Diagnosis of hyperopia
The evaluation and diagnosis of the patient with hyperopia aims to assess his clinical conditions, identify related conditions and possible co-morbidities, and correct of the patient refraction errors. Clinical evaluation of hyperopia assesses different aspect of the eye structurally and functionally.
– Assessing the patient visual acuity
The visual acuity of the patient depends on multiple factors such as
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- accommodation power to fully correct the patient hyperopia or not
- age of the patient on the time of the evaluation
- internal structure of the eye especially crystalline lens and the posterior chambre of the eye
so visual acuity in children may not be affected due to full accommodation effect, and there is no associated eye condition e.g., cataract, glaucoma, and other retinal diseases. In high degree of hyperopia distant vision could also be affected. Associated amblyopia would also compromise the visual acuity of the patient.
– Diffuse illumination by slit lamp
The slit lamp could give a good picture about the eye structures. In hyperopia the cornea and eyeball may be smaller. Examination of the anterior chambre could reveal shallow anterior segment. The slit lamp is used with a gonio lens to examine the iridocorneal angle. The gonioscopy is a mandatory for all cases of hyperopia to exclude closure angle in patients with hyperopia. Cataract should be excluded in
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- old age
- patients with diabetes
– Fundus examination
Fundoscopy is an important part of the clinical evaluation of hyperopia patients to rule out some associated retinal diseases such as pseudopopulist or pseudo papilledema.
– Cover test
This test is usually helpful in children with long term hyperopia without correction. Uncorrected hyperopia for long time may lead to accommodation squint.
