hyperopia signs and symptoms

Signs & Symptoms of Hyperopia

Squinting to see nearby text clearly or headaches from reading could point you toward signs of hyperopia, also known as farsightedness (long-sightedness in the UK). In this common issue, close vision is compromised.

Hyperopia is perhaps the most difficult to understand of all the refractive errors. Our focused exploration unpacks the signs and symptoms of hyperopia so that you’ll be clear on long-sightedness and how to correct it by the end.

Key Takeaways

  • Hyperopia, or farsightedness, is a refractive error caused by the cornea being too flat or the eye’s axial length being too short. This leads to light focusing behind the retina, causing blurry vision for close objects, while distant objects usually appear sharp.

  • Symptoms of hyperopia include difficulty focusing on near objects, need to squint, eye strain, and headaches, and can lead to more serious conditions like amblyopia and strabismus if untreated, especially in children.

  • Corrective options for hyperopia are available depending on the severity and individual circumstances, including glasses, contacts (like Ortho-K), and refractive surgeries such as LASIK and PRK.

  • An eye specialist or optometrist can diagnose farsightedness and begin treatment with corrective lenses.

Decoding Hyperopia: Recognising the Signs

Hyperopia difficulty with near vision reading book

Hyperopia, or farsightedness (long-sightedness in the UK), is a refractive error that alters how your eye focuses light. The result? Objects in the distance often appear sharp, while close-up objects are blurry, almost as if they are out of reach.

This condition is due to the light being focused behind the retina, the light-sensitive tissue at the back of the eye. It is often present together with astigmatism, another refractive error.

Farsightedness occurs more commonly when others in the family have it.

Struggling with near work can present significant challenges in daily activities like reading, writing, or using a smartphone.

Common symptoms of hyperopia include a need to squint to see clearly and difficulty reading and seeing near objects. These symptoms aren’t just inconvenient; they can affect your productivity, cause discomfort, and lead to more severe vision problems if left unchecked. Examining these symptoms more closely will better understand how hyperopia affects your eyesight.

Hyperopia farsightedness is an eye-focusing disorder and not an eye disease. It does not cause sight loss or other eye problems. However, you will likely need to wear eyeglasses or contact lenses.

Identifying Blurry Vision Up Close

If you’ve ever had to squint or strain your eyes to bring a page of text into focus, you’ve experienced what many adults with hyperopia go through daily. Near objects seem blurry and out of reach, making it difficult to perform tasks up close, such as threading a needle or reading small print.

This blurry vision is not due to a lack of effort on your part; it’s a result of how your eye refracts or bends light.

This can be particularly challenging in classrooms or offices, where reading and close work are integral and can significantly affect productivity and comfort.

Eye Strain and Discomfort

hyperopia eye strain

Beyond blurry vision, hyperopia can also cause significant strain and discomfort in your eyes. Ever felt a burning or aching sensation in or around your eyes after a long day of focusing on close tasks?

Or perhaps you’ve experienced headaches or discomfort after reading or using a computer for an extended period? These are all symptoms of strain associated with hyperopia. Mild farsightedness may not present with symptoms when younger but will with advancing age.

Moreover, hyperopia can trigger headaches, particularly when reading or focusing on close tasks for extended periods. This is caused by the extra effort your eyes put in to bring close objects into focus. Over time, this can lead to fatigue, discomfort, and a noticeable decline in quality of life.

Symptoms in Children

Hyperopia doesn’t just affect adults; it can also pose challenges for children. Recognising the symptoms of hyperopia in children can be a bit tricky, as they often manifest in behaviours rather than physical symptoms.

Asian boy in a consultation of an ophthalmologist

Children who have hyperopia might frequently:

  • Rub their eyes

  • Experience difficulty with reading

  • Avoid activities focusing on close objects, such as colouring on close objects, such as colouring or playing with toys

Moreover, children may exhibit the following symptoms:

  • Avoidance of reading and appearing uninterested

  • Discomfort caused by trying to focus on the text, making reading a chore rather than a pleasure

  • Strain, headaches, squinting, and tiredness due to the strain of focusing on close objects

Early recognition of these symptoms can help children receive corrective lenses and support for their eye health.

Understanding the Impact of Light on Hyperopic Eyes

So, what causes hyperopia? The answer lies in the shape of your eye and how it impacts the way light rays enter and focus.

In a perfect world, the cornea, the transparent front surface of your eye, and the lens, which sits just behind the iris, would work together to refract incoming light so it focuses directly on the retina. But for those with hyperopia, the story is a little different.

Hyperopia occurs when the shape of the cornea is too flat, or the axial length of the eye (the distance from the front to the back of the eye) is too short.

If the cornea is too flat or the axial length is too short, light focuses behind the retina rather than directly on it. This results in insufficient focus on nearby objects, leading to the following symptoms:

  • Blurry vision when looking at objects up close

  • Eyestrain or headaches after reading or doing close work

  • Squinting or straining to see clearly

  • Difficulty seeing clearly at night

If you experience any of these symptoms, you should visit an eye care professional for an eye exam, who may diagnose farsightedness and exclude other eye diseases.

We’ll explore in detail the functioning of the cornea and lens and the consequences of light entering the hyperopic eye incorrectly.

The Role of the Cornea and Lens

The cornea and lens play critical roles in how we see the world. The cornea provides over 66% of the eye’s focusing power, refracting incoming light onto the retina for clear vision. Its dome shape is crucial for accurately focusing light, and any irregularities in its shape can result in vision problems.

Accommodation: the Eye’s Ability to Focus

Doctor Measuring Hyperopic Eyes

In hyperopic individuals, incoming light does not converge properly on the retina, which is crucial for clear sight. This leads to difficulty focusing on nearby objects, causing the blurred vision characteristic of hyperopia.

The eye has a natural mechanism to focus properly and converge light rays onto the retina, known as accommodation.

Initially, people with hyperopia may be able to compensate for inappropriate light convergence and see well at all distances. Young people have a large amount of accommodation and maintain clear vision.

However, this lens accommodation deteriorates with age, leading to vision problems for hyperopic individuals over time.

This is why it’s not uncommon for adults, even those with perfect eyes all their lives, to suddenly find themselves needing reading glasses or bifocals as they age, coming on earlier than the normal arrival of glasses for close work aged 45-50.

The Severity Spectrum of Hyperopia

Just like many other conditions, hyperopia isn’t one-size-fits-all. The symptoms of farsightedness vary with the severity of hyperopia, from mild cases with subtle effects to severe cases with significant impairment.

This spectrum of severity is often categorized by diopters, a unit of measurement used in optometry. For example,

  • low hyperopia is up to +2.00 D
  • moderate hyperopia ranges from +2.25 to +5.00 D, and
  • high hyperopia is +5.00 D or over

The lens can accommodate hyperopia in younger individuals by changing its shape to increase focusing power. However, this ability diminishes as people age.

As a result, the symptoms of hyperopia can become more pronounced over time, affecting everyday activities and task performance. We shall examine how these different severity levels might manifest in terms of symptoms.

Mild Cases: Subtle Symptoms

Mild farsightedness, also known as mild hyperopia, may not cause noticeable symptoms due to the eye’s ability to accommodate. The ciliary muscle tone and accommodative effort are often sufficient to correct the slight farsightedness, with patients not noticing any significant impact on their vision.

However, those with slight hyperopia may find themselves squinting as a subtle adjustment to see more clearly.

The eyes’ remarkable ability to self-correct in mild cases of hyperopia is why many people may not even realise they have this condition. However, it’s important to note that even mild hyperopia can cause strain on the eyes over time, leading to symptoms such as headaches and tired eyes, particularly after tasks that require focusing on close objects.

Severe Farsightedness: Pronounced Difficulties

On the other end of the spectrum, severe hyperopia can lead to significant sight impairment. Individuals with severe farsightedness may find their vision significantly impaired, often able to see objects only if they are at a considerable distance.

This can lead to strain in or around the eye, manifesting as headaches and even dangerous situations when safety is compromised due to poor vision, such as while driving.

Everyday activities become challenging for individuals with severe hyperopia due to the poor quality of vision that they endure. Tasks such as reading, writing, or any activity requiring focus on close objects can be particularly daunting, often resulting in blurred vision and increased fatigue.

In these cases, even the full range of accommodation may fail to rectify the farsightedness, leading to persistent blurred vision when seeing near objects.

Diagnosing Hyperopia: Vision Testing Basics

Testing for hyperopia

So, how is hyperopia diagnosed? Confirming the presence of long-sightedness involves a series of tests to assess vision clarity and eye health.

Your eye doctor will use various tools and tests to determine if you have hyperopia and to what degree. These tests range from the basic vision clarity test, where you’ll read from an eye chart to more advanced tests using tools like a retinoscope or phoropter.

Your eye doctor will assess your eye muscles and how your eyes move together, known as ocular motility.

These vision testing basics are designed to give your eye doctor a comprehensive picture of your eye health and vision clarity. They’ll be able to diagnose not just hyperopia but any other potential eye conditions affecting your vision.

We will discuss the importance of eye exams and outline what you can expect during an eye appointment.

The Importance of Regular Eye Exams

Routine eye exams are crucial for maintaining optimal eye health. They’re especially important if you have a genetic predisposition for hyperopia, as early detection can lead to more effective treatment.

The American Academy of Ophthalmology suggests that adults without previous vision problems should begin eye exams at age 40, with the frequency of follow-up exams based on the individual’s age and health. More frequent exams may be needed in younger children.

Those over 40 and individuals with certain risk factors, such as a family history of eye disease, should have annual eye examinations.

Routine eye exams allow eye doctors to detect early signs of hyperopia or other eye conditions, enabling prompt treatment and better outcomes. Early detection is key in managing and treating any health condition, including hyperopia.

What to Expect During an Eye Exam

If you’ve never had an eye exam before, or it’s been a while since your last one, you may wonder what to expect. An eye exam for diagnosing hyperopia generally involves a series of tests to assess vision clarity and eye health.

You’ll be required to read from an eye chart, which helps measure how well you can see at various distances.

patient and optician doing Eye test with eye chart in clinic

Your eye doctor may use a retinoscope to observe how light reflects off the retina, which assists them in determining the lens power needed to correct your vision. They’ll also use a phoropter to fine-tune the prescription by testing different lenses to see which ones provide the clearest vision.

Your eye doctor will need to perform a dilated eye exam. This helps reveal any additional long-sightedness masked by your eye’s accommodation. It also allows a clear view of your retina and optic nerve to rule out eye disease.

These tests are designed to comprehensively understand your eye health and vision needs.

Correcting Your Vision: Options Beyond Wearing Glasses

Although glasses are a common solution for hyperopia, they’re not the only option. There are a variety of corrective options available that range from:

  • contact lenses

  • orthokeratology, a non-surgical procedure that involves wearing specially designed contacts overnight to reshape the cornea temporarily

  • various refractive surgeries, either to treat the cornea or replace the natural lens

These options offer potential alternatives to glasses for correcting hyperopia. Choosing the right option depends on several factors, including the severity of your hyperopia, your lifestyle, and your personal preferences.

We’ll examine a couple of these correction options in greater detail: contact lenses and refractive surgery.

Contact Lenses: A Closer Look

Contacts are a popular alternative to glasses for correcting hyperopia. Orthokeratology (Ortho-K) lenses stand out as a unique solution. These are specialty contacts designed to be worn overnight, temporarily reshaping the cornea.

While Ortho-K is more commonly used for myopia (nearsightedness) control, especially in children, it can also be used to correct mild to moderate hyperopia (farsightedness).

Ortho-K lenses have the following benefits:

  • FDA-approved for their effectiveness in correcting vision

  • Known for their good safety profile

  • Visual improvements achieved with Ortho-K lenses are reversible, allowing patients the flexibility to choose laser refractive surgery in the future if they wish.

  • There is a risk of corneal infection and abscess

The cornea reshaping effect of Ortho-K lenses can sustain clear vision throughout the day and benefit adults experiencing age-related hyperopia.

Refractive Surgery: Reshaping the Cornea

a laser reshaping the cornea

Refractive surgery offers a more permanent solution for correcting hyperopia than prescription eyeglasses. LASIK, LASEK, and PRK are procedures where the laser reshapes the cornea to correct farsightedness.

LASIK is preferred as there can be more regression of effect with LASEK or PRK for hyperopia. The laser steepens the central cornea by removing tissue from the outer areas.

Possible complications include dry eyes and night vision issues, though the latter is rare with modern lasers.

Other procedures, such as Conductive Keratoplasty (CK), use radiofrequency energy to reshape the cornea by steepening the central area, effectively correcting low hyperopia. However, its use has fallen away due to the short duration of benefit.

Another option is Refractive Lens Exchange (RLE), which replaces the eye’s natural lens with an artificial one to correct vision, similar to cataract surgery. The cornea is not affected, and this can be useful if there is significant dry eye.

Additional surgical options are available, including Implantable Contact Lens (ICL) surgery, which involves placing an additional lens inside the eye to provide high-quality vision correction without removing the natural lens.

ICLs can be an excellent option for patients too young to have RLE.

Your eye surgeon can provide you with more information on these surgical options and help you determine the best suited to your needs.

Complications Associated With Untreated Hyperopia

While it’s possible to live with hyperopia, untreated long-sight can lead to additional eye disorders, especially in severe cases and among children.

Two notable eye disorders arising from untreated farsightedness are lazy eye (amblyopia) and crossed eyes (strabismus). Severe hyperopia is also associated with an increased risk of angle-closure glaucoma, a serious condition resulting from a shallow anterior chamber depth.

However, it’s important to remember that these conditions are treatable, particularly when identified early. Regular eye exams can catch these conditions before they become a significant problem, helping to ensure that you maintain good eye health. Let’s explore the potential complications of untreated hyperopia in more detail.

The Link Between Hyperopia and Lazy Eye

Untreated hyperopia can contribute to the development of amblyopia. This condition occurs when the brain suppresses or ignores input from one eye, resulting in decreased vision in that eye. Hyperopia can alter the normal visual development and nerve pathway connections between the retina and the brain, leading to the development of laziness.

Lazy eye typically develops from birth up to age seven years, with hyperopia being a contributing factor. Therefore, it is crucial to have regular eye exams for children to detect and treat any potential vision problems early. With early detection and treatment, the effects of amblyopia can often be reversed, leading to improved vision.

Preventing a Squint (Crossed Eyes)

Another potential complication of untreated hyperopia is strabismus or crossed eyes. This condition, where the eyes don’t align properly when focusing on an object, is often associated with severe farsightedness in children.

The good news is that crossed eyes can often be prevented by using specially designed eyeglasses for children with hyperopia.

While the current evidence is uncertain, there is some indication that spectacle correction may offer benefits in preventing strabismus compared to no intervention at all. Regular eye exams can help detect and correct hyperopia early, reducing the risk of developing strabismus.


To wrap it up, hyperopia, or farsightedness, is a common eye condition affecting individuals of all ages. It is caused by a refractive error where light focuses behind, rather than on, the retina, leading to blurred vision for close objects.

Close up shot of boy checking vision with tonometer at eye clinic

Symptoms can range from mild to severe, affecting daily tasks such as reading and writing.

Regular eye exams are crucial for early detection and treatment, with various corrective options, including eyeglasses, contact lenses, and refractive surgery.

Untreated hyperopia can lead to complications such as lazy eye and crossed eyes, highlighting the importance of proactive eye health management.

So, when was the last time you had an eye exam? It might be time to schedule one.

Frequently Asked Questions

What are the symptoms of hyperopia in the eye?

The symptoms of hyperopia (farsightedness) include difficulty seeing nearby objects, strain, headaches, and discomfort when doing close tasks like reading or computer work. Additionally, individuals may experience blurry vision and the need to squint for clearer vision.

How do you know if a child has hyperopia?

If your child is older, they might mention that they can see things in the distance more easily than close things, or they might need to strain their eyes to see close things. This could be a sign of hyperopia.

What do people with hyperopia see?

People with hyperopia, or farsightedness, have difficulty seeing things up close, like words in a book, but can see distant objects. This condition can cause headaches and eye strain, but it can be corrected with eyeglasses, contact lenses, or surgery.

What is hyperopia?

Hyperopia, also known as farsightedness, is a common eye condition that causes difficulty seeing near objects. It is caused by the eye’s inability to refract light properly.

What are the symptoms of hyperopia?

The symptoms of hyperopia include difficulty focusing on near objects, the need to squint to see clearly, and eye strain symptoms such as burning, aching, and tiredness after focusing on close objects. If you are experiencing these symptoms, it is important to consult an optometrist for a comprehensive eye examination.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *