Hypermetropia #optometrist,#alim

1. Hypermetropia
MD ALIMULLAH
INTERN OPTOMETRIST
MGM Eye Institute

2. NORMAL EYE
( Emmetropia )

3. Ammetropia
REFRACTION IN A HYPERMETROPIC EYE

4.  It is a refractive condition where parallel
rays of light coming from infinity, come to
a point focus behind the retina, when the
accommodation is at rest.
 This condition was suggested by
KASTNER (mathematician)1755
Definition

5. HYPER = EXCESS
METRO = MEASURE
OPIA = IMAGE
This term hypermetropia given by
DONDER1858
Hyperopia

6.  Physiological condition – At birth , all eye
hypermetropic (extent 2.5 to 3.0 D)
 50% of the population does not reached in
emmetropia
Hyperopia

7. AETIOLOGICAL TYPES Or CAUSES OF
HYPEROPIA
• Axial Hyperopia.
• Curvature Hyperopia.
• Index Hyperopia.
• Abnormal position of lens &
POSITIONAL HYPERMETROPIA
• Absence of crystalline lens
• Pathological condition .

8. AXIAL HYPEROPIA
 Due to shortening of the axial
length.
 Normal axial length =22 to 24 mm
changes in axial length 1mm = 3
diopters refractive changes

9. CURVATURE HYPEROPIA:
Occurs when curvature of any
refracting surfaces is unduly small.
• If the cornea is flatter than normal,
results
Hyperopia
• Cornea plana (a congenital condition)
Changes in corneal curvature 1mm = 6
diopters refractive changes

10. Index hyperopia
Results as a decrease in refractivity of
lens .
In old age: refractive index of the lens
decreases leading to
hyperopia.

11. Abnormal condition of lens
• Posterior dislocation of the lens.
• Aphakia (congenital anomaly or due
to
trauma)

12. Pathological conditions
• Orbital tumors pressing the eye
ball
forward.
• Retinal detachment.
• CSCR(CENTRAL SEROUS CHORIORETINOPATHY)
• Intra – ocular neoplasm

13. CONSECUTIVE HYPERMETROPIA
CONSECUTIVE MYOPIA MAY RESULT OF FOLLOWING
*OVER CORRECTED MYOPIA AFTER REFRACTIVE
SURGERY . LASIK ( LASER-ASSISTED IN-SITU
KERATOMILEUSIS)
ICL (IMPLANTABLE CONTACT LENS )
UNPOWERED INTRAOCULAR LENS (IOL)IN CATARACT
SURGERY AND REFRACTIVE LENS EXCHANGE(RLE)

14. NOMENCLATURE HYPEROPIA
• Latent Hyperopia.
• Manifest Hyperopia.
a. Facultative Hyperopia
b. absolute Hyperopia.
• Total Hyperopia.

15. NOMENCLATURE OF HYPEROPIA
Latent hyperopia- part of hyperopia
corrected by the physiological tone of
the ciliary muscle.

16. Manifest hypermetropia
Remaining uncorrected amount of hyperopia.
A.Facultative Hypermetropia-
Amount of hyperopia overcome by an effort of
accommodation.
B. Absolute hypermetropia-
Amount of hyperopia cannot overcome by
accommodation.

17. Total Hypermetropia
Latent hypermetropia & Manifest
hypermetropia

18. Example –
Absolute hypermetropia = 3D
Facultative hypermetropia = 2 D
Manifest hypermetropia = 5 D
Latent hypermetropia = 1.50D(with cyclopegia)
Total hypermetropia = 6.50D

19. 1.Defective near vision: Rays of light
coming from near object are divergent. So,
they come to a point focus much behind the
retina.
2.Accommodative eyestrain: - In order to
see objects clearly eye accommodates
continuously, even for distant vision. This
cause eyestrain.
CLINICAL FEATURES

20. 3. Accommodative Esotropia: - Excessive
accommodation finally leads to convergent
squint.
4. Accommodation (Pseudo myopia): - Due
to excessive accommodation rays of light
may over converge and cause myopia.
CLINICAL FEATURES

21. CLINICAL FINDINGS
• Small eyeball.
• Cornea may be smaller.
• Anterior chamber shallow.
• Abnormal lens condition.

22. TREATMENT:-
1. SPECTACLES.
2. CONTACT LENS.
3. LASIK .

23. Glasses not required if :
• One line difference in visual
acuity, with good visual acuity.
• Anisometropia less than 1D .
• Hyperopia. less than 5D .
• No strabismus.
• Asymptomatic hyperopic child.
PEDIATRIC HYPERMETROPIA

24. If Anisometropia & astigmatism
• Correct 1/2 to 2/3 of hyperopia.
• Fully correcting astigmatism.
Glasses required :

25. Example
-
RIGHT EYE +7.00/-2.00 x
90
+4.00/-2.00 x
90
LEFT EYE +8.00/-2.50
X90
+4.00 /-
2.50 X90

26. The older hyperopic
Full correction for both far and near .

27. Hyperopia

28. Correcting Hypermetropia
Plus lens increase power of optical system

29. HYPEROPIA IN YOUNG ADULTS
The symptomatic young adult is
given partial correction 2/3 or
more of cycloplegic refraction .