Is hyperopia the same as astigmatism?

Jun 29, 2022 Source: Cainiu Health

Dr. Chen You

Introduction

Astigmatism is not hyperopia. Astigmatism and hyperopia are two distinct types of refractive errors, differing in both pathological features and clinical manifestations. From a pathological perspective, astigmatism refers to variations in refractive power along different meridians—caused by various factors—resulting in the inability to focus light to a single point; instead, light forms a small, blurred spot (diffuse circle), leading to indistinct retinal imaging. In contrast, hyperopia occurs when refracted light fails to focus directly on the retina.

Hyperopic astigmatism is closely associated with many unhealthy lifestyle habits. In particular, with the rapid advancement of science and technology, hyperopic astigmatism has significantly impacted daily life. Therefore, it is essential to learn how to use our eyes scientifically in everyday life. When hyperopic astigmatism occurs, timely treatment is also necessary. So, are hyperopia and astigmatism the same?

Are hyperopia and astigmatism the same?

Astigmatism is not the same as hyperopia. They are two distinct types of refractive errors, differing in both pathological features and clinical symptoms. From a pathological perspective, astigmatism results from variations in refractive power across different meridians—caused by various factors—leading to an inability to focus light into a single point; instead, light forms a small, blurred spot (diffuse patch), resulting in indistinct retinal imaging. Hyperopia, by contrast, occurs when light rays, after refraction, fail to focus on the retina and instead converge behind it. Clinically, patients with astigmatism typically experience blurred vision and are prone to visual fatigue. In contrast, individuals with hyperopia often exhibit no obvious symptoms early on; however, in advanced stages, both near and distance vision may become unclear.

Astigmatism arises due to uneven development of corneal curvature or underlying retinal disease, preventing incoming light from forming a clear, focused image on the retina. Hyperopia, on the other hand, is a condition caused by delayed axial elongation of the eye, congenital genetic disorders, or anatomical abnormalities such as a small crystalline lens or a small cornea. Generalized astigmatism impairs both near and distance vision and reduces overall visual quality. In mild hyperopia, visual acuity and function are usually unaffected; however, high-degree hyperopia may lead to amblyopia. Astigmatism requires prompt correction using spectacles or contact lenses. For hyperopia, comprehensive visual function screening and optical coherence tomography (OCT) of the fundus are recommended.

Patients are advised—when clinically indicated—to undergo combined fine sensory stimulation training and multispectral light irradiation therapy to promote healthy axial elongation of the eye and prevent amblyopia. We hope this information proves helpful to you.

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Is hyperopic astigmatism hereditary?

Hyperopic astigmatism of the eye is hereditary. If both parents have severe hyperopic astigmatism, their child may also have a smaller eyeball, resulting in more pronounced hyperopia. In fact, individuals are born with some degree of hyperopia. As children develop, the eyeball gradually increases in size, and the hyperopic refractive state progressively normalizes.

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How to prescribe glasses for hyperopia combined with astigmatism of −4.00 D?

If hyperopia and astigmatism occur during childhood, a thorough ophthalmic examination must be conducted at a hospital, including visual acuity testing, slit-lamp examination, refraction testing, and fundus examination. If the child has amblyopia—and other causes of amblyopia have been ruled out—cycloplegic refraction using atropine and subsequent refraction testing must be repeated. Following cycloplegia, the measured degree of hyperopia typically decreases by approximately 100–150 degrees.

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Which is more severe: astigmatism or hyperopia?

Astigmatism and hyperopia are both refractive errors. Due to differences in associated complications and severity, it is not possible to determine which condition is more serious. Astigmatism and hyperopia each carry their own clinical significance. If the degrees of astigmatism and hyperopia are relatively mild, they typically cause no significant visual impairment and are considered comparatively benign. Conversely, if both conditions are relatively severe and accompanied by related complications, symptoms become more pronounced and debilitating.

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Is it possible for myopia to become hyperopia?

Myopia does not transform into hyperopia. Myopia results from refractive abnormalities of the eye caused by various factors, leading light entering the eye to focus in front of the retina. Improved visual correction can be achieved through corrective lenses or refractive surgery for myopia. Myopia is classified into axial myopia and refractive myopia. The longer the axial length of the eye and the steeper the cornea, the higher the degree of myopia.