Hyperopia occurs when the axial length of the eyeball is too short, causing an outof-focus image to fall on the retina. Hyperopia is difficult to detect in children because they can compensate for the farsightedness by using their eye muscles( ciliary body) to

focus the image. They will test 20 / 20 at distance and near, but will have difficulty maintaining a clear image, especially at close distances.

These children will have to use their focusing muscle from the moment they open their eyes in morning until bedtime. When asked to perform near-point tasks such as reading or schoolwork, they will have to use double or triple the focusing effort of a non-farsighted“ normal” child. This leads to spasm of the focusing muscle, fatigue, and headaches. The only way they can relieve their ocular muscle spasm is to focus on a very distant object or“ stare off into space.”

Hyperopic children rarely complain of the difficulty they are experiencing as it is all they have ever known, or their version of normal. Many children subsequently develop

a general dislike for reading and schoolwork in general.

The non-farsighted or“ normal” child’ s focusing muscle is completely at rest for the majority of the day. Children who are not farsighted only have to use their focusing muscle for near work. Extended reading or near work causes them no discomfort or fatigue.

I often explain to parents that life for their farsighted child is like putting a 25-pound backpack on him / her immediately upon waking. Then reading is like adding an additional 25 pounds to the backpack. Although a child may be able to lift 50 pounds for a brief period, or for the amount of time it takes to read five letters for a vision test, fatigue sets in quickly and he / she will do anything to shed the extra 25-pound burden. Farsighted children experience similar fatigue of the focusing

system on a daily basis. They will often find any excuse to avoid sitting down to read or do schoolwork, because it is so uncomfortable. This inability to maintain sustained focus at near, and the constant need to look off in the distance for relief, can be misinterpreted as ADHD.

A comprehensive eye examination with dilating( cycloplegic) drops can easily detect farsightedness. Treatment is as simple as a pair of glasses. As the eyes mature, many children often outgrow their farsightedness.

Uncorrected farsightedness does not damage the health of the eyes, but it can put your child at a significant disadvantage during the formative years of early education.

Seraly Eye Care Associates, LLC offers free vision screenings to area preschools. If you would like your preschool to participate in the screening program, or if you would like a free vision screening for your child, contact our office at 724.942.1300.

For more information: 724.942.1300 seralyeyecare. com