Expert reviewer, Professor Simon Taylor, Consultant Ophthalmic Surgeon
Next review due March 2021

Long-sightedness means that you can’t focus on close objects, but you can see objects in the distance clearly. Doctors call this hyperopia or hypermetropia. Another name for long-sightedness is far-sightedness. Overall, around one in three people are long-sighted.

As we get older, long-sightedness becomes more common. If you are over 40, you may have noticed that small print becomes increasingly difficult to read. Age-related long-sightedness is a separate condition from hyperopia, which happens to everyone naturally as part of ageing – it’s called presbyopia.

Glasses on a table

About long-sightedness

Your eye has a clear window at the front (the cornea). At the back, it has a lining made of light sensitive nerve cells (the retina). Your lens is between the two. When you look at something, light rays from the object pass into your eye through your cornea, through your lens, and to your retina at the back of your eye. In a healthy eye, your cornea and lens bend the light so that it hits the retina when it is exactly in focus. Your cornea bends the light towards your retina and your lens ‘fine tunes’ it so that the focus is just right.

If you are long-sighted, you can't focus clearly on distant objects because light from them focuses behind your retina. This is either because your cornea is not curved enough or your eyeball is too short. If the light rays aren’t clearly focused on your retina, the objects you see look fuzzy or blurred. Objects that are further away don't look blurry, because the light rays from them focus in the right place on your retina.

Age-related long-sightedness

In order for you to focus precisely on close objects, the lens of your eye needs to change shape. This is called accommodation. As you get older, the lens becomes less elastic, which slowly decreases your eye’s ability to focus on nearby objects, or ‘accommodate’.

When long-sightedness results from ageing in this way, doctors call it presbyopia. It isn't a disease, but a natural part of the ageing process. There's no way of preventing it and it happens to everyone, so most older people eventually use reading glasses, even if their vision was normal earlier in life.

Symptoms of long-sightedness

Symptoms of long-sightedness are:

  • close objects appear fuzzy or blurred, while distant objects remain in focus
  • headaches
  • tired eyes and eye strain
  • narrowing your eyes to look at something

Many people have a small degree of long-sightedness. You may not even notice any problems with your sight. It’s only a problem if you can’t see well, or you have headaches or eye strain.

If you have age-related long sight, you’ll usually first notice when you realise you’re holding reading materials further away in order to focus on them properly. This is generally by the age of 45. Some people with presbyopia find it easier to read in a brighter, more direct light. You may also find that your eyes are tired or you have a headache after doing close-up work.

Symptoms in children

Babies and very young children are often mildly long-sighted, but this usually corrects itself by about the age of three.

It may be hard to tell that a child is long-sighted, which is why an eye test can be important. A child may show signs such as rubbing their eyes often, or avoiding looking closely at objects or reading.

It a child is very long-sighted, they may develop 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 a 'lazy eye', which can be permanent. 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 happens because your eyeball is shorter than normal, from front to back. You're more likely to develop long-sightedness if your parents have it, as it does run in families.

Age-related long-sightedness (presbyopia) is common in people by their mid-40s. Everyone older than 50 will have some degree of presbyopia.

Diagnosis of long-sightedness

If you or your child can see far away objects more clearly than near objects, you should book an appointment to see an optometrist (often called an optician) for an eye test. This is a registered health professional who examines eyes, tests sight and dispenses glasses and contact lenses. In order to diagnose sight problems, your optometrist will usually ask you to read a standard chart (called a Snellen chart) from a distance of 6 metres away. The chart has large letters at the top and small letters at the bottom. For younger children, there are charts with pictures instead of letters. Check the optometrist is happy measuring a child’s eyes in advance, as some don’t specialise in doing this.

Eye examinations are usually quick and painless, and for some people, including children and the over 60s, they are free. See our FAQ section for more information on who is entitled to a free eye test.

It's important for everyone 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.

You may need to have eye examinations more often as you get older or if you have:

  • a condition that may affect your sight, such as diabetes or glaucoma
  • a close relative who has a condition that may affect his or her sight, such as diabetes or glaucoma

Age-related long sight will continue to change until you are in your late 50s, as the lenses in your eyes continue to stiffen. Regular eye tests will help to make sure you are wearing the right reading glasses.

See your optometrist if you are concerned about your vision or your existing eye condition seems to have changed.

Treatment of long-sightedness

Glasses and contact lenses

Long-sightedness can usually be corrected by wearing glasses or contact lenses. These focus the light in the right place 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 close up.

Some people prefer contact lenses to glasses. They tend to be more expensive than glasses and you need to be comfortable touching your eyes to use them. You also have to be committed to looking after the lenses properly, particularly keeping them clean. Not cleaning lenses properly increases your risk of an eye infection.

There are several types of lenses, which fall into two main groups:

  • hard lenses, also called rigid gas permeable (RGP) lenses
  • soft lenses

Depending on the type, soft lenses can be used for a day, a fortnight or a month. Then you throw them away. If you use the longer-lasting ones, you have to look after them and keep them clean with special lens fluids, as you do with hard lenses.

Because they can be fiddly to put in and take out, contact lenses are not usually recommended for young children. For the same reason, glasses may also be more suitable than contact lenses for older people. Your optometrist will discuss with you which options are available for you.

If you have age-related long sight and already wear glasses or contact lenses, you can have multifocal lenses. These have different strengths in different parts of the lens. Some people like to use different contact lenses in each eye – one for close vision and one for far vision. This is called ‘monovision’.

You can now have contact lenses for age-related long sight even if you don’t otherwise need glasses or lenses. These correct your close vision, and some correct your distance vision too if needed. Some people find that their vision isn’t as sharp with multifocal contact lenses.


Laser eye surgery

This is also called laser refractive surgery. A laser is used to alter the shape of your cornea, so that light rays focus correctly on your retina. To treat long sight, the surgeon makes the centre of the cornea more pronounced by removing tissue from around the edge.

All laser eye surgery is done using local anaesthetic eye drops. This means you will be awake during the procedure. It takes about half an hour to treat both eyes.

To have laser eye surgery, your vision must have been stable for a year. It is not a suitable treatment for children because their vision may change.

You can now have laser eye surgery if you have age-related long sight. The surgeon treats one eye for distance and the other for close vision. The result is similar to monovision with contact lenses.

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.

Laser eye 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.

See our page about laser eye surgery for more details.

Lens implants

Clear lens exchange (CLE) or refractive lens exchange (RLE) involves removing the lens of the eye and replacing it with an artificial lens. You have this done under local anaesthetic. It’s basically the same as cataract surgery, but the lens that is taken out is not clouded. Your eye surgeon may suggest it if you are older, as older people often have the beginnings of a cataract. It is possible to have multifocal implants so that you can see clearly at a distance and when reading.

A variation on this treatment is to have a lens implant put in front of your natural lens. This is called a phakic intracocular lens. Your surgeon may suggest this if your long sight can’t be corrected easily with laser eye surgery. As with any surgery, there can be complications. These include infection and inflammation of the eye (uveitis). There can also be an increased risk of developing other eye conditions, such as cataract and glaucoma. Your eye surgeon will go through all the risks and benefits with you.

Frequently asked questions

  • Around three in every 100 children develop a squint, which can be caused by long-sightedness. The squint usually develops when the child is between 10 months and two years old, but they can happen up to the age of five.

    If your child is long-sighted, it means he or she has problems seeing things that are very close up. They try to over-focus and this can cause blurred or double vision. The brain tries to avoid double vision by switching off the image from one eye and making that eye turn inwards, so that it isn’t used. If this isn’t corrected, it could lead to your child having a ‘lazy eye’, meaning that the eye doesn’t work properly. This can become permanent.

    The aim of treatment for this type of squint is to correct the long-sightedness with glasses. Most children don't need anything more than glasses to correct their squint. But your child will need to wear their glasses all the time, and this can be difficult. They may need lots of encouragement to wear glasses because, at first, they may be able to see better without them. Their eyes will have become used to over-focusing without glasses. Given time, your child’s eyes will adapt to the lenses and their sight will improve.

    If your child has a lazy eye, they will usually need to cover the good eye with a patch, worn under their glasses. This makes the lazy eye work harder to focus and, in time, will improve the sight in that eye. Sometimes, eye drops can be used to blur the vision in the ‘good’ eye, instead of wearing a patch.

    Rarely, children need an operation to straighten a squint. This is usually done if the squint is very pronounced or if glasses don’t help to correct it.

  • Many people in the UK are entitled to a free eye examination on the NHS. But if you don’t come under any of the entitled groups, you will have to pay. You can have a free eye test if you:

    • are aged 60 or over
    • are under 16, or under 19 if you are in full-time education
    • have diabetes or glaucoma
    • have been told by an eye specialist that you are at risk of glaucoma, or are over 40 with a close relative who has glaucoma
    • are registered as blind or partially sighted
    • receive some state benefits, such as income support or universal credit (or your partner does)
    • are entitled to vouchers for complex lenses
    • are a prisoner on leave from prison

    Eye tests are also free for everyone in Scotland.

    If you think you qualify for a free eye test, check with your optometrist (a registered health professional who examines eyes, tests sight and dispenses glasses and contact lenses) for advice before you have your eyes tested.

    For those who have to pay, the price varies but is usually around £20 to £40. There are sometimes special offers so it’s worth shopping around. Check before you book though – there may be extra charges for additional tests.

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  • Reviewed by Graham Pembrey, Lead Editor, Bupa Health Content Team, March 2018
    Expert reviewer, Professor Simon Taylor, Consultant Ophthalmic Surgeon
    Next review due March 2021