Many people with mild hyperopia may not notice any problems in their younger years because the eye’s natural lens can compensate by adjusting its shape (a process called accommodation). As this ability decreases with age, particularly from the 40s onwards, the symptoms of hyperopia become more apparent. In fact, people with masked hyperopia can end up in reading glasses prematurely because of this compensation for distance vision.
Symptoms
The symptoms of hyperopia depend on the degree of the refractive error and your age:
- Difficulty focusing on close objects, especially when reading or using a phone
- Eyestrain or headaches after prolonged near work
- Squinting to see clearly
- Fatigue or discomfort during tasks that require sustained focus
- Blurred vision at both near and distance in higher degrees
In children, moderate to high hyperopia may not cause obvious symptoms but can lead to crossed eyes (strabismus) or a lazy eye (amblyopia) if not detected and corrected early.
Causes
Hyperopia is primarily determined by the shape and length of the eye, which are largely inherited. Most people are born slightly hyperopic, and the eye typically grows to the correct length during childhood. When it doesn’t grow enough, hyperopia persists.
Treatment
Glasses and contact lenses
These are the most common correction for hyperopia. They use a convex (plus power) lens to help focus light correctly on the retina.
Surgical options
For patients who want to reduce their dependence on glasses, surgical correction is available. Hyperopia can be more challenging to correct surgically, particularly in younger patients before presbyopia develops. The options depend on the degree of hyperopia, your age, and eye health:
- Laser eye surgery (LASIK, SMILE Pro/LALEX) — can correct low to moderate hyperopia. In general, laser correction can treat lower hyperopic prescriptions compared to myopic prescriptions, and suitability depends on factors like corneal thickness and curvature. PRK is less commonly used for hyperopia, as outcomes tend to be less predictable compared to LASIK.
- ICL surgery — ICL surgery may be an excellent option for higher degrees of hyperopia or when laser vision correction is not suitable. Careful assessment is required, as specific anatomical measurements, such as anterior chamber depth, help determine whether this lens-based approach is the right choice
- Refractive lens exchange (RLE) — often the most appropriate option for hyperopic patients over 45 to 50, particularly those with presbyopia. RLE replaces the natural lens with an artificial lens, correcting the hyperopia and removing the need for future cataract surgery
- PRESBYOND — a type of LASIK laser blended vision that can address hyperopia combined with presbyopia
Dr Chiu will assess your individual situation and recommend the most appropriate approach during your consultation.
Hyperopia and Angle-Closure Glaucoma
People with hyperopia tend to have shorter eyes with shallower anterior chambers (the space between the cornea and the iris). This anatomical feature can increase the risk of narrow-angle or angle-closure glaucoma, a condition where the drainage angle of the eye becomes blocked. If you’re hyperopic, your doctor may monitor the angle structure of your eyes and recommend preventive laser treatment (laser peirpheral iridotomy) if the angles are particularly narrow.
Frequently Asked Questions
Is hyperopia the same as presbyopia?
No, although they can feel similar. Hyperopia is a structural issue with the eye’s length or corneal shape. Presbyopia is age-related stiffening of the natural lens that affects everyone from the mid-40s. However, people with hyperopia often notice the effects of presbyopia earlier than those with normal vision or myopia.
Can hyperopia be corrected with laser surgery?
Yes, in many cases. Lower hyperopic prescriptions can be treated with laser. Higher prescriptions or patients with additional factors may be better suited to ICL or refractive lens exchange. Dr Chiu will assess suitability based on a comprehensive evaluation.
What is the difference between myopia and hyperopia?
Myopia and hyperopia are two of the most common vision conditions, and both relate to how the eye focuses light.
Myopia (short-sightedness) means distance vision is blurred. This usually occurs because the eye is slightly longer than normal, causing light to focus in front of the retina rather than directly on it.
Hyperopia (long-sightedness) affects near vision more commonly, or in higher degrees can affect distance and near vision. In this case, the eye is shorter or has less focusing power, so light focuses behind the retina instead of on it.
Both conditions are forms of refractive error and can be corrected with glasses, contact lenses, or vision correction procedures such as laser eye surgery or lens-based options like ICL surgery, and sometimes, RLE surgery
My child has been told they're long-sighted. Is this a problem?
Mild hyperopia in young children is quite common and often corrects itself as the eye grows. Higher degrees may need correction with glasses to prevent lazy eye or crossed eyes (strabismus). Your child’s optometrist or ophthalmologist will advise on whether correction is needed and monitor the situation over time.