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Lecture III Hypermetropia

Hyperopia, also known as farsightedness, is a refractive error where the eye focuses images behind the retina. It can be classified based on structure, degree, role of accommodation, and cycloplegia response. Signs include blurred vision, asthenopia, and amblyopia. Diagnosis involves patient history, visual acuity testing, retinoscopy, and ocular examination. Management options include optical correction, vision therapy, pharmaceuticals, and environmental modifications.

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Henok Biruk
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199 views20 pages

Lecture III Hypermetropia

Hyperopia, also known as farsightedness, is a refractive error where the eye focuses images behind the retina. It can be classified based on structure, degree, role of accommodation, and cycloplegia response. Signs include blurred vision, asthenopia, and amblyopia. Diagnosis involves patient history, visual acuity testing, retinoscopy, and ocular examination. Management options include optical correction, vision therapy, pharmaceuticals, and environmental modifications.

Uploaded by

Henok Biruk
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Lecturer three

Hyperopia
Gizachew T.
09/27/20 1
Out line
– Definition of hyperopia
– Classification of hyperopia
– Risk factors of hyperopia
– Natural history of hyperopia
– Common signs and symptoms and complications of
hyperopia
– Diagnosis of hyperopia
– Management of hyperopia
– Prognosis of hyperopia
– Quiz

09/27/20 Gizachew T. 2
Definition
Hyperopia - is a refractive error in which
parallel rays of light entering the eye reach a
focal point behind the plane of the retina, while
accommodation is relaxed.

09/27/20 Gizachew T. 3
• Even though it is physiological to get hyperopia in
children, its impact on visual development is critical.
• The effect varies widely, depending upon:
1. the magnitude of hyperopia
2. the age of the Px
3. the status of the accommodative and convergence
system
4. the demands placed on the visual system.
.

09/27/20 Gizachew T. 4
Cont.…..
• Individuals with uncorrected hyperopia may
experience:
• Blurred vision
• Asthenopia
• Accommodative dysfunction
• Binocular dysfunction
• Amblyopia
• Strabismus

09/27/20 Gizachew T. 5
Classification of Hyperopia

Basis of classification
• Ocular structure
• Clinical characteristics
• Degree
• Role of accommodation
• Effect of cycloplegia

1. Based on ocular structure


correlational hyperopia-normal refractive component with
minimal deviation from the normal
component hyperopia- a large deviation of refractive optical

component from the normal


09/27/20 Gizachew T. 6
2. Clinically hyperopia can be divided into
three categories:
1. Simple hyperopia: due to normal biological
variation
can be of axial or refractive type.
2.Pathological hyperopia is caused by abnormal
ocular anatomy due to maldevelopment, ocular
disease, or trauma.
3. Functional hyperopia results from paralysis of
accommodation

09/27/20 Gizachew T. 7
Cont.…
3) Hyperopia may also be categorized in to three by
degree of refractive error:
1. Low hyperopia up to ----+2.00 D
2. Moderate hyperopia ---- +2.25 to +5.00 D.
3. High hyperopia --------- >+5.00 D

09/27/20 Gizachew T. 8
4) Based on the role of accommodation:
1. Facultative hyperopia-overcome by accommodation.
 can be obtained by dry refraction when accom. is relaxed.
2. Absolute hyperopia: cannot be compensated with
accommodation
•The total magnitude of hyperopia is the sum of absolute and
facultative hyperopia.
5) Based on the outcome of dry and cycloplegic
refractions:
1. Manifest hyperopia: determined by non cycloplegic refraction,
may be either facultative or absolute.
2. Latent hyperopia : detected only by cycloplegic refraction, can
be overcome by accommodation/inherent tone of cilliary
muscle.
The sum of latent and manifest hyperopia is equal to the
magnitude
09/27/20 of hyperopia. Gizachew T. 9
clinical features
1. Physiologic Hyperopia
– Accounts the vast majority of the cases
– Due to an incongruence B/n AL and optical power
Etiologies
– Hereditary factors
– some environmental influence
– Relatively flat corneal curvature
– Insufficient crystalline lens power
– Increased lens thickness
– Short axial length

09/27/20 Gizachew T. 10
Symptoms, Signs, and Complications
• Constant to intermittent blurring of vision
• Asthenopia
• Red, teary eyes
• Frequent blinking
• Decreased binocularity
• Difficulty reading
• Amblyopia
• Strabismus
09/27/20 Gizachew T. 11
Cont.…..
•Active accommodation typically enables young
patients to overcome facultative and latent
hyperopia, but it may not be sustainable for long
periods under conditions of visual stress.
•signs and symptoms occur more readily and to
a greater degree in manifest and absolute
hyperopia.

09/27/20 Gizachew T. 12
2. Pathologic Hyperopia
• Hyperopia that results from abnormal biologic
variation of the refracting components of the eye
• May be due to maldevelopment of the eye during the
prenatal or early in postnatal period.
 Etiology
• Maldevelopment of the eye during the prenatal or early
postnatal period
• Corneal or lenticular changes
• Chorioretinal or orbital inflammation or neoplasms
• Neurologic or pharmacologic

09/27/20 Gizachew T. 13
Risk Factors
– Diabetes mellitus
– Contact lens wear
– Intraocular and orbital tumors
– Ocular inflammations.

09/27/20 Gizachew T. 14
cont.…..
• High hyperopia increases the risk of amblyopia
and strabismus.
• Young persons with hyperopia generally have
sufficient accommodative reserve to maintain
clear retinal images without producing
asthenopia.

09/27/20 Gizachew T. 15
Common Signs, Symptoms, and
Complications
– Fatigue
– Blurred vision
– Asthenopia
– Redness
– Squinting
– Decrease eye-hand coordination
– Esophoria
– Vergence problem

09/27/20 Gizachew T. 16
Diagnosis of Hyperopia
1. Patient History
– review of the nature of the presenting problem
and chief complaint,
– ocular and general health history,
– developmental and family history,
– use of medications and medication allergies, and
– vocational and avocational vision requirements.
– A positive family history of hyperopia,
amblyopia, or strabismus increases.
09/27/20 Gizachew T. 17
2. Ocular Examination
a. Visual Acuity
b. Refraction
• Static retinoscopy.
• Near point retinoscopy.
• Cycloplegic retinoscopy
• Subjective refraction.
• Autorefraction.
c. Ocular Motility, Binocular Vision, and Accommodation
d. Ocular Health Assessment and Systemic Health
Screening

09/27/20 Gizachew T. 18
Management of Hyperopia
1. factors to consider when planning treatment and
management strategies are:
• the magnitude of the hyperopia,
• the presence of astigmatism or anisometropia,
• the patient's age,
• the presence of an associated esotropia and/or
amblyopia,
• the status of accommodation and convergence,
• the demands placed on the visual system, and
• the patient's symptoms

09/27/20 Gizachew T. 19
2. Available Treatment Options
a. Optical Correction
b. Vision Therapy
c. Medical (Pharmaceutical) Therapy
d. Modification of the Patient's habits and
Environment

09/27/20 Gizachew T. 20

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