Hyperopia, also termed hypermetropia or farsightedness, is a common refractive error in children

and adults. Its effect varies greatly, depending upon the magnitude of hyperopia, the age of the
individual, the status of the accommodative and convergence system, and the demands placed on
the visual system. Individuals with uncorrected hyperopia may experience: • Blurred vision •
Asthenopia • Accommodative dysfunction • Binocular dysfunction • Amblyopia • Strabismus.
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 maintained in a state of relaxation.2
Clinically, hyperopia may be divided into three categories:7 • Simple hyperopia, due to normal
biological variation, can be of axial or refractive etiology. • Pathological hyperopia is caused by
abnormal ocular anatomy due to maldevelopment, ocular disease, or trauma. • Functional
hyperopia results from paralysis of accommodation.
Hyperopia may also be categorized by degree of refractive error:8 • Low hyperopia consists of
an error of +2.00 diopters (D) or less. • Moderate hyperopia includes a range of error from +2.25
to +5.00 D. • High hyperopia consists of an error over +5.00 D.
A hyperopia classification scheme that relates the role of accommodation to visual functioning
adds an important dimension to structure-based classifications:
Facultative hyperopia is that which can be overcome by accommodation.8 • Absolute hyperopia
cannot be compensated with accommodation.9
The total magnitude of hyperopia is the sum of absolute and facultative hyperopia. The
classification of hyperopia can also be based upon the outcome of noncycloplegic and
cycloplegic refractions: • Manifest hyperopia, determined by noncycloplegic refraction, may be
either facultative or absolute. • Latent hyperopia, detected only by cycloplegia, can be overcome
by accommodation.
Physiologic hyperopia Hyperopia that occurs when the axial length of the eye is shorter than the
refracting components the eye requires for light to focus precisely on the retina • Hereditary
factors, with some environmental influence • Relatively flat corneal curvature • Insufficient
crystalline lens power • Increased lens thickness • Short axial length • Variance from normal
separation of optical components of the eye • • Constant to intermittent blurred vision •
Asthenopia • Red, teary eyes • Frequent blinking • Decreased binocularity • Difficulty reading •
Amblyopia • Strabismus
hyperopia Hyperopia that results from other than normal biologic variation of the refracting
components of the eye • Maldevelopment of the eye during the prenatal or early postnatal period
• Corneal or lenticular changes • Chorioretinal or orbital inflammation or neoplasms •
Neurologic- or pharmacologicbased causes • Related congenital or acquired ocular or systemic
disorders
1. Moore, Bruce. Optometric Clinical Practice Guideline Care of the Patient With
Hyperopia.American Optometric Association.2008
2. Donders FC. London: New Syndenham Society, 1864:80-6.