When the front-to-back length of the eye is shorter than the population average, images are focused behind the centre of vision. This type of refractive error is called hyperopia. Children are expected to be hyperopic from birth. Since the length of the eye increases as we grow, a decrease in the degree of hyperopia is observed with age. Although the term hyperopia is known in everyday language as “not being able to see near”, people with hyperopia have difficulty seeing both near and far. Particularly around the age of 40, when the weakening of near-vision capacity (presbyopia) begins, the combination of hyperopia with presbyopia makes blurred vision more pronounced.
People with hyperopia — that is, those with +(plus) prescriptions — experience complaints such as confusing letters when reading, hazy vision, and pain around the eyes and in the head after prolonged reading or screen use. The fact that they see clearly without glasses does not mean that there is no defect in their eyes. For people with complaints of eye pain and fatigue, wearing glasses can be supportive in providing clear vision and reducing complaints, and for this reason it has become known in everyday language as “rest glasses”. As can be understood, wearing glasses is a supportive aid for relieving the complaints of hyperopic individuals, and has no curative or reductive effect on the eye prescription itself.
The alternatives to glasses for hyperopic refractive error are contact lenses, refractive surgery (LASIK or PRK / no-touch laser) and clear-lens exchange surgery. The first of these — contact lenses — when used in accordance with hygiene and usage rules, is considered a more comfortable option than glasses. There are contact lenses that correct distance refractive errors only, as well as multifocal (distance–near) contact lenses. In people over the age of 40, with the emergence of a need for near glasses alongside distance glasses, multifocal contact lenses provide a comfortable vision option for this age group.
In addition to glasses and contact lenses, surgical correction of refractive errors is also an option for hyperopic individuals. The first that comes to mind is refractive surgery — known in everyday language as “having the eye etched”, but in current laser methods no “etching” application is performed; it is a safe and comfortable surgical method carried out with the assistance of a femtosecond laser. With this surgical method, “zeroing the prescription” is not an accurate definition of the goal in hyperopic individuals. The real goal is to enable the person to see, to a large extent, without glasses in every area of life. If the structure of the eyes meets the criteria for refractive surgery, laser surgery may be applied.
Hyperopic refractive error can also be corrected with intraocular surgical methods. The first of these is the procedure of placing a lens inside the eye, defined as a phakic intraocular lens. For the pre-presbyopia age group whose near-vision impairment has not yet begun, with high hyperopia, where glasses, contact lenses and refractive surgery cannot be applied or are not preferred, it is a valuable option. The person’s own lens is left in place, and through this second lens to be placed on top of it, the person achieves distance vision without glasses. The second method is clear-lens exchange surgery. This operation can be performed in people who are in the presbyopic age, in whom cataract development has not yet begun, and who are suitable for the procedure. Clear-lens exchange involves the surgical removal of the person’s lens and its replacement with a trifocal (three-focus) intraocular lens. Because this procedure cannot be applied to every age and every eye, it requires a careful examination and detailed evaluation of tests. When applied to patients who meet the suitability criteria, near, intermediate and distance vision without glasses can be achieved.
Prepared by the Editorial Board of the Eye Foundation Hospitals.
