Farsightedness impacts about 5 to 10 percent of the American population, the National Eye Institute explains, and it can impact both children and adults. There are two main types of farsightedness, hyperopia and presbyopia, and treatment options can vary depending on the type and severity of the condition.(Learn More)

There are three main forms of refractive laser surgery for farsightedness, including LASIK (laser-assisted in-situ-keratomileusis), PRK (photorefractive keratectomy), and RLE (refractive lens exchange).(Learn More) Laser surgery involves permanently reshaping the cornea. While it is considered a minimally invasive procedure, there are some potential risks involved; however, the benefits often outweigh the possible cons. (Learn More)

There are some things you should know before getting laser surgery, and you will need to take certain measures before undergoing the procedure. (Learn More) Your eye prescription will need to have been stable for at least a year, and since the cornea is being reshaped, the measurements must fit into a certain range to be eligible for laser surgery. (Learn More) Recovery time is relatively quick, and it is important to take care of your eyes and follow your doctor's instructions after surgery to ensure a healthy recovery. (Learn More)

Laser surgery can eliminate the need for glasses or contacts, and be an effective means to correct blurry vision. Laser surgery has a high success rate, and most people are happy with the results.

Happy Woman Enjoying Nature on grass meadow on top of mountain cliff with sunrise

Hyperopia and Presbyopia

Farsightedness generally means that things far are more in focus than things up close. Hyperopia is a refractive error that occurs when the eyes focus on images behind the retina instead of on it, resulting in blurry vision. This can be due to an abnormally shaped cornea, the eyeball being too short, or aging of the lens causing it to be more rigid.

Hyperopia can impact both children and adults. The American Optometric Association (AOA) reports that both environmental and genetic factors can influence the formation and growth of the eye, which can lend a hereditary aspect to hyperopia. Children may grow out of it as their eyeballs grow and lengthen.

Hyperopia can range from mild to severe, and sometimes it may not even impact vision in mild cases. It can be missed on a standard eye chart exam since seeing things far away isn't usually an issue. A comprehensive optometric exam by a trained professional can help to diagnose hyperopia. Symptoms of hyperopia include:

  • Eye strain.
  • Eye fatigue.
  • Difficulty maintaining tight focus on close things.
  • Objects appearing blurry up close.

Presbyopia is a form of farsightedness that is typically related to age. The National Eye Institute explains that as a person ages, the lens of the eye hardens and becomes less flexible. This can cause the light to be focused behind the retina, causing farsightedness. The muscles around lens are also affected by aging, and anyone aged 35 or older is at risk for developing presbyopia.

Just as with hyperopia, presbyopia makes it hard to focus on things close up and can make reading difficult, causing eye strain, fatigue, and headaches. You may find yourself holding things at arm's length to try to and bring it into focus better. Presbyopia typically becomes noticeable in a person's 40s and can progress and worsen up to age 65, Mayo Clinic reports.

Both forms of farsightedness can be treated with laser refractive surgery, which reshapes the cornea to correct focusing issues. Mild farsightedness may be corrected with reading glasses or prescription eyeglasses when needed. Moderate to severe farsightedness can be treated with prescription eyewear or laser surgery.

Farsightedness Laser Surgery Treatment Options

Mayo Clinic publishes that refractive surgery is most commonly used to treat nearsighted eye conditions (myopia); however, laser surgery can be a viable option for farsightedness as well. Laser eye surgery uses a specialized laser to ablate the cornea, reshaping it to correct refractive errors.

In the case of hyperopia, the laser shapes the cornea to make it steeper, lengthening it so the focusing power is directed onto the retina instead of behind it. Both LASIK and PRK are forms of laser refractive eye surgery that can be used to correct hyperopia.

Presbyopia can be treated with a specialized procedure called monovision that corrects one eye for distance vision and the other eye for close-up sight. This procedure may not be for everyone, as it can take some getting used to as the eyes will no longer focus together, and there is an adjustment period. Hyperopia and presbyopia can also be treated with intraocular lens (IOL) implantation or RLE, which involves replacing the natural lens with an artificial clear lens.

The three main types of laser surgery options for farsightedness are:

  • Laser-assisted in-situ keratomileusis (LASIK). LASIK is one of the most common forms of laser eye surgery with a high success and satisfaction rate. The S. Food and Drug Association (FDA) publishes studies indicating that about 95 percent of patients are happy with their vision following a LASIK procedure.With LASIK, a specialized laser is used to create a small flap in the epithelial (outer part) of the cornea, which is hinged back, while a secondary laser is used to ablate the stroma (inner part), reshaping the curvature to the premeasured point. The flap is then replaced and allowed to heal on its own without the need for stitches or further medical intervention. The procedure is typically performed in under an hour, noninvasive, and considered safe.
  • Photorefractive keratectomy (PRK). PRK is actually a type of LASEK (laser-assisted subepithelial keratectomy) surgery that involves cutting a thin flap into the cornea's epithelial layer and removing it entirely before reshaping the cornea underneath. The epithelial will grow back on its own and fit to the new corneal shape naturally. PRK is an option for people who have thin corneas and may not be eligible for LASIK.
  • Refractive lens exchange (RLE). Lens replacement eye surgery, or RLE, actually replaces your natural lens with a completely new clear lens. This procedure is generally intended for people who may not be candidates for PRK or LASIK procedures and suffer from a high degree of hyperopia or presbyopia without cataracts. The journal Touch Ophthalmology publishes that RLE is generally more suited for correcting hyperopia than myopia, and the procedure can be helpful in correcting farsightedness when other options are not as viable.

Risks and Rewards of Laser Surgery for Farsightedness

LASIK and laser surgery procedures were initially intended to treat nearsightedness, or myopia. The Peer-Reviewed, Open Access Journal (PLOS One) publishes that it presents a different potential risk than myopic corrections, as it has been common for hyperopic eyes to lose their refractive power and regress post LASIK. Advances to technology over the years has lowered this potential risk, and laser surgery is more effective in treating hyperopia today.

Presbyopia has traditionally been treated with monovision LASIK, which means that the eyes are corrected differently. Since it can take a lot of adjustment, the eye being corrected for hyperopia often cannot be corrected as much as it may need to be for crystal-clear, close-up vision. Monovision can also cause some blurring with distance vision for some people. Newer technologies, such as IOLs and clear lens exchange procedures, are often preferable, the journal Review of Cornea and Contact Lenses reports.

Advances in IOL implants continue to be made, reducing the risks and improving the rewards for eligible patients. According to Optometry Times, RLE is a viable option for people who are not eligible for LASIK or PRK, even if their lenses are clear to begin with. There is a small risk for loss of vision due to infection or lens detachment, but it is considered minimal. In general, an RLE procedure is considered to be as safe and effective as other laser surgery procedures.

Laser surgery is a same-day procedure that is classified as minimally invasive, but it is still a surgical procedure with potential risk factors. Dry eyes, glares, halos around lights, decreased night vision, vision changes, and infection are all possible complications resulting from a laser eye surgery. The journal Review of Ophthalmology publishes that negative nighttime visual symptoms and prohibitive costs can be potential barriers for people seeking out IOLs for presbyopia.

Laser surgery for farsightedness is considered an elective procedure, and as such, it is rarely covered by insurance. Costs can range between $1,500 and $3,000 for each eye and can vary depending on the exact treatment needed and the severity of the condition being corrected.

In the long run, however, laser surgery may actually save you money on eye exams and prescription eyewear, as it can decrease the need to wear contacts or eyeglasses. There are payment and financing options to help people budget for laser eye surgery. The benefit of improved sight is often worth the cost.

patient undergoing prk surgery

Preparing for Laser Surgery and Eligibility

In order to be eligible for laser eye surgery to treat hyperopia or presbyopia, you will need to be in good health, and this includes good optical health. Your eyes will need to have been stable with their prescription for at least a year. For the treatment of presbyopia, you will need to not have cataracts forming. Mayo Clinic warns that LASIK procedures may not be ideal for severe hyperopia.

Your doctor can determine if you are a candidate for a laser eye surgical procedure and which one might be best. The ophthalmologist will perform precise measurements of the eyes prior to this determination to ensure that you have enough thickness on your cornea for LASIK. If you don’t, PRK may be a better option.

Consider your expectations for the procedure and talk with your doctor in order to ensure that you are both on the same page. In preparation for a laser eye surgery, you will usually need to stop wearing your contacts (if you wear them) for a few weeks.

What to Expect

Laser eye surgery can help to improve your farsighted vision and decrease your need for reading or prescription glasses. Your eyes may still change with age. Just because you've had LASIK or another procedure, you may still need reading glasses later in life. In addition, cataracts can still form, and laser surgery does not affect the risk for these either.

Recovery from a laser eye procedure is relatively quick, with LASIK being the least invasive and having the fastest recovery time. Generally, you will need to take a day or so off work and refrain from eye strain. You may need to avoid watching TV, reading, or spending time on the computer for a few days.

Strenuous exercise and contact sports, as well as swimming or hot tubs, should be avoided for a few weeks after a laser eye procedure. You will also need to keep lotions, creams, and makeup off your face and away from your eyes for a week or two. Avoid rubbing your eyes.

The FDA publishes that your vision can take a few months to stabilize completely, but you should be seeing better within a few days after a laser surgery procedure. You will need to attend a follow-up appointment with your surgeon a day or two after the procedure, and follow the instructions given by the surgical team to enhance healing.

References

 

Facts About Hyperopia. (July 2016). National Eye Institute.

Hyperopia FAQs. (2018). American Optometric Association.

Facts About Presbyopia. (October 2010). National Eye Institute.

Presbyopia. (December 2017). Mayo Clinic.

Farsightedness. (June 2018). Mayo Clinic.

LASIK Quality of Life Collaboration Project. (September 2018). U.S. Food and Drug Administration.

Updates and Challenges in Refractive Lens Exchange. (March 2018). Touch Ophthalmology.

Hyperopic Refraction Correction by LASIK, SMILE, or Lenticule Implantation in a Non-Human Primate Model. (March 2018). PLOS One.

Presbyopia: The State of Surgical Correction. (March 2018). Review of Cornea & Contact Lenses.

The Pros and Cons of Clear Lens Exchange. (August 2014). Optometry Times.

Presbyopic IOLs: Choosing Wisely. (January 2018). Review of Ophthalmology.

Lasik Surgery: Is It Right for You? (March 2017). Mayo Clinic.

What Should I Expect Before, During, and After Surgery? (July 2018). U.S. Food and Drug Administration.