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Long-sightedness

This factsheet is for people who have long-sightedness, or who would like information about it.

Long-sightedness, known medically as hyperopia or hypermetropia, is a common vision problem. If you’re long-sighted, you won’t be able to focus on close objects, but you will be able to see distant objects clearly. Another name for long-sightedness is far-sightedness.

About long-sightedness

When you look at something, light rays from the object pass into your eye through your cornea (the clear structure at the front of your eye). These then pass through your lens, towards your retina at the back of your eye. In a healthy eye, your cornea and lens bend the light to focus it on your retina. Your cornea focuses the light towards your retina and your lens ‘fine tunes’ the focusing of this light.

The lens of your eye is naturally disc-shaped and very flexible. This allows you to focus from a range of distances, on objects that are far away to those that are very close up.

To focus on near objects, the ciliary muscles at either side of your lens tighten causing it to change shape. Your lens becomes thicker and more curved, bringing light rays and close objects into sharp focus on your retina. This is called accommodation. To focus on objects in the distance, your lens returns to its natural resting state.

Illustration showing the different parts of the eye

Long-sightedness is caused by a refractive error. This means there is a problem with the way your eye focuses light rays.

If you're long-sighted, you will have difficulty seeing close objects clearly because light rays are focused behind your retina. This may be because your eyeball is too short, your cornea isn't curved enough or your lens isn't thick enough. You may find that close objects are blurred. Distant objects won't look blurry because the light rays don't need as much focusing power, so they focus on your retina properly.

Refractive errors, such as long-sightedness, can’t be prevented, but they can be easily diagnosed and treated with corrective glasses, contact lenses or surgery.

Long-sightedness often starts in childhood.

Illustration showing long-sightedness

Age-related long-sightedness

The lens of your eye needs to change shape to focus on smaller objects. This is called the elasticity of your lens. As you get older, this elasticity is gradually lost, which slowly decreases your eye’s ability to focus on nearby objects.

Age-related long-sightedness is medically known as presbyopia. Presbyopia isn't a disease – it’s a natural part of the ageing process. Almost everyone will develop age-related long-sightedness, regardless of whether you already wear glasses or contact lenses or not.

Symptoms of long-sightedness

Symptoms of long-sightedness are:

  • close objects appear fuzzy or blurry, while distant objects remain in focus
  • headaches
  • tired eyes

Many people have a small degree of long-sightedness. It’s only a problem if it affects your ability to see well, or causes you headaches or eye strain.

If you have presbyopia, you may also have double vision. You usually notice presbyopia at around the age of 45, when you realise that you need to hold reading materials further away in order to focus. Some people with presbyopia find that they need a brighter, more direct light when they are reading.

A symptom of long-sightedness in children is a squint. This is where one eye points inwards (sometimes outwards) more than the other. If a squint isn't treated in a baby or young child, it can lead to permanent vision problems, such as a 'lazy eye'. Squint usually only occurs with significant long-sightedness, but if you think your child has a squint, it's important to contact your GP for advice.

Causes of long-sightedness

Long-sightedness most commonly occurs because your eyeball is shorter than normal (measured front to back). You're more likely to develop long-sightedness if other people in your family have it.

A common cause of long-sightedness is ageing (presbyopia). This condition is common in individuals by the age of 40, and all people older than 50 experience some degree of presbyopia. You may be at risk of developing presbyopia at a younger age (premature presbyopia) if you regularly do tasks that require very close-up work.

Diagnosis of long-sightedness

If you can see far away objects more clearly than near objects, you should book an appointment to see an optometrist (a registered health professional who examines eyes, tests sight and dispenses glasses and contact lenses) to have your eyes tested.

It's important to have regular eye tests. As well as diagnosing any vision problems, they can reveal other conditions, such as glaucoma (an eye condition caused by a build-up of pressure in your eye), diabetes or high blood pressure. Having an eye examination is an important part of looking after your health. You should have an eye examination every two years, even if you have no problems with your vision.

Some people will need eye examinations more often because they have already been diagnosed with an eye condition that will need regular check-ups. See your optometrist if you are concerned about your vision or if your existing eye condition seems to have changed.

Eye examinations are usually quick and painless, and for some people, they are free. Ask your optometrist or GP for more advice.

Treatment of long-sightedness

Glasses and contact lenses

Long-sightedness can usually be corrected by wearing glasses or contact lenses. Convex lenses – in a pair of glasses or contact lenses – are usually prescribed. They bend light more sharply to refocus the rays on your retina. If you don’t have any other vision problems, such as astigmatism (where the cornea at the front of your eye isn’t perfectly curved), you might only need to wear glasses for reading or other tasks that you do up close.

Glasses are usually recommended for children that need them. They may also be more suitable for older people than contact lenses. Your optometrist will discuss with you what options are available.

Wearing contact lenses can increase your risk of getting an eye infection. It's important that you care for your lenses and store them properly to prevent infection. Follow all the advice your optometrist gives you.

If you develop presbyopia and already wear glasses or contact lenses, you may be prescribed bifocal or varifocal (progressive) lenses. These lenses are of different strengths in different parts of the lens. If you use contact lenses, you might choose to correct one eye for close vision and one eye for far vision. This is called ‘monovision’.

It's important to have check-ups with your optometrist every two years. This will help to make sure that your glasses or contact lenses stay the correct strength for you.

If you’re prescribed glasses or contact lenses, it may take you a few days to get used to them.

Surgery

Laser refractive surgery
A laser can be used to make alterations to your cornea, so that light rays are correctly focused onto your retina. The operation is carried out under local anaesthesia. This completely blocks pain from your eye and you will stay awake during the procedure. It only takes a few minutes.

There are various types of laser refractive surgery. These include:

Laser refractive surgery isn't suitable for everyone and you will need to talk to an ophthalmic surgeon to find out if it's right for you. It may be helpful to write down a list of questions or enquiries to take with you to your first assessment. Laser surgery can't be used to treat presbyopia. This is because your lens changes the light focus, not your cornea.

Your vision may be blurred for the first few days or weeks after the procedure, as the healing process occurs. Depending on the exact procedure you have done, your vision may take anything from one week to several months to improve.

Lens replacement surgery
Clear lens exchange or refractive lens exchange involves removing your lens and replacing it with an artificial one. It’s possible to correct both long-sightedness and presbyopia using this procedure. Some artificial lenses are designed to allow you to focus, so that you can see both near and far objects clearly. It’s also possible to correct one of your eyes for distance and the other for near sight. Your surgeon will discuss these options with you.

Phakic intraocular lenses
Laser eye surgery is not possible for some people, usually because they have significant long-sightedness. In recent years, lenses have been designed to sit inside your eye in front of your natural lens. These come in two types. One is designed to sit in front of your iris (the coloured part of your eye) and the other is designed to sit in front of your natural lens (behind your iris). These types of lenses have particular advantages and disadvantages – your surgeon will discuss these with you.

Scleral expansion surgery
Scleral expansion surgery is a procedure that has been used in the past to treat presbyopia. It involves your surgeon making small cuts in your eye and inserting bands to stretch the part of your eye that controls focusing. However, the National Institute for Health and Clinical Excellence (NICE) has recommended that this procedure should no longer be done because it hasn't been proven to be effective and risks may outweigh the benefits.

 

Produced by Alice Rossiter, Bupa Health Information Team, June 2012.

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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