Eye terminology can be very confusing. When your optometrist diagnoses you or your family members with farsightedness, that is usually the end of the explanation. Farsightedness can create so many different effects on your vision that it can seem like it’s not even a visual condition. Being farsighted (farsighted) usually results in good distance vision, with problems induced by near tasks such as reading and computer work. It is a somewhat confusing term as farsightedness is actually an optical error of distance vision, while the symptoms are more common when near vision is used.

To further complicate the situation, if your optometrist determines that your eye prescription is extremely farsighted, you will not see clearly near or far. If you are young and have a low or moderate degree of farsightedness, your vision may be clear for all distances. It’s no wonder people have a hard time understanding the concept of farsightedness and why ophthalmologists often shy away from trying to explain it. Fortunately, there is a muscle called the ciliary muscle that surrounds the lens of the eye and is attached to the lens with small fibers. Active contraction of this muscle loosens the tension in the lens of the eye and increases the focusing power of the eyes. In lesser amounts of farsightedness if you are under forty, the focusing ability of your eye can adapt to farsightedness and clear your vision both far and near easily. Eye doctors use the words focus and accommodation interchangeably to indicate that the eye muscle has been put to work to increase the eye’s power for near vision.

Farsightedness in even lower amounts has been shown to interfere with reading in some children and adults, but typically within two to three prescription units it begins to create vision-related symptoms. Children and adolescents have a tremendous amount of adaptations, and sometimes very large prescriptions for farsightedness are not noticed because they can clear near and far vision when focusing. They will often suffer from headaches and an unconscious aversion to reading due to eyestrain and the constant effort required to maintain clear vision. As we age, we gradually lose the ability to concentrate. This focus degradation begins between the ages of fifteen and twenty, but affects distances so close at first that we never notice it because we don’t use our vision an inch or two away.

Farsighted people have a different type of problem than nearsighted people. They have to constantly focus to keep their distance vision clear, and as objects get closer, they have to increase their focusing efforts even more. This isn’t a problem if you’re young and less farsighted, but as you get older or more farsighted, the extra effort you put in starts to show. This initially occurs with reading and computer use, due to the extra effort of concentrating in addition to the amount required by the distance. In high-tech areas like northern Colorado, there is a higher percentage of the population using computers all day, and optometrists are seeing more symptoms of farsightedness. Uncorrected farsighted vision can be an important component of computer vision syndrome. Eye patients will often be prescribed glasses or contact lenses for near work that only correct for distance farsightedness. This reduces the amount of focus needed for near-normal levels. The remaining normal effort to read or work on a computer rarely causes visual discomfort. This is another reason why your optometrist may not tell you much about your farsightedness. It’s hard for them to explain why a distance glasses prescription is recommended when you only have near problems.

As farsighted optometry patients enter their forties, they find that they have gradually started wearing glasses all the time. Many people mistakenly believe that wearing glasses has weakened their eyes, and sometimes feel that their eye doctor has made them dependent on glasses. This is an incorrect assumption, as the loss of accommodative ability would have occurred without wearing glasses and would have been a problem at a younger age in the absence of corrective glasses. This loss of focusing power is a visual condition specified as presbyopia, which patients often mistake for farsightedness. Although it progresses from an early age as explained above, it is only diagnosed when you reduce your ability to focus so that you cannot see at about sixteen inches, the average reading distance.

Optically, the farsighted eye is often too short and light is focused behind it rather than on the retina for distance. There may also be individual components of the eye that are too weak to focus vision properly. The lens may be underpowered, or the clear corneal tissue at the front of the eye may be slightly less curved than normal. A lens with plus or plus power is used to correct farsightedness. This is a lens that is thicker in the middle and thinner at the edges, like a biconvex lens. The best optical design for clear central and peripheral vision is a lens that is more curved at the front and still curved forward at the back, just to a lesser degree. This results in a lens with a center that is relatively far from the front of the eye, with a bulging appearance.

As you move an ophthalmic lens used for farsightedness away from the eye, the eye appears larger, much like the effect of moving a magnifying glass away from an object. This also increases the size of the image that the eye sees. Advanced optical designs have eliminated the resulting type of bug-eye appearance through the use of aspherical lens designs. Aspheric lenses start with a spherical front lens surface in the center (like the curve of a tennis ball), then the curvature gradually decreases or flattens out toward the edge of the lens. This is the traditional design that has an accompanying spherical curvature on the rear surface of the lens. New emerging freeform lens technology makes it possible to rectify aspherical lens curves on the back surface of a lens. These lenses are very sophisticated designs that use different degrees of asphericity in different tangential lines to compensate for astigmatism in their prescription.

Either way, the flattened lens design allows the lenses to sit closer to your eyes, reducing magnification or bug-eye effect. The aspherical design due to the complex peculiarities of the optics also counteracts various forms of optical aberrations (blurred vision) that normally occur when looking to the side of a spherical lens using a flatter lens design. A common misconception is that aspheric lenses improve vision. They do not significantly improve vision, but they do allow for thinner, lighter, and more aesthetically appealing lenses at less magnification. The aspherical design allows these improvements to be achieved without compromising clear peripheral vision. The lenses available to your ophthalmologist have undergone quantum advances in the last five years, probably equivalent to all the advances made in the previous fifty years. Improvements in lens design are beginning to resemble computer chips doubling in capacity every eighteen months. The future of eyewear has never been so bright!

Some facts about the farsighted eye:

• Some people are farsighted in one eye and myopic in the other. If the amounts are just right, they can see near and far without bifocals.
• President James Buchannan was farsighted in one eye and myopic in the other (and had an eye tic).
• President Harry Truman was clairvoyant.
• Latent farsightedness occurs when a child has compensated for it by steadily focusing in distance for so long that they cannot relax their eyes to get a true reading of the prescription. Only checking the glasses prescription after special eye drops have removed the eyes’ ability to focus can produce an accurate prescription reading.
• The Ohio State University has started a study to see if providing prescriptions that are not strong enough for babies with extreme farsightedness will help the eyes correct themselves.
• The eyes tend to become a little more hyperopic (or less myopic) between the ages of forty and fifty.
• Young or middle-aged men can develop fluid swelling in the central retina and become farsighted as a direct result of stress.
• Farsighted children tend to have farsighted brothers and sisters, but not necessarily parents with the eye condition.
• About one in four people is farsighted, but the number is slowly declining as the prevalence of myopia increases.

Contact lenses can be very helpful in correcting farsightedness for a number of reasons. Unlike glasses that tilt away from the eye, contact lenses sit just on the surface of the eye and therefore provide very little magnifying effect. When you wear contact lenses, you’re always looking through the optical center of the lens, which is the maximized point for good vision. This is due to the fact that contact lenses move with your eye when you look to the sides. With glasses, you see through the angled lens when you turn your eyes, and this creates optical aberrations that degrade your vision. These benefits often result in contact lenses being the primary choice for corrective eyewear for higher levels of farsightedness in children and adolescents. This is often an age where your appearance is extremely important to your self-esteem. Who doesn’t want to look their best, especially when the old alternative was bug-eye magnifying glasses that weighed a ton and kept slipping down your nose?

Eye exams are valuable in detecting prescription eye problems, but farsightedness is often missed because children have great ability to focus and pass the 20/20 test. Only a comprehensive eye exam by your ophthalmologist can ensure that your children and teens have the correct eye prescription for efficient reading and learning at school. Schedule an annual eye exam today. And don’t forget the new options you have as a farsighted adult.