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Presbyopia vs. Hyperopia: What's the Difference?

By Jon McKenna
Learn the causes, symptoms, and treatment options for farsightedness (hyperopia) and nearsightedness (presbyopia).

Farsightedness, or hyperopia, is a common vision problem that is often confused with presbyopia. The conditions produce similar effects but have distinct causes and may be treated differently. Here’s what you need to know about the differences between the two.

What is Hyperopia?

Hyperopia is another term for farsightedness. With hyperopia, you can see far-off objects clearly but have to squint to focus when you look at objects nearby. 

Hyperopia is normally caused when your eyeball is shorter than normal or your cornea (the front surface of your eye) is not curved enough, Howard R. Krauss, MD, a neuro-ophthalmologist in Santa Monica, Calif., tells WebMD Connect to Care. As a result, light rays are not refracted properly though your eye.

“With extreme hyperopia, children around age 2 may develop crossed eyes, which can be treated, in part, with glasses,” Krauss says. “In less severe hyperopia, early symptoms can include headaches while reading. Someone will have a premature need for reading glasses and, ultimately, for prescription glasses or contact lenses.”

What is Presbyopia?

According to the Mayo Clinic, presbyopia is caused by the hardening of the lenses in your eyes as you age. As they lose flexibility, the lenses have trouble focusing light within your eye, Nathan Bonilla-Warford, an optometrist and owner of Bright Eyes Family Vision Care in Tampa, Fla., tells WebMD Connect to Care. With presbyopia, you may have a hard time focusing on books and other nearby objects.

“Symptoms may include difficulty reading materials up close, blurred vision, eye strain and, in some cases, headaches,” Bonilla-Warford says. “People with early presbyopia will often find themselves holding reading material further away to make it easier to read. Symptoms usually are noticed starting around age 40.”

Can LASIK Treat Both?

In some situations, your doctor may recommend LASIK (laser-assisted in situ keratomileusis) eye surgery to correct either hyperopia or presbyopia. During a LASIK procedure, a special laser is used to change the shape of one or both of your corneas to improve your vision.

Among surgical vision correction options, LASIK is usually a better option for “mild to moderate” hyperopia or presbyopia and only once your prescription has stopped changing from year to year, Krauss says. If your issue is more severe, Krauss says, a lens implant or replacement may be a better option.

If you experience presbyopia, your doctor will likely begin by recommending high-powered reading glasses, bifocal or other prescription glasses, or multifocal contact lenses to improve near vision, Bonilla-Warford says.

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