Hyperopia is a refractive error. In case of hyperopia, the vision is unclear, both near and distance vision.
What are refractive errors?
When the light comes in contact with the ocular surface, it undergoes a refraction process by passing through the transparent media represented by the cornea, aqueous humour, lens and vitreous. The light rays change their direction, so the image of the things we look at is projected onto the retina (the visual receptor). This is the normal case, of an emetropic eye (without diopters), which sees clearly at all distances
When the projection of the images is not performed appropriately onto the retinal surface, the vision is blurry
Blurry vision can be caused by hyperopia (light focuses behind the retina), by myopia (light focuses in front of the retina) or by astigmatism (the image is projected uneven). All these three cases are refractive errors, accompanied by visual disturbances.
What is and how does hyperopia occur?
Hyperopia is a refractive error. Hyperopia manifests mainly by blurred near vision but the distance vision may also be impaired.
The cause is represented by abnormal focus of the light rays, behind the retina (we talk about a “shorter” eye). Most of the children have a mild, physiological hyperopia, which corrects over time (it is a process of normal growth and development of the eye). Sometimes, hyperopia is accompanied by astigmatism.
If one or both parents are hyperopic, there is a chance that the child develops the same ophthalmic condition.
How does it manifest?
In the attempt to see better, the eye accommodation effort is permanent (for both distance and near vision). Therefore, eye pains, headaches, or visual fatigue can occur.
Can hyperopia give any complications?
The main complication of hyperopia is amblyopia, which occurs only in young children. The installation of strabismus may alert parents. When strabismus is present at birth, there is a high possibility to accompany hyperopia.
Amblyopia can by treated by the age of 7, therefore, it is recommended that the child undergoes an ophthalmologic examination before the age of 3. If there is a refractive power difference between the eyes (for example, one eye is normal and the other one is hyperopic, or if both eyes are hyperopic, but with different values), there is a risk for the eye with a higher dioptric value to develop amblyopia. What does this mean? The child will use mainly the eye with a lower dioptric value. Thus, the other eye not being used, it gets “lazy” or amblyopic.
Can hyperopia be healed?
The role of the optical correction is to improve the vision, not to heal the hyperopia
The eyes reach maturity after the age of 20, when the persons who does not want to wear glasses or contact lenses may undergo dioptre reduction surgical treatment. Before reaching this age, it is important to wear appropriate optical corrections, in order to preserve a good vision by the time of the intervention. In case of an amblyopic eye, with a low vision, the dioptres reduction will not improve sight (because the “lazy” eye is not commonly used to see).
Most often, dioptre reduction surgical treatments are performed by laser. Its role is to reshape the cornea (the cornea becoming a lens which focuses appropriately). This procedure can be performed successfully in cases of hyperopia of less than 3 to 4 plus dioptres.
If the dioptres are higher, the recommended procedure is the artificial lens implant. The lens is customized, in order to correct any refractive error.
Which are the hyperopia correction methods?
Hyperopia can be treated by following techniques:
The FemtoLASIK is a modern dioptre correction method, which requires two types of lasers: the Femto laser and the Excimer. The diopter reduction laser treatments are quick, silent, odourless, independent of the environment, and personalized with an error gap of less than one micron.
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This is a more invasive technique, similar to cataract surgery, where the eye lens is replaced with a multifocal artiﬁcial lens with a refractive power adjusted to the parameters of the patient. Therefore, after the surgery, the patient no longer needs glasses. After implantation, the artiﬁcial lens remains functional for the rest of the patient’s life.
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PRK / LASEK are two similar methods of diopter correction by means of excimer laser. The technique is based on the property of the corneal epithelium (the first layer of the cornea) to regenerate naturally and consists in the partial removal of this layer. Subsequently, the cornea is reshaped by means of the laser, thus obtaining the correction of the diopters. The difference between these techniques consists of the fact that in case of LASEK, the removed epithelium is repositioned after the laser treatment, being gradually replaced by a new epithelium.
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