Refractive Disorders

  • Eyes with refractive errors cannot focus viewed objects clearly on retina, unlike...
  • Eyes without refractive errors which can focus light rays onto retina
  • Myopic eyes have excessive refractive power so that they focus far away objects in front of the retina
  • Hyperopic eyes have insufficient refractive power so that they focus far away objects behind the retina
  • Astigmatic eyes have uneven corneal curvature so that they cannot produce a point focus on the retina
  • Presbyopic eyes have lost their ability to increase focusing power for objects viewed at reading distance (accommodation)
  • Blurred vision that often clears with squinting or looking through pinhole
  • Patients with myopia have blurred vision for objects viewed far away
  • Patients with hyperopia have blurred vision mostly for objects viewed nearby
  • Patients with astigmatism have blurred vision for objects viewed at any distance
  • Patients with presbyopia have blurred vision for objects viewed at reading distance
  • Lesions of the ocular media, retina, and visual pathway
  • Refer to vision care providers, who are able to detect and correct refractive errors and distinguish them from other causes of impaired vision
  • Nearly all refractive errors can be corrected with spectacles or contact lenses, or by surgically reshaping cornea
  • Myopia is corrected with a spherical concave lens that moves the focus backwards in the eye so that it falls onto the retina
  • Hyperopia is corrected with a spherical convex lens that moves the focus forward onto the retina
  • Astigmatism is corrected with a cylindrical lens, which has more focusing power in one axis than another
  • Presbyopia does not appear until after age 40; before then, the lens is flexible enough so that contraction of the ciliary muscle allows it to assume a convex front surface and focus objects viewed at reading distance; after age 40, the lens proteins gradually degenerate, the lens stiffens, and will not round up to allow focusing of near objects on the retina
  • Presbyopia is corrected by placing a convex lens in front of the eye. Because it is used only for seeing near objects, it is prescribed either as a half-glass or as the bottom part of a bifocal if the patient needs a correction for distance viewing