Key takeaways:
Hyperopia, or farsightedness, can affect people of all ages — including children.
After the age of 40, a natural condition called presbyopia causes many people to need reading glasses.
Glasses, contact lenses, and surgery can be treatment options for both hyperopia and presbyopia.
Although farsightedness is another name for hyperopia, it’s not the same as presbyopia, which is also called age-related farsightedness. Is that blurry enough for you?
These conditions are sufficiently confusing without adding similar-sounding names into the mix! But both hyperopia and presbyopia are common. Keep reading to find out more about the differences between them, what causes them, and what to do if they’re creating problems for you.
What is hyperopia?
Hyperopia is simply another name for farsightedness. People with hyperopia see objects far away more clearly than they see objects up close. Objects that are up close look blurry.
Hyperopia is caused by the natural shape of your eyeball. If you have hyperopia, the front-to-back length of your eye is too short, causing your focus to be a bit off. Because eyeball shape is something you are born with, hyperopia affects both children and adults.
Your natural lenses are clear, cushion-shaped discs inside your eyes. You bend these lenses (without even realizing it) when you focus up close. Often, young people don’t notice hyperopia right away. That’s because the natural lenses inside their eyes are soft and easy to adjust.
People who are farsighted need to bend their lenses quite a bit to make up for the shape of their eyes. The closer they want to see, the harder they have to work.
What is presbyopia?
Past the age of 40, our lenses get stiffer. This is called presbyopia, and it causes us all to lose some of our ability to focus our eyes. It shows up as trouble seeing things that are up close — like a newspaper.
Presbyopia occurs because of molecular changes that happen inside our lenses over time. Our lenses become more difficult to bend, so we have to work harder to see objects that are right in front of our faces.
Ultimately, presbyopia is the loss of our ability to change our eyes’ focus.
Can you have presbyopia if you’re farsighted?
Yes. People who are naturally farsighted will start to notice presbyopia sooner than people who are not farsighted. That’s because people with hyperopia really need to work hard to see up close. As presbyopia sets in and their lenses get stiffer, the extra work becomes noticeable very quickly.
Can you have presbyopia if you’re nearsighted?
Yes. However, if you’re nearsighted, your eyes focus up close naturally — without bending your lenses much at all. That means presbyopia doesn’t cause as much of a problem right away.
What are the options for treating hyperopia and presbyopia?
Glasses, contact lenses, or surgery can help you see more clearly when you have hyperopia, presbyopia, or both.
Glasses
For hyperopia, you’ll want prescription glasses. These glasses provide extra focus all the time.
If you have presbyopia, over-the-counter reading glasses could be more helpful. These glasses are intended to be used only when you’re reading or working on something right in front of your face. They provide an extra boost of focusing power to make close-up objects clear.
Bifocals can be a good choice for people who have both hyperopia and presbyopia. They allow you to have two different prescriptions in a single lens — your regular one at the top and a stronger one at the bottom.
Contact lenses
Prescription contact lenses are an alternative to glasses for people with hyperopia. These lenses add extra focusing power all the time.
When presbyopia kicks in, you’ll find your regular contact lenses aren’t strong enough to give you clear up-close vision. At that point, you can:
Get stronger contacts (but not too strong, because you’ll still want to keep your distance vision clear for driving).
Keep your regular contacts, and pull on reading glasses when you want to see up close.
Use a stronger contact in one eye (for up-close vision), and use a weaker contact in the other eye (for distance vision). This is called monovision.
Surgery
Although hyperopia can be treated with refractive surgery, like LASIK or PRK, these surgeries don’t work as well for hyperopia as they do for nearsightedness. Plus, since this type of surgery doesn’t affect your lens (it’s an adjustment of your cornea), it doesn’t stop presbyopia — and that means your vision will continue to change as you get older.
Refractive lens exchange (RLE), also called clear lens exchange, is another option for people with both hyperopia and presbyopia. In a procedure similar to cataract surgery, your natural lens is removed and replaced with a permanent intraocular lens implant. Since intraocular lenses come in a variety of strengths and multifocal combinations, you can work with your eye surgeon to find a solution that works for you.
The bottom line
Both hyperopia and presbyopia make it hard to see objects up close, but they’re actually different visual problems. Hyperopia is a life-long condition that requires you to focus more strongly when you need to see up close. Presbyopia kicks in later, and makes focusing itself more difficult. Various treatment options, including glasses, contacts, and surgery, can help.
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References
Alió, J. L., et al. (2014). Refractive lens exchange in modern practice: When and when not to do it? Eye and Vision.
Boyd, K. (2014). Farsightedness: What is hyperopia? American Academy of Ophthalmology.
Boyd, K. (2018). What is monovision (or blended vision)? American Academy of Ophthalmology.
Boyd, K. (2022). What is presbyopia? American Academy of Ophthalmology.
Katz, J. A., et al. (2021). Presbyopia – A review of current treatment options and emerging therapies. Clinical Ophthalmology.
