This document discusses hyperopia (farsightedness), which occurs when parallel rays of light focus behind the retina at rest. It defines different types of hyperopia such as physiological and pathological. Symptoms include eye strain, headaches, and blurred near vision. Diagnosis involves visual acuity tests, retinoscopy, and subjective refraction. Treatment options include convex lenses, contact lenses, and refractive surgery like LASIK. The prevalence of hyperopia changes with age, from high levels in infants to low levels in adults that may increase again in older age.

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2.  Emetropia-parallel incident rays come to
focus on the retina when accommodation is
at rest
 Ametropia-parallel incident rays are not
focused on the retina when accommodation
is at rest

3. Hyperopic (infant)
Emmetropic (10 years old)
Myopic (25 years old)
Hyperopic (60 years old)
Less hyperopic (80 years old)

4.  HYPERMETROPIA
 MYOPIA
 ASTIGMATISM

5.  Parallel rays come to focus BEHIND the
retina when accommodation is at rest
 The common name for this refractive error is
FAR-SIGHTEDNESS
 Patient cannot see near object

6.  Physiological
 Due to normal etiological conditions
 Imperfect emmetropinisation
 Hereditary factors
 Pathological
 Prenatal maldevelopment of eye
 Corneal or lenticular changes due to orbital
inflammation
 Neurologic or pharmacologic based causes

7.  Axial length
The axial length of the eye is shorter than normal
due to imperfect emmetropization
 Refractive power
 The refractive power of the eye is too weak
 Curvature hyperopia
 Cornea or lens has a flat curvature
 Increase index of refraction
 Due to increase density in some parts of the optical system
of the eye
 Loss of accommodation
 Due to age, drug medications
 Aphakia (no lens)
 Due to cataract removal

8. Hypermetropia
Latent Manifest
Facultative Absolute

9.  Overcome physiologically by the tone of
ciliary muscle
 Amounts to only one diopter
 Can be revealed only after cycloplegia

10.  FACULTATIVE HYPERMETROPIA
Can be overcome by an effort of
accommodation
 ABSOLUTE HYPERMETROPIA
Cannot be overcome by an effort of
accommodation

11.  Age
 The mean refractive error is +2.00D in newborns
 The mean refractive error is +1.00 to +0.50D in
children at age 6
 The mean refractive error is plano in children at
age 10
 The mean refractive error is skewed toward
myopia in children after age 10

12. Gender
 In general, there are no
significant differences
between males and
females
 Hyperopia is more
common in females

13.  Miotic pupil
 Enables accommodation and increased depth of
focus
 Esophoria
 Inward deviation of the eyes
 With accommodation, eyes tend to converge
 Decreased visual acuities at distance and
near, especially the latter
 Occasional diplopia or double vision

14.  Asthenopia or
ocular fatigue
 Frontal headaches
 Avoidance of visual
tasks, especially at
near
 Blurry vision at
near
 Intermittent
blurring of vision

15.  Visual acuity tests – distance and near
 Accommodation tests
 Retinoscopy
 Subjective refraction

16.  CONVERGING LENS
 CONTACT LENS
 REFRACTIVE SURGERY

17.  SPECTACALS
 Single vision CONVEX
glasses
 CONTACT LENS
 Soft contact lenses
 Rigid gas permeable
contact lenses

18.  SURGICAL
 IOL implantation
 Photo-refractive keratoplasty
 LASIK

19. Uncorrected VA Refractive Error (D)
20/30 0.50
20/40 0.75
20/60 1.00
20/80 1.50
20/120 2.00
20/200 2.50

20.  Optometry, journal of American optometric
association
 Duke-Elder, David Abrams (1986). The Practice of
Refraction (9th ed.).
 Bennett AG, Rabbetts RB (1984) Clinical
Visual Optics
 ‘care of patients with hypermetropia’, American
optometric association