Farsightdness

PATHOLOGY

A hypermetropic eye can be corrected naturally, within certain limits, for many years through the focusing capacity or accommodation. When accommodation is able to compensate hypermetropia, the natural visual acuity of hypermetropic patients is very good. This compensation is, however, limited and can take place only for low to moderate degrees of hypermetropia. In fact, if the accommodation is insufficient to compensate the whole refractive error, then visual acuity appears to be decreased and images appear to be out of focus at all distances.

If the cornea and/or the lens present a focusing power that is lower than normal, the visual image will be focused behind the retina. In this situation the eyes will not be able to focus correctly on near objects and people and the consequence will be a refractive defect that takes the name of refractive hypermetropia.

SYMPTOMS

The symptoms often reported by the patient is a blurred vision from far and near.

DIAGNOSIS

It is possible to make a diagnosis for hypermetropia during an eye examination by an ophthalmologist, both with the simple reading of the characters of the eye chart and with an in-depth instrumental investigation.

The instrumental tests that have a more widespread use are:

– Autoreftactometry, a detective system for ocular refractive error measurement which provides corneal and refraction parameters;

– IOL Master, which measures the length of the eyeball which, in the case of hypermetropia, appears to be reduced;

– Corneal Topography, which provides certain fundamental anatomic parameters by analyzing the possible alterations of the corneal curvature, which can give rise to hypermetropic defects;

– B-Scan Ultrasonography, in order to evaluate in very hypermetropic patients whether there are inside the eye alterations having a morphological character, since the eyeball appears to be smaller than normal and structural anomalies or malformations of the tissues could derive therefrom.

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TREATMENT

CORRECTION

Also for this refractive error a permanent correction is today possible thanks to refractive surgery, which makes it possible to vary the curvature and, therefore, the dioptric power of the cornea in such a way as to compensate the refractive error.

SURGICAL THERAPY

Among the surgical methods more frequently used we point out: PRK, i-LASIK and SMILE.

With refractive surgery with excimer laser it is possible to compensate the refractive error and avoid the correction with spectacles or contact lenses.

Refractive surgery is executed under local anesthesia, without pain both during and after surgery, it lasts only a few minutes and consists in modifying the curvature of the corneal surface. The “excimer laser” in the PRK (Photo Refractive Keratectomy) surgery enables to have a disintegration or “vaporization” of the more superficial corneal layers, i.e. the corneal epithelium, the Bowman membrane and part of the stroma. Thanks to this surgery, the eye can focus again the images on the macular area and the patient can see again distinctly in a very short time without the need of glasses or contact lenses.

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