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What is long-sightedness?
Long-sightedness (or far-sightedness) is a common problem where it’s more difficult to focus on objects close to you. It is the opposite of short-sightedness, in which objects in the distance are out of focus. The medical name for this is hyperopia or hypermetropia. Here, I talk about long-sightedness and the treatment options available to help correct your vision.
What are the causes of long-sightedness?
Long or short-sightedness is determined by the shape of the eyeball. Your cornea (the clear outer layer at the front of your eye) bends the light rays towards your retina at the back of your eye. If you’re long-sighted this is usually because either your cornea is less curved than it should be or your eyeball is shorter (smaller) than it should be.
In age-related long-sightedness, the lenses in your eyes become less elastic. This slowly decreases the ability of your eyes to focus on things close by, such as a book or text on a phone screen. Age-related long-sightedness is called presbyopia.
What are the symptoms of long-sightedness?
If you’re long-sighted, objects or writing close up appears fuzzy or blurred, while distant objects remain in focus. Most children are a bit long-sighted when they are younger, but because their eyes they have lots focussing power they can still see clearly.
Children may show signs such as rubbing their eyes often or avoiding reading and looking closely at objects. If they are very long-sighted, they may develop a squint. A squint is when one eye points inwards (or sometimes outwards) more than the other. If you think your child has a squint, it’s important to see an optician as soon as possible.
In the case of age-related long-sightedness, you may have the following symptoms:
- difficulty reading menus, books and phone screens – especially in dim lighting
- narrowing your eyes or squinting
- headaches and eye strain (sore, tired, red and watery eyes) when doing close up work such as reading or screen work
How can I know if I’m long-sighted?
You should have an eye examination every two years, even if you have no vision problems. Always go for a test sooner if you do notice any problems. Some people are entitled to free eye tests, including children and people over 60.
At your eye test, your optician (also known as an optometrist) will:
- ask about your general health and any problems you’re having with your eyes or vision
- examine your eyes to check how healthy they look, and may take photographs or scans too
- assess both your distance and near vision
Near vision (how well you see close up) is usually assessed by reading from a testing card, which you hold at normal arm’s length. The words get smaller as you go down the page. For young children, letters can be replaced by pictures or shapes.
If you’re long-sighted, you’ll get a prescription at the end of your test. You’ll also be told how often to have your eyes checked. This is usually every two years for adults, but may be more often for children. Regular eye tests will help to make sure you are wearing the right reading glasses.
When should you wear glasses for long-sightedness?
Long-sightedness can usually be corrected by wearing glasses or contact lenses. Children who are very long-sighted should wear glasses to help prevent lazy eye (amblyopia).
You can buy glasses for age-related long-sightedness over-the-counter (without needing a prescription). You may find that you can manage with these for certain close work such as reading. But they won’t be the same standard as prescription glasses made especially for you.
If you need reading glasses for age-related long-sightedness as well as glasses for distance (or near) vision, you can get bifocal or varifocal lenses. These have different strengths in different parts of the lens.
How can contact lenses help long-sightedness?
You may prefer to wear contact lenses for cosmetic or practical reasons (for instance, if you’re taking part in certain sports). Some people also find that their vision is clearer with contact lenses.
The different types of contact lens fall into two main groups.
- Soft lenses. These are flexible and mould to the shape of your eye. Depending on the type, they can be used for a day, a fortnight or a month, then you throw them away.
- Rigid gas permeable (RGP) lenses. These aren’t so flexible and don’t mould to your eye. You keep and reuse them for longer periods of time. They can take a bit of getting used to, but they’re useful for people with certain specific eye problems.
You need to be comfortable touching your eyes to use contact lenses and be committed to looking after them properly. Not cleaning lenses properly increases your risk of an eye infection.
Children should only wear contact lenses once they’re able to put them in and take them out safely, and look after them properly.
Can you correct long-sightedness with surgery?
Surgery can be an option to correct long-sightedness rather than relying on glasses or contact lenses.
Laser eye surgery (or laser refractive surgery) aims to reshape your cornea using a laser so that light rays focus correctly on your retina. All laser eye surgery is done using local anaesthetic eye drops, so you’ll be awake during the procedure. Surgery generally last half an hour to treat both eyes.
You may also be able to 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.
If laser surgery is not an option, you can also have lens implants. An artificial lens is inserted into your eye to correct your sight. This can be either done by:
- taking out your own lens and a replacement is put in (known as refractive lens exchange which is the same as cataract surgery)
- a lens implant is put in front of your natural lens (known as ‘Phakic lens)
It’s possible to have multifocal implants so that you can see clearly at a distance and when reading.
While many people find their vision improves with surgery, it’s not always possible to get perfect eyesight. There’s also a risk of problems such as glare, poor night vision or dry eyes. You’ll need to speak to an ophthalmic surgeon about the risks and benefits involved in surgery.
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