Hyperopia: Common Concerns and Genetic Factors

Q: Hyperopia: Common Concerns and Genetic Factors

Hello： <br>1. <br>Regarding the issue of eye alignment, it may be due to pseudostrabismus (asymmetry in the sclera of both eyes) or residual esotropia. <br>Additionally, high hyperopia in both eyes can appear as esotropia (similar to how high myopia can appear as exotropia). <br>

Please consult about hyperopia eye issues?

Hello Dr.
Wang: I currently have hyperopia of over 500 degrees in my left eye and over 300 degrees in my right eye.
I had corrective surgery for esotropia when I was younger, and my vision has been around 1.0 in recent checks.
However, I have a few questions for you:
1.
When I look at objects on my right side, a larger portion of the black pupil in my left eye seems to move toward my nose, but this is not the case when I look to the left.
Could this be due to the fact that my esotropia surgery did not fully correct the issue?
2.
I have heard that people with hyperopia are more prone to presbyopia.
If I develop presbyopia in addition to my hyperopia, could my prescription reach 800 or 900 degrees? Does this mean that without glasses, I would be unable to drive or maintain a normal daily routine? Additionally, what kind of eye conditions might I develop as I age?
3.
Will my hyperopia be inherited by my children? What is the likelihood that my child could have a higher degree of hyperopia than I do after correction?
4.
Why did my hyperopia not gradually decrease during development, or even turn into myopia, while other family members do not have hyperopia? Why is this the case for me?
Thank you for your answers, Doctor.

Yuan shi yan de ren, 30~39 year old female. Ask Date: 2010/03/14

Dr. Wang Zhishun reply Ophthalmology

Hello:
1.
Regarding the issue of eye alignment, it may be due to pseudostrabismus (asymmetry in the sclera of both eyes) or residual esotropia.
Additionally, high hyperopia in both eyes can appear as esotropia (similar to how high myopia can appear as exotropia).
If you want to know the cause, it is advisable to seek a consultation.
2.
Presbyopia is a problem with near vision that occurs with age; there are no specific preventive measures.
Presbyopia increases the degree of correction needed for near vision.
Therefore, regardless of the degree of presbyopia, distance vision is not affected.
Hyperopia does not have specific related complications like myopia.
3-4.
High hyperopia may be hereditary (or pass through generations), but the inheritance rate is actually not very high; the probability is higher if both parents have it.
However, there is no need to worry; proper eye care is sufficient.
High hyperopia does not necessarily decrease during the eye development period; the mechanisms behind this are still not fully understood in medical theory.
Theoretically, everyone is born with high hyperopia, which gradually decreases, but this is not guaranteed.
It is more important to monitor whether vision development is normal.

I hope this information is helpful to you! Thank you.

Reply Date: 2010/03/14

More Info

Hyperopia, commonly known as farsightedness, is a refractive error where distant objects may be seen more clearly than nearby objects. It occurs when the eyeball is too short or the cornea has too little curvature, causing light rays to focus behind the retina. Understanding hyperopia involves not only the optical aspects but also genetic factors and potential concerns associated with the condition.

1. Eye Alignment and Surgery: Your observation about the left pupil appearing to move inward when looking to the right could be related to your history of strabismus (crossed eyes) and the surgery you underwent. Strabismus surgery aims to align the eyes properly, but sometimes, the alignment may not be perfect, leading to residual misalignment or compensatory movements. This can cause the eye to appear to turn inwards when focusing on objects to the side. It would be beneficial to consult with an ophthalmologist who can assess your eye alignment and provide recommendations for any further treatment if necessary.

2. Presbyopia and Hyperopia: As you age, the lens of the eye becomes less flexible, leading to presbyopia, which makes it difficult to focus on close objects. If you already have hyperopia, the onset of presbyopia can indeed exacerbate your vision issues, potentially requiring stronger corrective lenses. While it is difficult to predict exact prescription changes, it is possible that your hyperopia combined with presbyopia could lead to a higher prescription, possibly in the range of 800-900 degrees. Without corrective lenses, you may find it challenging to drive or perform daily activities, especially those requiring near vision, such as reading or using a computer.

3. Genetic Factors: Hyperopia can have a genetic component, meaning it can run in families. If you have hyperopia, there is a possibility that your children may inherit a predisposition to the condition. However, the degree of hyperopia can vary significantly among individuals, and while your children may also be hyperopic, it is not guaranteed that their degree of hyperopia will be greater than yours. Environmental factors, lifestyle, and overall eye health also play significant roles in the development of refractive errors.

4. Development of Hyperopia: It is not uncommon for hyperopia to remain stable or even increase during childhood, especially if there are no significant visual demands that promote myopia (nearsightedness). In some cases, children may not develop myopia due to genetic factors or because their visual system is not under enough stress to induce a shift in refractive error. The absence of hyperopia in other family members does not rule out the possibility of individual variations in eye development.
In summary, hyperopia is a multifaceted condition influenced by both genetic and environmental factors. Regular eye examinations are crucial for monitoring your vision and making necessary adjustments to your corrective lenses. If you have concerns about your eye health or the potential for passing on hyperopia to your children, discussing these with an eye care professional can provide clarity and guidance tailored to your specific situation.

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