FARSIGHTEDNESS

With farsightedness:

• Nearby objects may appear blurry
• You need to squint to see clearly
• You have eyestrain, including burning eyes, and aching in or around the eyes
• You experience general eye discomfort or a headache after a prolonged interval of conducting close tasks, such as reading, writing, computer work or drawing

If your degree of farsightedness is pronounced enough that you can’t perform a task as well as you wish, or if your quality of vision detracts from your enjoyment of activities, see an eye doctor. He or she can determine the degree of your farsightedness and advise you of options to correct your vision.

Since it may not always be readily apparent that you’re having trouble with your vision, the American Academy of Ophthalmology recommends the following intervals for regular eye exams:

Adults

If you don’t wear glasses or contacts, have no symptoms of eye trouble and are at a low risk of developing eye diseases, have a baseline eye exam around age 40. Then have an exam at the following intervals:

• Every two to four years between 40 and 54 years
• Every one to three years between 55 and 64 years
• Every one to two years beginning at age 65

If you’re at high risk of certain eye diseases, such as glaucoma, the frequency of visits should be increased to:

• Every two to four years up to age 40
• Every one to three years between 40 and 54 years
• Every one to two years from age 55 onward

If you wear glasses or contacts, you’ll likely need to have your eyes checked every year. Ask your eye doctor how frequently you need to schedule your appointments. But if you notice any problems with your vision, schedule an appointment with your eye doctor as soon as possible, even if you’ve recently had an eye exam. Blurred vision, for example, may suggest you need a prescription change, or it could be a sign of another problem.

Children and adolescents

Children need to be screened for eye disease and have their vision tested by a pediatrician, an ophthalmologist or another trained screener during the newborn period, and then at every routine health exam throughout early childhood.

Additionally, it’s recommended that school-age children be screened at school or through community programs approximately every two years to check for vision problems.

DIAGNOSIS

Farsightedness is diagnosed by a basic eye exam. A complete eye examination involves a series of tests. Your eye doctor may use odd-looking instruments, aim bright lights directly at your eyes and request that you look through an array of lenses. Each test allows your doctor to examine a different aspect of your eyes, including your vision.

RECOMMENDED MEDICATIONS

The goal of treating farsightedness is to help focus light on the retina through the use of corrective lenses or refractive surgery.

Corrective lenses

In young people, treatment isn’t always necessary because the crystalline lenses inside the eyes are flexible enough to compensate for the condition. But as you age, the lenses become less flexible and eventually you’ll probably need corrective lenses to improve your near vision.

Wearing corrective lenses treats farsightedness by counteracting the decreased curvature of your cornea or the smaller size (length) of your eye. Types of corrective lenses include:

• Eyeglasses. The variety of eyeglasses is wide and includes bifocals, trifocals, progressive lenses and reading lenses.
• Contact lenses. A wide variety of contact lenses are available — hard, soft, extended wear, disposable, rigid gas permeable and bifocal. Ask your eye doctor about the pros and cons of contact lenses and what might be best for you.

If you’re also having age-related trouble with close vision (presbyopia), monovision contact lenses may be an option for you. With monovision contacts, you may not need correction for the eye you use for distance vision (usually the dominant eye). But a contact lens can be used for close-up vision in your other eye. Some people have trouble adapting to this kind of vision because 3-D vision is sacrificed in order to be able to see both nearby and in the distance clearly. Monovision contacts can be worn intermittently as desired.

Modified monovision contact lenses are another option. With this type of contact lens, you can wear a bifocal contact lens in your nondominant eye and a contact lens prescribed for distance in your dominant eye. You can then use both eyes for distance and one eye for seeing objects nearby.

Refractive surgery

Although most refractive surgical procedures are used to treat nearsightedness, they can also be used for farsightedness. These surgical treatments correct farsightedness by reshaping the curvature of your cornea. Refractive surgery methods include:

• Laser-assisted in-situ keratomileusis (LASIK). LASIK is a procedure in which an ophthalmologist makes a thin, circular hinged flap cut into your cornea. Then your eye surgeon uses an excimer laser to remove layers from the center of your cornea to steepen its domed shape. An excimer laser differs from other lasers in that it doesn’t produce heat. After the laser is used, the thin corneal flap is repositioned.
• Laser-assisted subepithelial keratectomy (LASEK). Instead of creating a flap in the cornea, the surgeon creates a flap involving only the cornea’s thin protective cover (epithelium). Your surgeon will use an excimer laser to reshape the cornea’s outer layers and steepen its curvature and then reposition the epithelial flap. To facilitate healing, you may wear a bandage contact lens for several days after the procedure.
• Photorefractive keratectomy (PRK). This procedure is similar to LASEK, except the surgeon removes the epithelium. It’ll grow back naturally, conforming to your cornea’s new shape. You may need to wear a bandage contact lens for a few days following surgery.
• Conductive keratoplasty (CK). This procedure uses radiofrequency energy to apply heat to tiny spots around the cornea. The effect resembles plastic wrap being stretched by heat. The degree of change in the curvature of the cornea depends on the number and spacing of the spots as well as the way in which the cornea heals after treatment. The results of CK aren’t permanent.

Some of the possible complications that can occur after refractive surgery include:

• Undercorrection or overcorrection of your initial problem
• Visual side effects, such as a halo or starburst appearing around lights
• Dry eye
• Infection
• Rarely, vision loss

Discuss the potential risks and benefits of these procedures with your eye doctor.