Symptoms of hyperopia
The symptom of hyperopia depends on the age of the patient and the degree of hyperopia. The age of the patient at presentation is particularly important
- In young children, the child can not address his own complaints
- The accommodation effects may not be able to overcome high myopia degree in immature age
The degree of myopia has impact on the symptoms; on small refraction errors the accommodation can correct this error without the patient even notices, while in high errors the accommodation cannot compensate hence the patient may has clear symptoms. According to patient presentation, the patients of hyperopia can be classified into two categories:
1) Asymptomatic
In which the patient has a good ciliary muscle tone, and a good effective accommodation. This combination can overcome small degree of hyperopia without any notice from the patient.
2) Symptomatic
In this category the patient has a variety of symptoms or complaints such as
- Eye deviation: The parents usually notice this symptom. the deviation could be unilateral, or bilateral eye deviation, in this case the deviation could be alternative, or simultaneous. In a study by Lambo et al.founded that in young patient with hyperopia, the most common eye deviation was accommodative estropia, which is inward deviation of the eye. The prevalence of accommodation estropia in USA is near 1-2% of the population.
- Eye strain: it is also known as asthenopia, it is because of accommodation system working hard to correct the refraction error of hyperopia. The asthenopia is usually accompanied with other symptoms as headache, photophobia, lacrimation, and redness of the eye. The asthenopia can be triggered by prolonged sessions of near work activities.
- Diminished near vision: if the hyperopia is fully corrected with the effects of accommodations, after prolonged time, the patient may complaints of asthenopia and decrease in near object vision. If the hyperopia is higher more than the effect of accommodation to correct, the patient usually complains of diminished of near and far vision.
- Pseudo-myopia: it is a sudden attack of temporary blurry vision in adolescents and young adults with uncorrected hyperopia. This symptom may be due to prolonged use of accommodations.
- Recurrent conjunctivitis: refraction errors cause frequent rubbing of the eye, which could be a source of infection to the eye.
- Early-onset presbyopia: it is a gradual deterioration of the eye ability to visualize the near objects. In normal populations, presbyopia is part of the aging process; the normal person starts to experience it in early or mid-forties. In hyperopia, due to the deterioration of the accommodation power, the presbyopia may appear earlier than in emmetrope.
Clinically, hyperopia is classified into three main categories: simple, pathological, and functional
- Simple hyperopia:it is due to disturbance of the normal functions and structures of the eye
- Pathological hyperopia:it occurs following trauma, surgical, or diseases in the eye
- Functional hyperopia:it occurs in cases of accommodation fails or dysfunction
