Hyperopia, or farsightedness, is generally present from birth. It may not be instantly recognizable in mild cases, which can go undetected for years until the child is old enough to recognize images. At that point, the farsightedness can become apparent.

It is quite normal for many children to be farsighted, especially when they are younger. In many children, the farsightedness disappears before the teenage years.

Onset and Treatment
Although farsightedness is normally present at birth, the eye can correct itself naturally as it grows. The eye stops growing around age nine. If at that point there is still a small amount of farsightedness present, the lens of the eye may change its shape to fix the eyes’ vision, a process called accommodation.
Around age forty when the eyes start to degrade, the lens can lose its flexibility and this accommodation can disappear, resulting in a condition called presbyopia. Presbyopia is actually a natural symptom of the aging process and refers to the eyes’ diminishing ability to focus.

Around this age people start having trouble with close work- any work that requires the eyes to focus on an object close to them. They may also have trouble seeing objects far away as well.

Symptoms of hyperopia include headaches, aching eyes, eye strain and trouble seeing objects that are up close.

A farsighted person may need to wear glasses or contacts to correct their vision or they may need no treatment at all as the eye can adjust to make up for the farsightedness. Farsightedness is common in children and often has no impact on the quality of life for the farsighted child in most mild cases.

A child with hyperopia may rub their eyes a lot, complain of headaches, and may have trouble reading. This difficulty with reading may present as a lack of interest in younger children.
Hyperopia in children can be hard to detect. For example, a child who has hyperopia may not stand very far away from the TV screen to see. They may stand right up close to it.

This is because the farsighted child is used to not being able to focus on finer details and standing closer to the screen allows them to at least see blurry images.

Their eyes have never been able to see fine detail, unlike a nearsighted child, who knows they can see fine detail at certain distances. A nearsighted child has very good vision at a closer range and is used to being able to see detail when objects are held close to the face.

The compensating behavior of a nearsighted child and a farsighted child might look the same on the outside. Only an eye exam by a professional can diagnose whether a child is farsighted or nearsighted.

Hyperopia is another name for farsightedness. Farsighted may sound like the opposite of nearsighted, but it is not. Farsightedness is actually very different from nearsightedness.

Nearsighted people can see close up objects and have trouble with seeing objects at a distance. Farsighted people have trouble focusing on objects in general due to a refractive error in the eyes.

Refraction is the bending of light. When a light wave enters the eye, it is bent by the cornea as it makes its way through to land on the retina. In a normal eye, the flexibility of the lens, the curvature of the cornea and the length of the eye work together to produce a clear image on the retina.

In a farsighted person, either the eye is too short or the cornea is too flat. This causes the point of focus to occur behind the retina instead of on top of it. Hyperopia is not an eye disease, but an eye disorder. Because of the role refraction plays in farsightedness, hyperopia is known as a refractive disorder.

Hyperopia, or farsightedness, is generally present from birth. It may not be instantly recognizable in mild cases, which can go undetected for years until the child is old enough to recognize images. At that point, the farsightedness can become apparent.

It is quite normal for many children to be farsighted, especially when they are younger. In many children, the farsightedness disappears before the teenage years.

Onset and Treatment
Although farsightedness is normally present at birth, the eye can correct itself naturally as it grows. The eye stops growing around age nine. If at that point there is still a small amount of farsightedness present, the lens of the eye may change its shape to fix the eyes’ vision, a process called accommodation.
Around age forty when the eyes start to degrade, the lens can lose its flexibility and this accommodation can disappear, resulting in a condition called presbyopia. Presbyopia is actually a natural symptom of the aging process and refers to the eyes’ diminishing ability to focus.

Around this age people start having trouble with close work- any work that requires the eyes to focus on an object close to them. They may also have trouble seeing objects far away as well.

Symptoms of hyperopia include headaches, aching eyes, eye strain and trouble seeing objects that are up close.

A farsighted person may need to wear glasses or contacts to correct their vision or they may need no treatment at all as the eye can adjust to make up for the farsightedness. Farsightedness is common in children and often has no impact on the quality of life for the farsighted child in most mild cases.

A child with hyperopia may rub their eyes a lot, complain of headaches, and may have trouble reading. This difficulty with reading may present as a lack of interest in younger children.
Hyperopia in children can be hard to detect. For example, a child who has hyperopia may not stand very far away from the TV screen to see. They may stand right up close to it.

This is because the farsighted child is used to not being able to focus on finer details and standing closer to the screen allows them to at least see blurry images.

Their eyes have never been able to see fine detail, unlike a nearsighted child, who knows they can see fine detail at certain distances. A nearsighted child has very good vision at a closer range and is used to being able to see detail when objects are held close to the face.

The compensating behavior of a nearsighted child and a farsighted child might look the same on the outside. Only an eye exam by a professional can diagnose whether a child is farsighted or nearsighted.

Farsightedness in adults can be corrected via several surgical and non-surgical options:

Conductive keratoplasty: a non-surgical method where low-energy radio waves are used to re-shape the cornea. The waves shrink the connective tissue that hold the cornea in place and cause it to be stretched back into shape.
Laser eye surgery: A surgical procedure where vision is corrected by removing a small part of the eye with a laser. By using a highly focused laser beam, a specialist cuts away a bit of eye tissue, flattening the cornea and correcting the focus.
Intraocular lens transplant with clear lens extraction: A surgical procedure where the eye’s natural lens is replaced by an implant. The natural lens is removed, and a synthetic lens is put in its place. This allows most people to achieve 20/40 vision or better over time.

Diagnosis
Diagnosis of hyperopia can be made with a complete routine eye exam. The exam consists of questions about the patient’s eye sight and a physical inspection of the eyes.

The eye doctor’s inspection of the eyes consists of several tests. A retinoscope allows the doctor to see the surface of the retina, while phoropter allows them to measure the refractive error of the eye and assign a prescription.

When other causes of farsightedness, such as eye disease, are ruled out and the problem with vision is determined to be a refractive error, the doctor will use a phoropter. This is the machine that allows the doctor to show a series of lenses to a patient, switching back and forth between them to determine the best fit for corrective lenses.

Risks
In extreme cases of farsightedness, glasses may be needed to prevent accommodative esotropia, a crossing of the eyes. As the eye works to accommodate for farsightedness, the eyes may become crossed. Wearing glasses can straighten out the eyes and prevent them from crossing.

Another problem that can develop from extreme farsightedness is amblyopia. This is the most common cause of vision problems in children. Amblyopia is “a lazy eye”. It is caused by the brain ignoring signals from an eye producing blurred images, which makes the ignored eye weaker over time as it is not being used by the brain. Corrective treatment can include wearing glasses or wearing a patch over the normal eye to strengthen the weakened one.

There is no path of prevention for hyperopia. Taking care of your overall health is the best way to take care of your eye health. Not smoking, exercising and eating a healthy diet high in antioxidants are all ways to take care of your eyes by taking care of your body.

When to see an eye care professional
If you notice your child is squinting a lot or sitting closer to the TV, or if they have trouble catching a tossed ball, they might be affected by hyperopia. In adults, you may notice increased eye strain and headaches, trouble performing close work or aching eyes.

Always see an eye care professional immediately if you have any sudden changes in vision. This includes darkening around the edges of your vision, dark spots in front of your eyes, halos around bright lights, a loss of vision in one part of your field of sight or any other noticeable change.

Glaucoma is actually a group of eye diseases that lead to damage of the optic nerve (the bundle of nerve fibers that carries information from the eye to the brain), which can then lead to vision loss and the possibility of blindness.

Optic nerve damage usually occurs in the presence of high intraocular pressure, but glaucoma can occur with normal or even below-normal eye pressure.

There are two main forms of glaucoma: open-angle (which is the most common form and affects approximately 95% of individuals) and closed-angle. There are also several other varieties of glaucoma, including secondary, normal-tension, congenital, pseudoexfoliation syndrome, juvenile, neovascular, pigmentary, and irido-corneal-endothelial syndrome (ICE syndrome).

Worldwide, it is estimated that about 66.8 million people have visual impairment from glaucoma, with 6.7 million suffering from blindness. In the United States, approximately 2.2 million people age 40 and older have glaucoma, and of these, as many as 120,000 are blind due the disease. The number of Americans with glaucoma is estimated to increase to 3.3 million by the year 2020. Vision experts estimate that half of those affected may not know they have it because symptoms may not occur during the early stages of the disease.

Glaucoma is a leading cause of blindness among African Americans and Hispanics in the United States. African Americans experience glaucoma at a rate of three times that of Caucasians and experience blindness four times more frequently. Between the ages of 45 and 64, glaucoma is fifteen times more likely to cause blindness in African Americans than in Caucasians.

High-risk factors for open-angle glaucoma, the most common form of the disease, include being an African American and over 40, having a family history of the disease, and being over 60 for the general population. Those who are very nearsighted, have a history of diabetes, have experienced eye injury or eye surgery, or take prescription steroids also have an increased risk of developing glaucoma. It has also been suggested that individuals with Japanese ancestry may be at a greater risk for normal-tension glaucoma, and that those of Asian and Eskimo descent may have a greater risk for closed-angle glaucoma.

Open-angle glaucoma, by far the most common form, has no symptoms at first. At some point, side vision (peripheral vision) is lost and without treatment, total blindness will occur.

Closed-angle glaucoma (acute glaucoma) results from a sudden, complete blocking of the fluid flowing out of the eye. Symptoms may include severe pain, nausea, vomiting, blurred vision, and seeing a rainbow halo around lights. Closed-angle glaucoma is a medical emergency and must be treated immediately or blindness could result rapidly.

Currently, there is no “cure” for glaucoma; however, early diagnosis and treatment can control glaucoma before vision loss or blindness occurs.

There are several tests that can help your eye care professional detect glaucoma; these include a visual acuity test, visual field test, dilated eye exam, tonometry (which measures the pressure inside of the eye), and pachymetry (which uses ultrasonic waves to help determine cornea thickness). Individuals at high risk for glaucoma should have a dilated pupil eye examination, and a visual field test annually.

Early treatment for open-angle glaucoma will usually begin with medications (pills, ointments, or eyedrops, for example) that either help the eye to drain fluid more effectively or cause it to produce less fluid. Several forms of laser surgery can also help fluid drain from the eye. Incisional surgery to create a new opening for fluid to drain is usually performed after the other treatment options have failed.

When a patient has glaucoma or is at high risk for developing the disease, physicians may document how the optic nerve changes over time by making drawings, taking photographs, or using a new technique called optic nerve imaging. Scanning laser polarimetry (GDx), confocal scanning laser ophthalmoscopy (Heidelberg Retinal Tomograph or HRT III), and optical coherence tomography (OCT) are all examples of optic nerve imaging techniques. The patient’s eye care professional will make the determination as to which method(s) to use.

New research is focusing not only on lowering pressure inside the eye, but is also exploring medications that will protect and preserve the optic nerve from the damage that causes vision loss as well as the role of genetic factors. There has been progress in understanding the genetics of glaucoma in the last few years. Genes have been found that are associated with congenital glaucoma, juvenile glaucoma, normal-tension glaucoma, adult-onset open-angle glaucoma, pigmentary glaucoma, and other conditions that are associated with secondary glaucoma.

Computer Vision Syndrome (CVS) is complex eye and vision problems related to near work which are experienced during, or related to computer use. CVS is characterized by visual symptoms which result from interaction with a computer display or its environment. In most cases, symptoms occur because the visual demands of the task exceed the visual abilities of the individual to comfortably perform the task.

Computer vision syndrome (CVS) affects three out of four computer users. It is a series of symptoms related to extended periods of computer usage. Although it is no cause for panic, measures can be taken to relieve symptoms of CVS.

CVS can appear as a variety of symptoms. Headaches, eye strain, neck and back aches, sensitivity to light, blurred vision, double vision, and dry or irritated eyes are all possible problems related to CVS.

Any computer user can develop CVS. Your vision, your computer, and the environment where you use your computer are all factors that can lead to CVS.

There are many aspects of computers and the work environment in which they are used which may cause or contribute to the development of eye or vision difficulties. To obtain optimum visual comfort and work efficiency, all computer operators who could benefit from a visual correction should wear it. One way to help ensure this is to remove financial barriers to the employee for obtaining an eye examination and, when needed, treatment for eye and vision problems. This can often be accomplished by having an employer or third party sponsored program which provides eye care services for employees who work at computers.

As part of an eye care program for computer operators, it may be necessary to determine whether any treatment, usually in the form of eyeglasses, is specific to the computer task or whether the same glasses or treatment would be required for general vision needs. This may establish whether the employee is eligible to receive occupationally related eye care services under the program.

Whether a particular vision condition requires correction with eyeglasses or other treatment depends upon the clinical findings and the judgment of the examining doctor. However, the following criteria are recommended to help determine whether the care provided is computer related. These criteria are based upon the individual diagnosis and/or prescribed treatment. Since it is necessary for computer operators to have an eye and vision examination to determine whether these criteria are met, it is recommended that an examination be provided as part of the computer eye care program.

Vision problems occur frequently among video display terminal (VDT) workers. Most worker health surveys show that the most frequent health related complaints among workers at VDTs are visually related. However, more public and professional attention is currently being directed towards the avoidance of musculoskeletal disorders such as wrist problems (e.g., Carpal Tunnel Syndrome), bursitis, muscle strains (e.g., neck tension syndrome), tendon disorders (e.g., de Quervain’s disease), and tenosynovitis (e.g., trigger finger) among others. These disorders are generally classified as Cumulative Trauma Disorders (CTD) or as Repetitive Strain Injuries (RSI).

VDT related vision problems are at least as significant a health concern as the musculoskeletal disorders. Most studies indicate that visual symptoms occur in 50-90% of VDT workers, while a study released by NIOSH showed that 22% of VDT workers have musculoskeletal disorders. A survey of optometrists indicated that 10 million primary eye care examinations are provided annually in this country primarily because of visual problems at VDTs – not a small public health issue. Vision problems are pervasive among computer workers and are the source of worker discomfort and decreased work performance.

There appears to be a communication gap regarding the nature and extent of vision problems related to VDT use. The vision problems experienced by VDT workers are varied and are difficult to grasp and understand by those who don’t specialize in vision. The misunderstanding may also be the result of unfounded reports of cataracts caused by VDTs, exaggerated manufacturer claims about the need for UV and other radiation protections, and misleading statements about the effects of specialty tinted and coated lenses (e.g., computer glasses) among other products.

In order to improve communication and understanding of the vision problems at computers, the American Optometric Association supports the use of the term “Computer Vision Syndrome” (CVS) to broadly encompass the visual problems experienced at VDTs. CVS can be used to refer to the entirety of visual problems experienced by computer users and therefore improve communication and understanding of these problems. However, since there is not a single factor or visual disorder which causes the visual problems at computers, CVS encompasses many different symptoms, disorders and treatments.

Impact of Computer Use on Children’s Vision
When first introduced, computers were almost exclusively used by adults. Today, children increasingly use these devices both for education and recreation. Millions of children use computers on a daily basis at school and at home.

Children can experience many of the same symptoms related to computer use as adults. Extensive viewing of the computer screen can lead to eye discomfort, fatigue, blurred vision and headaches. However, some unique aspects of how children use computers may make them more susceptible than adults to the development of these problems.

The potential impact of computer use on children’s vision involves the following factors:

Children often have a limited degree of self-awareness
Many children keep performing an enjoyable task with great concentration until near exhaustion (e.g., playing video games for hours with little, if any, breaks). Prolonged activity without a significant break can cause eye focusing (accommodative) problems and eye irritation.

Accommodative problems may occur as a result of the eyes’ focusing system “locking in” to a particular target and viewing distance. In some cases, this may cause the eyes to be unable to smoothly and easily focus on a particular object, even long after the original work is completed.

Eye irritation may occur because of poor tearflow over the eye due to reduced blinking. Blinking is often inhibited by concentration and staring at a computer or video screen. Compounding this, computers usually are located higher in the field of view than traditional paperwork. This results in the upper eyelids being retracted to a greater extent. Therefore, the eye tends to experience more than the normal amount of tear evaporation resulting in dryness and irritation.

Children are very adaptable
Although there are many positive aspects to their adaptability, children frequently ignore problems that would be addressed by adults. A child who is viewing a computer screen with a large amount of glare often will not think about changing the computer arrangement or the surroundings to achieve more comfortable viewing. This can result in excessive eye strain. Also, children often accept blurred vision caused by nearsightedness (myopia), farsightedness (hyperopia), or astigmatism because they think everyone sees the way they do. Uncorrected farsightedness can cause eye strain, even when clear vision can be maintained.

Children are not the same size as adults.
Since children are smaller, computers don’t fit them well. Most computer workstations are arranged for adult use. Therefore, a child using a computer on a typical office desk often must look up further than an adult. Since the most efficient viewing angle is slightly downward about 15 degrees, problems using the eyes together can occur. In addition, children may have difficulty reaching the keyboard or placing their feet on the floor, causing arm, neck or back discomfort.

Children often use computers in a home or classroom with less than optimum lighting
The lighting level for the proper use of a computer is about half as bright as that normally found in a classroom. Increased light levels can contribute to excessive glare and problems associated with adjustments of the eye to different levels of light.

Steps to Visually-Friendly Computer Use
Here are some things to consider for children using a computer. Children have different needs to comfortably use a computer. A small amount of effort can help reinforce appropriate viewing habits and assure comfortable and enjoyable computer use.

Have the child’s vision checked.
This will make sure that the child can see clearly and comfortably and can detect any hidden conditions that may contribute to eye strain. When necessary, glasses, contact lenses or vision therapy can provide clear, comfortable vision, not just for using the computer, but for all other aspects of daily activities.

Strictly enforce the amount of time that a child can continuously use the computer.
A ten-minute break every hour will minimize the development of eye focusing problems and eye irritation caused by improper blinking.

Carefully check the height and arrangement of the computer.
The child’s size should determine how the monitor and keyboard are positioned. In many situations, the computer monitor will be too high in the child’s field of view, the chair too low and the desk too high. A good solution to many of these problems is an adjustable chair that can be raised for the child’s comfort, since it is usually difficult to lower the computer monitor. A foot stool may be necessary to support the child’s feet.

Carefully check the lighting for glare on the computer screen.
Windows or other light sources should not be directly visible when sitting in front of the monitor. When this occurs, the desk or computer may be turned to prevent glare on the screen. Sometimes glare is less obvious. In this case, holding a small mirror flat against the screen can be a useful way to look for light sources that are reflecting off of the screen from above or behind. If a light source can be seen in the mirror, the offending light should be moved or blocked from hitting the screen with a cardboard hood (a baffle) attached to the top of the monitor. In addition, the American Optometric Association has evaluated and accepted a number of glare screens that can be added to a computer to reduce glare. Look for the AOA Seal of Acceptance when purchasing a glare reduction filter.

Reduce the amount of lighting in the room to match the computer screen.
Often this is very simple in the home. In some cases, a smaller light can be substituted for the bright overhead light or a dimmer switch can be installed to give flexible control of room lighting. In other cases, a three-way bulb can be turned onto its lowest setting.
Children have different needs to comfortably use a computer. A small amount of effort can help reinforce appropriate viewing habits and assure comfortable and enjoyable computer use.

Astigmatism is a very common disorder and is easily corrected. Most of us have some degree of astigmatism. Astigmatism results in blurred vision at all distances. It is known as a refractive disorder of the eye. Refraction is the bending of light. When a light wave enters the eye, it is bent by the cornea as it makes its way through to land on the retina. The cornea, lens and retina contribute to clear vision at all distances. In astigmatism, vision is blurred due to either an irregularly shaped cornea or lens.

Causes
Lenticular astigmatism is rarer and caused by an irregularly shaped lens. It is associated with diabetes as blood sugar levels can result in a change in the lens’ shape. Corneal astigmatism is much more common and caused by an irregularly shaped cornea. The cornea is normally symmetrical and round, but in astigmatism the cornea can become elongated like a football. This causes the light rays to split in the eye, never achieving a singular point of focus.

Why some people are born with an elongated cornea is unknown. Some studies show that it could be hereditary. Astigmatism is prevalent in premature babies and babies born at a low body weight.

Astigmatism can be caused by injury to the eye and subsequent scarring of the cornea. Some surgeries that can scar the cornea may also cause astigmatism. Keratoconus, a disease of the eye that causes a thinning of the cornea to occur, can cause astigmatism by changing the shape of the cornea.

Diagnosis
A diagnosis of astigmatism can be made during the course of a comprehensive eye exam. A phoropter allows the doctor to show a series of lenses to a patient, switching back and forth between them to determine the best fit for corrective lenses.

A keratometer, a device to measure the curvature of the cornea, may be used as well. Corneal topography is a technologically advanced treatment where computer imaging is used to make a map of the cornea. This map provides the most complete view of the cornea and is used when diagnosing astigmatism, as well as being used to fit contacts to the eye and prepare patients for eye surgery.

Onset and Treatment
Astigmatism reveals itself early. While slight cases of astigmatism may not need to be corrected, large amounts of astigmatism can cause blurred vision, headaches and eye strain.

People who have myopia, nearsightedness, or hyperopia, farsightedness, are likely to have some degree of astigmatism. Myopia, hyperopia and astigmatism are all known as refractive disorders as they affect the way that the eye is able to bend, or refract, light rays onto the retina.

A complete eye exam will test for astigmatism. Retinoscopy or an automatic refraction test may be performed to detect astigmatism.

Treatment options for astigmatism include eyeglasses or contact lenses. Orthokeratology is another treatment that involves wearing special contact lenses that gradually reshape the cornea into its proper dimensions.

Advanced Treatment
Advanced treatments for astigmatism include:
• Laser eye surgery: A surgical procedure where vision is corrected by removing a small part of the eye with a laser. Using a highly focused laser beam, a specialist cuts away a bit of eye tissue, flattening the cornea and correcting the focus.

• Astigmatic keratotomy: A surgical procedure where the cornea is reshaped by a surgeon. Tiny cuts are made in the cornea along the steepest curves, refocusing the light that enters the eye to its proper place. This surgery is replacing laser eye surgery as the preferred treatment for high levels of astigmatism.

There is no known way to prevent astigmatism. Maintaining overall health as a means to eye health is always recommended. Fruits and vegetables high in vitamins A, C and E are key foods for eye health.

Taking frequent breaks while doing close work allows the ocular muscles to unwind and can help ward off eye strain. Try looking off into the distance every ten minutes or so to keep your eyes relaxed. Wearing sunglasses to prevent UV damage to the eyes helps keep vision sharp later in life.

When to see an eye care professional
If you are experiencing headaches, fatigue, eye strain or blurred vision, you may have astigmatism and should be examined by an optometrist or ophthalmologist.

Always see an eye care professional immediately if you have any sudden changes in vision. This includes darkening around the edges of your vision, dark spots in front of your eyes, halos around bright lights, a loss of vision in one part of your field of sight or any other noticeable change.