Lecture on Hypermetropia For 4th Year MBBS Undergraduate Students By Prof. Dr. Hussain Ahmad Khaqan

1. Hypermetropia
Prof. Dr. Hussain Ahmad Khaqan
 MD
 FRCS(Glasgow)
 FCPS(Ophth.)
 FCPS(Vitreo Retina)
 MHPE (KMU)
 CICO(UK)
 CMT(UOL)
 Fellowship in Medical Retina (LMU, Munich)
 Fellowship in Vitreo Retinal Surgery (LMU, Munich)
 Consultant Ophthalmologist & Retinal Surgeon
Professor of Ophthalmology
Lahore General Hospital, Lahore
Ameer Ud Din Medical College, Lahore
Post Graduate Medical Institute, Lahore
Shaukat Khanum Memorial Cancer Hospital & Research Centre ,Lahore

2. DEFINITION
• Hypermetropia, or hyperopia, is the condition in
which parallel light rays from infinity converge on a
focus behind the retina after refracting on the cornea
and lens either because the refracting power of the
eye is too weak or the anteroposterior diameter is
too short.

3. CLASSIFICATION CONTINUE..
1- Hypermetropia may be classified according to the size of refractive error.
The American Optometric Association (AOA) definitions are:
• Low (≤+2D)
• Moderate (2–5D)
• High (>5D)

4. 2- Hypermetropia may be classified as simple, pathological, or functional.
• In simple hypermetropia, the structures and dimensions of the eye lie
within normal limits.
• In pathological hypermetropia, the ocular anatomy is abnormal (e.g.
developmental abnormality or other ocular pathology).
• Functional hypermetropia arises from failure of accommodation.
CLASSIFICATION CONTINUE..

5. 3- Hyperopia can be divided into latent and manifest hyperopia.
Manifest hyperopia has its facultative and absolute component. The
facultative component, which can be compensated by accommodation,
decreases progressively with age, so the absolute hyperopia will eventually
become evident in those hyperopes that did not exhibit this component
earlier in life (when hyperopia is totally neutralized by accommodation). In
such symptomatic patients, absolute hyperopia increases and symptoms
become more evident around the age of 40, requiring greater optical
correction. Myopes, as they have the near point at a shorter distance, usually
have a “natural protection” against presbyopia. Myopes with small refractive
errors, however, will also require positive diopter power for near objects after
a more significant progression of presbyopia.
CLASSIFICATION

6. • Figure: Hyperopia.(i) absolute hyperopia—fraction of the hyperopia that cannot be corrected
by accommodation. (ii) Facultative hyperopia—can be measured by divergent lenses. M—
Manifest hyperopia. L—Latent hyperopia, detected with cycloplegic eyedrops. (∞-infinite).

7. COMPLICATIONS
• Accommodative esotropia
• Amblyopia (children)
• Early onset of presbyopia
• Angle-closure glaucoma
• Retinoschisis.

8. TREATMENT
• Mild degrees of hypermetropia are often left uncorrected, as a young
individual can exert some accommodation to achieve clear distance vision.
However, uncorrected hypermetropia may lead to symptoms of ocular
fatigue or headaches as a result.
Correction of hypermetropia requires:
1-Provision of a convex lens external to the eye (spectacles or contact lens)
2- Refractive surgery to increase in the refractive power of the eye.