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Farsighted Eyes – What Your Optometrist Should Have Told You About This Confusing Vision Condition
Eye terminology can be very confusing. When your optometrist diagnoses you or your family members with farsightedness, that’s usually the end of the explanation. Farsightedness can create so many different effects on your vision that it may not even seem like a single vision condition. Farsightedness (hyperopia) usually results in good distance vision, with problems caused by near tasks such as reading and computer work. It’s a bit of a confusing term because farsightedness is actually an optical error of distance vision, while the symptoms are most common when using near vision.
To further complicate the situation, if your optometrist determines that your eye is extremely farsighted, you will not see clearly near or far. If you are young and have low or moderate farsightedness, your vision may be clear at all distances. It’s no wonder people have trouble understanding the concept of farsightedness, and why ophthalmologists often shy away from trying to explain it. Fortunately, there is a muscle called the ciliary muscle that surrounds the lens in the eye and is attached to the lens by small fibers. Active contraction of this muscle relaxes the tension on the eye lens and increases the focusing power of the eye. In smaller amounts of farsightedness if you are under the age of forty, the eye’s ability to focus can adjust to farsightedness and easily clear your distance and near vision. Eye doctors use the words focusing and accommodation interchangeably to mean that the eye muscle has begun to work to increase the eye’s power for near vision.
Even small amounts of hyperopia have been shown to interfere with reading in some children and adults, but typically between two and three prescription units begin to produce vision-related symptoms. Children and teenagers have a tremendous amount of accommodation, and sometimes very large farsightedness prescriptions go unnoticed because they can clarify near and far vision by focusing. They will often suffer from headaches and an unconscious aversion to reading due to the strain on their eyes and the constant effort required to keep their vision clear. As we age, we gradually lose the ability to focus. This degradation of focus begins between fifteen and twenty years of age, but at first it affects distances so close that we do not notice them at all because we do not use our vision an inch or two away.
Farsighted people have a different kind of problem than those who are nearsighted. They must constantly focus to maintain clear vision at a distance, and as objects get closer, they must increase their focusing efforts even more. This is not a problem if you are young and have a smaller amount of hyperopia, but as you get older or with a larger amount of hyperopia the extra effort you are putting in starts to be noticeable. This happens initially with reading and computer use, due to the extra effort of focusing on the amount needed for distance. In high-tech areas like Northern Colorado, a higher percentage of the population uses computers all day, and optometrists see more symptoms of farsightedness. Uncorrected farsightedness can be a significant component of computer vision syndrome. Eye patients will often be prescribed glasses or contact lenses for near vision that only correct distance in farsightedness. This reduces the amount of focus required for near-normal levels. The remaining normal effort of reading or working on the computer rarely creates visual discomfort. This is another reason why your optometrist may not tell you much about your farsightedness. It is difficult to explain to them why distance glasses are recommended for you when you only have problems up close.
As farsighted optometry patients enter their early forties, they find that they have gradually started wearing glasses all the time. Many people mistakenly believe that wearing glasses has weakened their eyes, and sometimes they think that their eye doctor has made them dependent on the lenses. This is an incorrect assumption, since loss of accommodation would occur without spectacles and would be a problem at an earlier age in the absence of corrective spectacles. This loss of focusing power is a visual condition specified as presbyopia, which patients often confuse with farsightedness. Although it progresses from an early age, as previously explained, it is only diagnosed when it reduces your focusing capacity so that you cannot see at about sixteen inches, the average reading distance.
Optically, the farsighted eye is usually too short and light is focused behind it instead of on the retina for distance. There may also be individual components of the eye that are too weak to adequately focus vision. The lens might be slightly smaller in light, or the clear corneal tissue at the front of the eye might be curved slightly less than normal. A lens with plus or positive strength is used to correct hyperopia. This is a lens that is thicker in the middle and thinner at the edges, like a biconvex lens. The best optical design for clear central and peripheral vision is a lens that is more curved in the front and still curved forward in the back, just to a lesser extent. This results in a lens centered relatively far from the front of the eye, with a bulging appearance.
As you move the ophthalmic lens used for farsightedness away from the eye, the eye appears larger, just like the effect produced by moving the magnifying glass away from the object. This also increases the size of the image that the eye sees. Advanced optical designs have eliminated the resulting bug-eyed appearance by using an aspherical lens design. Aspheric lenses start with a spherical front surface of the lens in the center (like the curve on a tennis ball) and then the curvature gradually decreases or flattens towards the edge of the lens. This is a traditional design that has an accompanying spherical curvature on the back surface of the lens. Newly developed free-form lens technology enables the grinding of aspheric lens curves on the back surface of the lens. These lenses are of a very sophisticated design that use different degrees of asphericity in different tangential lines to compensate for astigmatism in your diopter.
Either way, the flattened lens design allows the lenses to be closer to your eyes reducing magnification or the bug eye effect. The aspherical design thanks to the complex characteristics of the optics also counteracts several forms of optical aberrations (blurring of vision) that commonly occur when looking to the side of a spherical lens using a flatter lens design. A common misconception is that aspheric lenses improve vision. They do not significantly improve vision, but allow for thinner, lighter, more cosmetically attractive lenses with lower magnification. The aspheric design allows these improvements to be achieved without compromising clear peripheral vision. The lenses available to your eye doctor have seen quantum advances in the last five years, probably equivalent to all the advances made in the previous fifty years. Improvements in lens design are beginning to resemble computer chips whose capacity doubles every eighteen months. The future for lenses has never looked brighter!
Some facts about the farsighted eye:
- Some people are farsighted in one eye and shortsighted in the other. If the amounts are correct, I can see near and far without bifocals.
- President James Buchannan was farsighted in one eye and nearsighted in the other (and had eye twitching).
- President Harry Truman was farsighted.
- Latent farsightedness occurs when a child has compensated by constantly focusing at a distance for so long that they cannot relax their eyes to properly read the prescription. Only checking the eyeglass prescription after special eye drops have eliminated the eyes’ ability to focus can give accurate prescription readings.
- Ohio State University has begun a study to determine whether giving extremely farsighted infants prescriptions that are not strong enough will help the eyes correct themselves.
- The eyes become slightly more far-sighted (or less short-sighted) between the ages of forty and fifty.
- Young to middle-aged men can develop fluid swelling in the central retina and become farsighted as a direct result of stress.
- Children who are farsighted tend to have farsighted siblings, but not necessarily parents with the eye problem.
- About one in four people is farsighted, but this number gradually decreases as myopia increases.
Contact lenses can be very useful in correcting farsightedness for a number of reasons. Unlike glasses that curve away from the eye, contact lenses sit right on the surface of your eye and therefore provide very little magnification. When you wear contact lenses, you always look through the optical center of the lens, which is the point that is maximized for good vision. This is due to the fact that contact lenses move with your eye when you look away. With glasses, you look through the lens at an angle when you turn your eyes, and this creates optical aberrations that worsen your vision. These advantages often lead to contact lenses being the primary choice for vision correction for more farsighted children and teenagers. This is often the age when their appearance is extremely important to their self-confidence. Who doesn’t want to look better, especially when the old alternative was eye-enhancing lenses that weighed a ton and kept sliding down the nose.
Vision tests have value in detecting vision problems, but they often miss farsightedness because children have a great ability to focus and pass the 20/20 test. Only a thorough ophthalmic examination by your ophthalmologist can ensure that your children and teenagers have the correct eye prescription for effective reading and learning in school. Schedule their annual eye exam today. And don’t forget the new possibilities you have as a farsighted adult.
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