Diagnosis
Visual acuity is affected according to the amount of hyperopia, as well as the patient's age, visual demands, and accommodative ability.
In severe cases of hyperopia from birth, the brain has difficulty merging the images that each individual eye sees. This is because the images the brain receives from each eye are always blurred. A child with severe hyperopia has never seen objects in detail and might present with amblyopia or strabismus. If the brain never learns to see objects in detail, then there is a high chance that one eye will become dominant. The result is that the brain will block the impulses of the nondominant eye with resulting amblyopia or strabismus. In contrast, the child with myopia can see objects close to the eye in detail and does learn at an early age to see detail in objects.
The child with hyperopia will typically stand close in front of a television. One would have expected that the child would stand far away because the child is hyperopic, but because the brain has never learned to see detailed lines and object contours the child sees objects blurred. While children with myopia learn to see sharp lines because they can see perfectly well very close to their eyes, the brain of a child with hyperopia cannot see sharp lines, so they stand right in front of the television to at least see blurred images. This blurred vision may also cause a child to develop a squint because the two eyes do not detect sharp lines which the brain can use to map the separate images of the two eyes together to form a single image. Each eye functions independently. So a child with hyperopia from birth presents with decreased visual perception.
The parents of a child with hyperopia do not always realize that the child has a problem at an early age. A hyperopic child might have problems with catching a ball because of blurred vision and because of a decreased ability to see three-dimensional objects. The child will typically perform below average at school. As soon as a child starts identifying images, a parent might find that the child cannot see small objects or pictures.
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