19Feb

Hyperopia: types, causes and treatment

Hyperopia is a violation of the refractive power of the visual organ, in which the image of objects is not focused on the retina itself, as it should be normal, but in the plane behind it. With farsightedness, the vision of a person is characterized by the fact that the ability to distinguish objects close to one another is significantly impaired.

The prevalence of the considered illness among the adult contingent( available as a person of 18 years) is approximately 35-45%.In children up to 7-12 years old, this disease has a physiological nature and in 90% of cases it occurs in children under 3 years old, and at the age of 13-14 years the incidence of the disease is 35%.

The weakness of refraction is characteristic for hypermetropia. This leads to the fact that even with long-range vision, a considerable accommodation voltage is required. As a rule, people suffering from this disease perceive the image of objects in an indistinct form, as if slightly blurred.

Adopted in the ophthalmology medical term, which is usually designated this disease - is hypermetropia. Its origin is associated with such words of the Greek language as hyper( which means "over"), metron( which means "measure") and ops - "eye".

It should be noted that in olden days, none other than this vision defect was a good stimulus for a very useful invention called glasses.

This happened in the XV century, marked by the appearance and development of printing. Reading books, people who had not even previously suspected that they saw badly near, began to understand that it was not easy to read them: the letters in the lines blurred.

In order to help such people and were invented and made special glasses for reading. By the way, lenses for myopic were invented much later( only a whole century later).

Types and degrees of farsightedness: overt and covert disease

Classification of this disease makes it possible to divide hypermetropia into different species.

One of the approaches, based on the mechanism of the development of the disease, can be divided into axial and refractive hyperopia. The first is associated with a shortened anteroposterior axis of the eyeball, and the second is due to a change in the refractive power in the direction of decrease.

According to another classification, there is an obvious, as well as latent farsightedness. The latter is discussed in the case when there is compensation for the existing anomaly of the refractive force of the organ of vision due to the tension of accommodation. And if self-correction of hypermetropia is impossible and there is a need to use convex-lenses, the disease is regarded as obvious.

It should be noted that with age, the latent form of the disease, as a rule, is transformed into an explicit one.

Generally speaking, depending on age, the selection of such types of farsightedness as natural, congenital and senile is based. The first can be observed in children as a physiological phenomenon;the second is a congenital weakness of refraction;and the third develops in old age and, in this connection, also has the name of age-related hypermetropia( physicians call this kind of presbyopia a kind of farsightedness).

Note also that according to refractometry and depending on what kind of correction( expressed in diopters) is required in a particular case of the disease among doctors, it is customary to distinguish three degrees of farsightedness: +2 diopters indicate a weak degree of disease;the average degree is + 5 diopters;more than 5 diopters this is nothing more than a high degree of hypermetropia.

Causes of the development of the farsightedness

The development of hyperopia as well as in the case of myopia is associated with the mismatch of the refractive force before the anterior posterior size of the optic organ. However, there are significant differences. In particular, with hypermetropia such a discrepancy is a consequence of the relative weakness of the eye refractive apparatus, or arises as a result of the shortened anteroposterior axis of the optic apple. I must say that in some patients the shortened axis is combined with insufficient optical power, which, of course, is not at all a favorable sign. Nevertheless, even alone, both of these mechanisms lead to the fact that the rays after their refraction in the structures of the eye are focused at a point located behind the retina, in which, in fact, the essence of the farsightedness of the eye.

Newborn babies usually have so-called physiological far-sightedness. This state is usually not threatened by anything and is not a bad sign. This type of hypermetropia is explained by the fact that the longitudinal size of the visual apple at a given age is small, but it increases as the baby grows, which consequently leads to normalization of vision( refraction becomes commensurate with the establishment of a normal eye size).This happens usually to 12 years. However, it is also possible that the growth of the eye will progress, which will lead to the development of myopia, i.e.myopia. The delay in the growth of the eye promotes hyperopia. In particular, the aggravation of the degree of hypermetropia in children is observed when this disease is combined with a variety of anomalies of the eye that arise in utero( for example, microphthalmia, aniridia, lenticone, etc.).In addition, it can occur with other developmental defects( wolf mouth, hare lip).

How to determine hyperopia: is it a plus or a minus?

It should be noted that by the time when the growth of the body is fully completed, the disease of hyperopia is observed in almost half of people, in the other half, either emmetropia( normal refraction) or nearsightedness.

Despite this fact, very many long-sighted individuals manage to fully compensate for the weakness of the refractive media of the eye apparatus for a long time( for example, up to 35-40 years).This is achieved, as a rule, due to the constant tension of the ciliary muscle of the organ of vision, which ensures the retention of the lens in the convex state, and this, as is known, increases its refractive power.

In the future, the ability to accommodation inevitably decreases, and by about 60 years the possibility of compensation is completely exhausted. As a result, we have a steady decrease in image clarity and at a distance when looking at, and when seeing objects near.

In this case, it is customary to talk about the so-called senile hyperopia, which, as already mentioned above, is usually called presbyopia. Restoration of vision with farsightedness of this type is possible only with the constant use of glasses with collecting lenses. That is why in terms of hypermetropia, designation is used in positive( positive) diopters.

By the way, this fact is the answer for those people who ask a question from the category: farsightedness is a plus or minus?

It must also be said that the development of hypermetropia is characterized by a condition such as aphakia. This is a congenital or acquired absence of the lens, most often associated with its removal( for example, in the surgical struggle with cataracts) or with trauma of this eye structure( for example, lens dislocation).

With the development of such a state, the refractive power of the ocular media is greatly reduced. Visual acuity can be of the order of 0.1.In this case, correction with strong positive glasses or implantation of an intraocular lens is required.

Signs of progressive farsightedness

Signs of hyperopia of low degree at a young age, as a rule, are not expressed. Vision both near and far is maintained at a fairly good level due to the accommodation tension.

The average degree of the described ailment is characterized by the fact that long-range vision remains practically unaffected. But during work at close range, such symptoms as the appearance of rapid fatigue in the visual apple, the appearance of pain in the eyes, as well as in the region of the brow, in the forehead and in the nose are developing. There is visual discomfort, which is joined by the feeling that letters and even lines merge with each other and become vague. The object in question is always wanting to be kept away from the eyes, and the workplace is better illuminated.

Symptoms of hyperopia of a high degree are expressed in a significant decrease in vision near and far, as well as in the appearance of asthenopic symptoms, which include a feeling of "sand" and raspiraniya in the eyes, pain in the head and rapid development of visual fatigue.

In the absence of correction of congenital hyperopia in children, the likelihood of joining the existing ailment of a converging( or so-called friendly) strabismus becomes quite high. The reason for this is the fact that in order to achieve the best visibility of vision it is necessary to keep the oculomotor muscles in constant tension so that the eyes are reduced to the nose. Progressive farsightedness in a compartment with strabismus can lead to the development of amblyopia.

With hypermetropia, recurrent inflammatory diseases of the eyelid and connective membrane are quite common. Often against its background, barley or haljazion occur. All this is usually due to the fact that people with hypermetropia involuntarily rub their eyes, thus contributing to the introduction of infectious agents.

In older people, this disease appears to be one of the factors that lead to the development of glaucoma .

Farsightedness test: how to check the disease

This disease is usually diagnosed by an oculist who knows how to determine hyperopia during visual acuity testing.

As a rule, visometry in the case of hypermetropia is carried out without correction, using test positive lenses( the so-called refractive index test).

Diagnosis of the described ailment should always include a study of refraction. This can be a skiascopy or a computer variant of refractometry.

In young patients or children, refractometry as a test for the farsightedness of a latent version of the flow is usually carried out under conditions of induced cycloplegia( the scientific name of the parony of the ciliary muscle of the eye) and mydriasis( in simple terms, the dilatation of the pupil), which are achieved by instillation of a drug called Atropine.

ultrasound, as well as echobiometry as diagnostic methods for hypermetropia are used to determine the size of the anteroposterior axis of the organ of vision.

Quite important action of the doctor besides how to test for farsightedness is also the detection of concomitant eye diseases. For this purpose, peri- or tonometry, ophthalmic or gonioscopy, biomicroscopy and other studies can be performed.

How to cure an eye disease of the farsightedness

When speaking about conservative methods of treating hyperopia, it should be noted immediately that in the absence of asthenopic complaints and stable binocular vision of preserving its acuity and for that, and for the other eye is not & lt;1.0 correction is not shown.

In respect of infant hyperopia, perhaps the main method of correction is the selection of glasses. In this preschoolers with a degree of hyperopia over +3 diopters should be assigned glasses for permanent wearing. If by the age of 6-7 years during the medical observation of the condition of the visual organ there is no tendency to the formation of strabismus and / or amblyopia, it is quite possible to abolish the eye correction used to correct the farsightedness.

If among the symptoms of hypermetropia there is an asthenopia, then in view of the existing individual characteristics and the presence of concomitant diseases, as a rule, selection of "plus" glasses( instead of them you can use corrective contact lenses).

How to improve hyperopia: correction and vitamins

In some cases, with visual impairments within +3 diopters, doctors prescribe night orthokeratological lenses to patients. And as a solution to the question of how to improve the correction of hyperopia in the presence of a high degree of disease, write out either complex glasses or two pairs of glasses, one of which is intended for work at close range, while others are required for use in long-distance operation.

Also in the quality of conservative therapy of the disease under consideration is used the course hardware treatment and the appointment of a complex of physiotherapeutic procedures. The first includes software and computer treatment, as well as the use of devices such as Ambliocor or, for example, Amblyotrener, as well as Synoptophor or, say, "Rucheyk" and many others. Physiotherapy consists in the direction of the massage of the neck-collar zone, the appointment of laser or magnetotherapy, etc.

The use of supplements and vitamins for hyperopia can also give a definite positive result. And when watching TV, doctors recommend putting on perforating glasses, which help to reduce the tension of accommodation.

How to treat hyperopia in adults: laser therapy

Starting from the age of 18, when considering how to cure hyperopia, which is within +6 diopters, you can think about laser correction.

In this regard, the most popular techniques are those such as LASIK and LASEK, as well as Super LASIK or, for example, EPI-LASIK.Do not forget about the PRK, i.e.photorefractive keratectomy.

Of course, any of these methods are specific features, has its own testimony, as well as contraindications. Nevertheless, their essence is to form a corneal surface with individual parameters.

It is worth noting that the excimer laser correction favorably differs from its nontraumatic. This fact excludes the development of complications from the cornea of ​​the eye and minimizes the likelihood of occurrence of astigmatism.

Correcting hyperopia by surgical intervention

When deciding how to treat hyperopia in adults, ophthalmologists can recommend surgical intervention. It can consist, for example, in the refractive replacement of the lens. In this case, the eye's own lens is removed( this is called a lenseectomy) and instead of it an intraocular lens of the required optical power is inserted( this procedure is called hyperartiphakia).This method of treatment is used, including, and with presbyopia.

Surgical methods include the treatment of hyperopia by hyperphagia( with the implantation of a positive phakic lens), the use of thermokeratocoagulation or keratoplasty.

Eye disease prevention of farsightedness

When talking about how to treat hyperopia, one should not forget about the prevention of this disease.

In the case of detection of hypermetropia, the patient must strictly follow all the prescribed recommendations and adhere to the correct visual regimen. In particular, to use sufficient lighting, to engage in eye gymnastics and alternate moments of visual work with periods of active rest.

Similar recommendations apply to the prevention of hyperopia. We must not forget that complications of this disease can be amblyopia and strabismus, glaucoma and recurrent inflammatory processes in the eyes. Therefore, all patients suffering from hypermetropia are recommended to visit the ophthalmologist at least 2 times a year.