Farsightedness: A-to-Z Guide from Diagnosis to Treatment to Prevention

Boy wearing glasses with a book, but looking into the distance. Could this be for farsightedness?

Introduction to farsightedness:

When parents take their child for an eye exam for any reason, they are likely to hear that their child has hyperopia. What does this mean? What should be done about it?

What is farsightedness?

Rays of light that enter the eye are supposed to be focused by the cornea and the lens to land on the retina so that we can see clearly. In some children, the focal point is somewhere behind the retina. This situation is called farsightedness, or hyperopia.
A child may be farsighted because the eye is shorter than average, because the lens or cornea bends light less than average, or because the lens is farther backward in the eye than average. Farsightedness, like nearsightedness and astigmatism, is a type of refractive error.

Usually, farsighted children can see distant objects clearly, but closer objects may appear blurred. Children are often able to accommodate for this with extra work of the eyes. Then, near vision is still clear; it just takes more work.

Who gets farsightedness?

Most babies are born farsighted. As the eyeball lengthens with growth, the farsightedness decreases until normal vision is achieved. That is why young children often leave the eye doctor with a diagnosis of developmental hyperopia, or hyperopia appropriate for age.

Hyperopia beyond that which is appropriate for age often runs in families.

What are the symptoms of farsightedness?

With mild hyperopia, there may be no symptoms. The child is able to accommodate for the farsightedness without much effort, and is comfortable with both near and far vision.

The greater the degree of farsightedness, the more work that is required to accommodate for it. This may result in discomfort or mild headaches with prolonged reading or close work. Eye rubbing and inflamed eyelids are common. Sometimes lack of interest in reading is the only symptom.

When hyperopia is even worse, near vision is blurry even with effort.

Is farsightedness contagious?

No

How long does farsightedness last?

Farsightedness tends to improve throughout childhood as the eyeball lengthens. It may well disappear by adolescence.

How is it diagnosed?

The degree of farsightedness can be measured accurately at any age, without cooperation from the child. The eyes often need to be dilated for the examination.

In older children, farsightedness is sometimes measured by placing different strength lenses in front of the eye, and asking which one allows them to see better. A convex lens may make vision clearer for someone with farsightedness. Even if the vision is already clear, some farsighted children prefer the convex lenses because the work of near vision is reduced.

How is it treated?

Most farsighted children do not need glasses or contact lenses. Those with significant symptoms, however, can benefit from convex lenses.

How can farsightedness be prevented?

Farsightedness, like other refractive errors, is difficult to prevent. Years of poor vision or extra eye work can be prevented by vision screening. In addition, children whose families have a history of significant farsightedness or other refractive error should have a formal eye exam at an early age.

Related concepts:

Hyperopia

Dr. Alan Greene

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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