Hyperopia (farsightedness) with Astigmatism

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If you have been wearing contacts and/or glasses for a year, or for 30 years, it should not have an impact on your potential laser vision correction surgery. Approximately 98% of persons who undergo refractive laser surgery obtain 20/40 or better visual acuity, which is the visual acuity required to obtain a drivers license without wearing corrective lenses.

Does my degree of farsightedness with astigmatism matter?

Yes, the degree of hyperopia does matter, as does the degree of hyperopia with astigmatism when it comes to FDA approved treatment levels with the LASIK procedure. The FDA has approved the use of its VISX STAR S2 Excimer Laser System(TM) as safe and effective for the treatment of from 1 to 6 diopters of hyperopia (farsightedness), with up to one diopter of astigmatism.

Patients who were formerly considered poor candidates for refractive surgery are increasingly becoming eligible for surgical correction because a complementary combination of procedures can now be employed. Refractive combinations make sense when the two procedures address different refractive problems, different aspects of the total problem, when the problems exceed the approved scope of the individual procedure or when the first procedure has altered the eye in such a way as to narrow down options for further enhancement.

Essentially, surgeons are finding today that 2 procedures may need to be performed to effectively treat the refractive error. With hyperopia greater than the approved treatment level, of say +7, the surgeon may utilize the LASIK procedure to bring the patient's vision to a level of only +1D or +2D and then, in say 3-6 months, may perform the LASIK procedure again, to bring the visual acuity to the ideal 0.0 - normal (20/40 or better). The caveat is that the laser must not remove too much corneal tissue and if the combined procedures would result in this outcome, then the patient may just have to be satisfied with a small degree of farsightedness until further technology is developed and approved.

With high levels of astigmatism associated with a hyperopic eye, the surgeon may perform AK, or Astigmatic Keratotomy, to correct the excessive refractive error and may, if necessary, in 3-6 months, use the LASIK procedure to fine-tune the remaining refractive error, as long as the remaining astigmatism measured 1D or less.

Does age Matter?

Laser eye surgery used to be for those under 40, this is not true anymore. More and more patients over 40, 50 and even some over 60 have had successful laser eye surgery. Patients need to be at least 18 years of age or older for the treatment of mild nearsightedness. Patients under 18 may not have finished developing (hence stabilized vision) and may need to wait until they are at least 18 years old. If you have a higher degree of nearsightedness or astigmatism you should probably wait until you are 21. This is something you will need to discuss with your opthmalogist.

What are my choices?

Patients with Hyperopia (farsightedness) with or without astigmatism can be effectively treated with LASIK. The PRK and RK procedures are not approved to treat hyperopia. The options available to each patient depend on the patient's degree of refractive error, the surgeon's skill and procedure preference and the laser used.

Summit Technology Inc. Autonomous LADARVision excimer laser system received a unanimous recommendation for approval for laser in situ keratomileusis (LASIK) for the treatment of hyperopia from 0 to 6 D of sphere and up to 6 D of astigmatism at the spectacle plane, although some special conditions for labeling were also recommended by the Ophthalmic Devices Advisory Panel of the Food and Drug Administration (FDA). If approved, Summit's system would have the broadest range of approvals of any FDA-approved laser, according to the company.

The final approved range of hyperopic astigmatism and spherical hyperopia treatment is to be determined pending FDA evaluation of 9-month data.

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Symptoms of hyperopia with astigmatism include:

blurred or distorted vision
blurred vision of distant objects
squinting
eyestrain
headaches
fatigue or blurred vision at certain distances

For more information about Hyperopia, visit AllAboutVision.com.

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