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Long-sightedness


Expert reviewer, Professor Simon Taylor, Consultant Ophthalmic Surgeon
Next review due October 2023

Long-sightedness (also called far-sightedness) is a common problem where you find it more difficult to focus on objects close to you than objects in the distance. The medical name for this is hyperopia or hypermetropia. When long-sightedness is related to the natural process of ageing, it’s called presbyopia.

Glasses on a table

About long-sightedness

Different parts of our eye help us to focus on objects properly. 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. Your lens, which sits behind your pupil, changes in shape to ‘fine tune’ the image so that the focus is just right.

If you’re long-sighted, light rays from objects close by focus at a point behind your retina, rather than directly on it. This is either because your cornea is too flat 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.

When you’re younger, these problems might not be noticeable at first because the focusing power of your lens can overcome your long-sightedness for a while. Long-sightedness tends to become more common in adults as they get older and the lens loses the ability to focus properly. For more information, see our section: Age-related long-sightedness.

Age-related long-sightedness

The change in your vision that happen as you get older is different from the long-sightedness that you may have earlier in life. Age-related long-sightedness is caused by the lenses in your eyes becoming 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.

This is a natural part of the ageing process and tends to become noticeable by your early to mid-40s. Most people eventually need to use reading glasses, even if their vision was normal earlier in life.

Symptoms of long-sightedness

If you’re long-sighted, objects or writing close up appears fuzzy or blurred, while distant objects remain in focus. In the case of age-related long-sightedness, you may notice difficulty reading things up close – for example, menus, books and phone screens – especially in dim lighting. You might notice you’re narrowing your eyes or squinting to try and see more clearly. You may get headaches and eye strain (sore, tired, red and watery eyes) when you’ve been doing close work such as reading or screen work.

It may be hard to tell that a child is long-sighted, which is why eye tests are important. A child may show signs such as rubbing their eyes often or avoiding reading and looking closely at objects. If you or your child can see far away objects more clearly than near objects, you should book an eye test with an optician (also known as an optometrist). This is a registered health professional who examines eyes, tests sight and dispenses glasses and contact lenses.

If a child is long-sighted, they may develop a squint – 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. See our FAQ on squint for more information.

Having an eye test

It’s important for everyone to have regular eye tests. You should have an eye examination every two years, even if you have no problems with your vision. Always go for a test sooner if you notice changes in your vision or are having any problems. Some people are entitled to free eye tests, including children and people over 60. See our FAQ section for more information.

At your eye test, your optician will ask about your general health and any problems you’re having with your eyes or vision. They’ll examine your eyes to check how healthy they look, and may take photographs or scans too. They’ll assess both your distance and near vision.

Near vision (how well you can see things close up) is usually assessed by asking you to read some text 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 need to book an appointment for a young child, mention the child’s age when you book. This is important so you can be certain that the optician is able to do an eye test for a young child.

If you’re long-sighted, your optician will give you your prescription at the end of your sight test and tell you how often you should have your eyes checked. This is usually every two years for adults but may be more frequent for children. Age-related long sightedness gradually gets worse as you get older. Regular eye tests will help to make sure you are wearing the right reading glasses.

Treatment of long-sightedness

Long-sightedness can usually be corrected by wearing glasses or contact lenses. The lenses in your glasses or contact lenses focus the light in the right place on your retina. Surgery is also an option for some people.

Glasses

If you don’t have any other vision problems, you might only need glasses for reading or other tasks that you do close up.

You can buy glasses for age-related long-sightedness over-the-counter (without needing a prescription from an optician). You may find that you can manage with these for certain close work such as reading. But bear in mind that they won’t be the same standard as prescription glasses that are made especially for you. Also, it’s still important to have regular eye tests to pick up on any other issues with your eyes.

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 for your glasses. These have different strengths in different parts of the lens.

Contact lenses

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. You also have to be committed to looking after them properly. If you have reusable contact lenses (soft or RGB), you’ll have to look after them and clean them with special lens fluids after every use. 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. This may be difficult for younger children. For the same reason, glasses may also be more suitable than contact lenses for older people, who may have trouble looking after them.

It’s not always straightforward to get contact lenses for age-related long-sightedness. However, bifocal and varifocal contact lenses are available and do work well for some people. Another option is to use different contact lenses in each eye – one for close vision and one for far vision. This is called ‘monovision’. Ask your optician about what options you have.

Surgery

Some people opt to have surgery to correct their long-sightedness rather than rely on glasses or contact lenses. Surgery to correct long-sightedness isn’t available on the NHS nor is it covered by private health insurance schemes; you’ll need to pay for the procedure. It also isn’t suitable for everyone. You have to be over 18, and must have had no – or only very little – change in your prescription over the last two years.

There are several different types of surgery, but we describe the main types here.

Laser eye surgery

Laser eye surgery (also called laser refractive surgery) aims to reshape your cornea using a laser so that light rays focus correctly on your retina. There are different types of laser eye surgery but for long sightedness the surgery involves making your cornea more curved. All laser eye surgery is done using local anaesthetic eye drops, so you’ll be awake during the procedure. It generally takes about 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.

Lens implants

Lens implants involve implanting an artificial lens into your eye to correct your sight. Your surgeon may suggest this if your long sight can’t be corrected easily with laser eye surgery.

You may have your own lens taken out and a replacement put in. This is known as refractive lens exchange and is basically the same as having cataract surgery. Your eye surgeon may suggest this if you are older, as older people often have the beginnings of a cataract (cloudy lens). It’s possible to have multifocal implants so that you can see clearly at a distance and when reading. Alternatively, you may have a lens implant put in front of your natural lens (known as a ‘Phakic’ lens).

Deciding on surgery

As with any type of surgery, there are certain risks and complications as well as benefits associated with laser eye surgery and lens implants. 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 see an ophthalmic surgeon to discover if surgery is right for you, and to discuss all the risks and benefits involved.

Frequently asked questions

  • Many children don’t need anything more than glasses to correct their squint. However, some children may need to wear an eye patch; occasionally they may need surgery.

    Squint is when your eyes point in different directions; it is often caused by long-sightedness in children. If your child is long-sighted, their eyes try to focus harder when looking at things close up. This can cause their eyes to turn inwards too much, which may lead to a squint. If this isn’t corrected, your child may adapt to not using that eye. This is called having a ‘lazy eye’ and means that the eye doesn’t work properly. This can become permanent if it’s not treated while your child’s vision is still developing (before the age of seven or eight).

    The first step in treatment for squint is to correct the long-sightedness with glasses. This helps the eyes to relax and stop over-focusing. Your child will need to wear their glasses all the time, and they may need lots of encouragement at first.

    If your child has already developed 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, your optician may suggest using eye drops to blur the vision in the ‘good’ eye, instead of wearing a patch.

    If your child’s squint is very pronounced or if glasses don’t help to correct it, they may be offered surgery to correct it.

  • Many people in the UK are entitled to a free eye examination on the NHS. But if you aren’t in 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’re in full-time education
    • have diabetes or glaucoma
    • have been told by an eye specialist that you’re at risk of glaucoma
    • 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 free for everyone in Scotland.

    If you think you qualify for a free eye test, check with your optician for advice before you have your eyes tested.

    You may also be entitled for eyesight tests through your employer, if you regularly work with display screen equipment (for example, PCs, laptops, tablets or smartphones). The price of an eye test varies but is usually around £25 to £40. There are sometimes special offers so it’s worth shopping around. Check what is covered before you book – there may be extra charges for additional tests.



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Related information

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  • Reviewed by Pippa Coulter, Freelance Health Editor, October 2020
    Expert reviewer, Professor Simon Taylor, Consultant Ophthalmic Surgeon
    Next review due October 2023

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