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Hypermetropia
MD ALIMULLAH
INTERN OPTOMETRIST
MGM Eye Institute
NORMAL EYE
( Emmetropia )
Ammetropia
REFRACTION IN A HYPERMETROPIC EYE
 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
HYPER = EXCESS
METRO = MEASURE
OPIA = IMAGE
This term hypermetropia given by
DONDER1858
Hyperopia
 Physiological condition – At birth , all eye
hypermetropic (extent 2.5 to 3.0 D)
 50% of the population does not reached in
emmetropia
Hyperopia
AETIOLOGICAL TYPES Or CAUSES OF
HYPEROPIA
• Axial Hyperopia.
• Curvature Hyperopia.
• Index Hyperopia.
• Abnormal position of lens &
POSITIONAL HYPERMETROPIA
• Absence of crystalline lens
• Pathological condition .
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
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
Index hyperopia
Results as a decrease in refractivity of
lens .
In old age: refractive index of the lens
decreases leading to
hyperopia.
Abnormal condition of lens
• Posterior dislocation of the lens.
• Aphakia (congenital anomaly or due
to
trauma)
Pathological conditions
• Orbital tumors pressing the eye
ball
forward.
• Retinal detachment.
• CSCR(CENTRAL SEROUS CHORIORETINOPATHY)
• Intra – ocular neoplasm
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)
NOMENCLATURE HYPEROPIA
• Latent Hyperopia.
• Manifest Hyperopia.
a. Facultative Hyperopia
b. absolute Hyperopia.
• Total Hyperopia.
NOMENCLATURE OF HYPEROPIA
Latent hyperopia- part of hyperopia
corrected by the physiological tone of
the ciliary muscle.
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.
Total Hypermetropia
Latent hypermetropia & Manifest
hypermetropia
Example –
Absolute hypermetropia = 3D
Facultative hypermetropia = 2 D
Manifest hypermetropia = 5 D
Latent hypermetropia = 1.50D(with cyclopegia)
Total hypermetropia = 6.50D
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
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
CLINICAL FINDINGS
• Small eyeball.
• Cornea may be smaller.
• Anterior chamber shallow.
• Abnormal lens condition.
TREATMENT:-
1. SPECTACLES.
2. CONTACT LENS.
3. LASIK .
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
If Anisometropia & astigmatism
• Correct 1/2 to 2/3 of hyperopia.
• Fully correcting astigmatism.
Glasses required :
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
The older hyperopic
Full correction for both far and near .
Hyperopia
Correcting Hypermetropia
Plus lens increase power of optical system
HYPEROPIA IN YOUNG ADULTS
The symptomatic young adult is
given partial correction 2/3 or
more of cycloplegic refraction .
Alimullah (Hypermetropia) (1).pptx
Alimullah (Hypermetropia) (1).pptx

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Alimullah (Hypermetropia) (1).pptx

  • 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.
  • 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 .
  • 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 .

Editor's Notes

  1. REFRACTION IN A HYPERMETROPIC EYE