribe corrective lenses, diagnose and treat common and complex eye disorders, and perform eye surgery.
• Optometrist. An optometrist has a doctor of optometry (O.D.) degree. Optometrists are trained to provide complete eye evaluations, prescribe corrective lenses, and diagnose and treat common eye disorders.
• Optician. An optician is a specialist who helps fit people for eyeglasses or contact lenses, using prescriptions from ophthalmologists and optometrists. Some states require opticians to be licensed. Opticians are not trained to diagnose or treat eye disease.

Here's some information to help you get ready for your appointment.

What you can do

• If you already wear glasses, bring them to your appointment. Your doctor has a device that can determine what type of prescription you have. If you wear contacts, bring an empty contact lens box from each type of contact you use.
• Tell your doctor about symptoms you have, such as trouble reading up close or difficulty with night driving, and when they began.
• Make a list of all medications, vitamins and other supplements you take, including doses.
• List questions to ask your doctor.

For farsightedness, questions to ask your doctor include:

• When do I need to use corrective lenses?
• What are benefits and drawbacks to glasses?
• What are benefits and drawbacks to contacts?
• How often should I have my eyes examined?
• Are more-permanent treatments, such as eye surgery, an option for me?
• Do you have brochures or other printed material I can have?
• What websites do you recommend?

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

• How severe are your symptoms?
• Does your vision improve if you squint or move objects closer or farther away?
• Do others in your family use corrective lenses? Do you know how old they were when they began having trouble with their vision?
• When did you begin wearing glasses or contacts?
• Do you have any serious medical problems, such as diabetes?
• Have you started any new medications, supplements or herbal preparations?