Hyperopia: Causes, Symptoms, Remedies and Laser Intervention

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What it is and what symptoms

Hyperopia is a vision disorder that causes blurry vision of near objects compared to distant ones. In cases of severe farsightedness, even distant objects may appear unclear and blurry. The main cause of hyperopia is insufficient length of the eye. For this reason, it is very common in children since when they are born the eye is small and develops later with growth. Therefore, children’s hyperopia decreases with the physical development typical of puberty. Many people are farsighted without realizing it because the eye compensates for the defect automatically, through the mechanism of accommodation (contraction of the lens by means of the ciliary muscle). The constant effort to always see clearly causes migraines that are rarely attributed to the eyes. Only when farsightedness can no longer be compensated for by the eye’s lens (usually with advancing age), farsightedness becomes evident in blurry vision. Hyperopia can be corrected through the use of converging or positive lenses, contact lenses or with laser surgery for hyperopia.

Symptoms of hyperopia

Hyperopic people have difficulty looking at nearby objects but are able to focus only on distant objects, using accommodation, i.e. the contraction of the lens by means of the ciliary muscle. Consequently this muscle is never at rest causing headaches and eye discomfort. This mechanism, in fact, causes various disorders:

  • Burning
  • Increased tearing of the eye
  • Eye pain and headaches especially after strenuous activities (writing, reading, computer work)
  • Annoyance in the presence of a lot of light
  • Sense of heaviness in the eyes.

How Hyperopic People See

Mild farsighted people see poorly up close but well at a distance. Highly hyperopic people see poorly even from afar. Hyperopic people see better in the morning and when they are rested. The more you strain your eyesight, especially near vision, the more you risk developing eye discomfort, heaviness and blurred vision. In fact, the hyperopic person can see better by straining the eye muscles responsible for focusing. After a while the effort produces discomfort in the eye. Then when the muscle gets tired it can no longer focus and the vision becomes blurred.

The Causes of Hyperopia

There are essentially two causes of hyperopia:

  1. Small eye
  2. Slightly curved cornea

The consequence is that the images are not focused on the retina but behind it. For this reason, it is difficult to see especially up close. Hyperopia is common in children due to the smallness of the eye which grows over time thus reducing hyperopia. It is very important to carry out an eye examination around three years of age to diagnose any hyperopia early and thus be able to correct it in a timely manner. Otherwise the child may develop a missing eye, not learning to use the eye correctly.

How to Cure Hyperopia

Hyperopia can be corrected with glasses or contact lenses. The alternative, if you want to completely eliminate your glasses or contact lenses, is surgery. There are different types of intervention using the excimer laser or intraocular lenses. The excimer laser allows you to correct up to 3 diopters of hyperopia. In more serious cases, other solutions are needed such as phakic lenses or pseudophakic intraocular lenses which are implanted inside the eye.

When to Operate on Hyperopia

The minimum age for laser eye surgery is 20 years. However, hyperopia must be stable for at least 2 years, otherwise it may return after surgery, making retreatment necessary. Over the age of 45, other interventions can also be considered to correct hyperopia. For example, you can consider Phacorefractive surgery which consists in replacing the crystalline lens with an intraocular lens that allows you to see well from far away and up close without glasses. After the age of 60 it is usually no longer recommended to perform laser surgery for hyperopia because often there are already opacities in the lens – or they could appear within a short time – and this could cause the hyperopia to return. In this case, it is advisable to perform the Phacorefractive operation, which consists in replacing the lens itself with an intraocular lens that has the right power to correct hyperopia and presbyopia. Depending on the type of intraocular lens used, you may or may not need to use glasses for near reading. With the latest generation intraocular lenses you can see well from far away and up close without glasses (multifocal, bifocal, trifocal, high tech etc). Laser surgery can be performed on both eyes. In the case of correction of hyperopia by implanting phakic intraocular lenses or phacorefractive, it is usually possible to operate on both eyes a couple of days apart. In cases of severe hyperopia, intraocular contact lenses – also called phakic lenses – can be implanted inside the eye with the advantage of having very fast vision recovery.

How Much Does Laser Surgery Cost

The cost of the operation to correct hyperopia varies from 2,000 to 5,000 euros per eye depending on the type of technique used. Laser surgery costs around 2,000 euros per eye and typically works up to three diopters of hyperopia. Beyond 3 diopters, more sophisticated interventions are required. The Phakic lens implant, on the other hand, costs around 4,000 euros per eye. If hyperopia is also associated with presbyopia, it is necessary to replace the lens with the implantation of a sophisticated intraocular lens such as trifocal lenses or with increased depth of field. In this case, the cost increases and varies from 3,500 to 5,000 euros.

Risks of the Intervention

There are no particular risks for laser surgery for hyperopia. Complications after this type of surgery are very rare when performed with the latest generation lasers. In the initial period there may be a slight myopia. This is not a complication but the normal post-operative course. In rare cases, there may be an incomplete correction of hyperopia which makes it necessary to perform laser surgery again. Alternatively, you go back to using glasses or contact lenses. Finally, if adequate hygiene and health standards are not adopted, there is a risk of infection. For this reason, antibiotic eye drops are usually used immediately after surgery.

Is the Intervention Reimbursable?

Laser surgery for hyperopia in agreement can be performed with the main insurance companies, supplementary funds and health funds. Some insurances provide direct payment of the medical service without any cost to the patient, others provide indirect assistance. In this case the patient will receive a refund after presentation of the invoices for the services received. Each insurance has its own price and reimbursement schedule. Read the list of affiliated insurance companies here. Laser surgery for hyperopia can no longer be performed through the National Health Service (SSN) or ASL (Local Health Authority). Hyperopia laser surgery was carried out through ASL in past years but today with spending reduction policies this is no longer possible.

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