Myopia improvement probably the same as hyperopia progression

Research notwithstanding, it’s my experience that hyperopia (farsightedness) progresses over time in many cases, just like myopia…in all age people. It’s common in kids who wear glasses for hyperopia, and it’s also well known (talk with any good eye doctor…that’s where my info came from) that most people go toward less myopia or more hyperopia between age 40 and 60 or so, even if they don’t do anything special (as long as they aren’t wearing lenses that are way too strong, and giving hyperopic defocus at distance).

Since the eyeball has to shorten to cause hyperopia to progress, why wouldn’t the same thing be able to happen in someone with a negative refractive state, as long as similar conditions are met? As we know, it does happen…that’s how we improve our myopia. It’s possible to even overshoot 0.0 eventually, and become hyperopic when one was formerly myopic (of course, you wouldn’t want to intentionally go past the minor hyperopia/emmetropic low plus range, because then you’re creating a different issue).

But it does happen. People become more farsighted all the time under the right conditions. This is yet another argument (and a very solid one) you can use against people who don’t believe in this stuff. Refractive states are just that…they aren’t diseases that magically progress over time. The eye/brain apparently does not “care” what your refractive starting point or current state is…only the stimuli it’s exposed to. And it reacts to that in a predictable manner by changing its focal length.


There are some interesting things going on with hyperopes. Because they can accommodate to counteract their hyperopia they tend to pass vision screening tests at school so they don’t get sent to the eye doctor. As children many of them have reading or learning difficulties because it’s harder (more accommodation required) to do near work. A young plus three +3 hyperope can see 20/25 uncorrected. At lower levels of hyperopia they can see 20/20 or better uncorrected. Because more of them are falling through the cracks fewer of them are probably getting into lens wear until later in life (something like 40% don’t get diagnosed until age 70.)

I suspect you’re right, that myopia reversal is the same thing as hyperopia progression.

They’re able to avoid getting sent to the eye doctor even though it’s probably harder or more miserable for them to spend long hours reading books or at the computer.

The optometry industry tends to leave hyperopes alone to fend for themselves and it’s always been that way. Part of the reason may be that the school nurse says the child’s eyes are fine, and they see fine at distance and can read (not very comfortably)… so it’s hard to explain to parents why they need to buy glasses if they even bothered to show up at the optometrist’s office in the first place. The kids probably just don’t get as absorbed in near work as much as their friends and stay out of the “ever increasing prescription” trap. When they do show up to ask for glasses at age 75, everybody their age is expected to need bifocals or reading glasses anyway. So they fly under the radar their whole lives until presbyopia kicks in.,are%20much%20more%20interested%20in%20myopia%20than%20hyperopia.

Between replies to me there is

I am still in search what is AF. And how to get it. I, when I was at -2.5, had cornea of -1.0 astigmatism. And any to correct for. The same is one of my family, he has -1.25 or so astigmatism, but 20/20 without cylinder is achievable so no any if there’s enough sphere.

Now, it doesn’t work in me. I can’t get clear image unless I correct for all astigmatism. Reducing even 0.25 cyl from ideal brings nothing but unresolvable blur, no change at all in image. So I am not sure what’s ciliary spasm and it seems I have it as I have a feeling I can’t unfocus fully - something physical interferes with it as I feel something not allowing at the side of temples in both eyes.

As well, I suspect high myopia in me could be from old slight trauma. I fell at the age of 2 or so on the back of my head. To add into “genetics and myopia”

My main thought here is also how myopization and hyperopization(?) connects with astigmatism, in particular corneal.

I think you are taking this search for AF thing too seriously and also seeing it as too binary. You probably already AFd without realising. Just look at something slightly blurry and stare relaxed for 5-10 seconds then blink. If there’s any clearing up at all, even a bit, you have done AF

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People report astigmatism increasing after spherical was successfully reduced.

Also, I have read cases where astigmatism decreased by 1.0 after ciliary spasm was resolved, for example Simone (-10 to -7).

So I try to not correct right eye fully, just the same as left to try it for compensation of that 1.0.

Interesting, do hyperopes have more against the rule or with the rule and how much corneal vs actual astigmatism difference?

@lajos did not encounter that, tried with left eye

Here’s a study from Russia that was posted before (I think) by @halmadavid (???)

Researchers gave plus lenses to a bunch of kids with risk factors for myopia and followed them for 9 years. If I understand correctly the treatment was to wear spectacles with +1D over “full correction” for kids who had risk factors for myopia (myopic parents). They were told to wear the glasses everywhere except in the water.
None of them developed myopia, all of them underwent a hyperopic shift after just a month. The treatment group had 96 eyes (48 kids) with no myopia even after 9 years. :nerd_face: All of the treatment group kept full uncorrected visual acuity.

They used a different treatment on myopes that’s probably less relevant to us here.

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What has puzzled me for the last year or two is if hyperopia is progressive, and accommodation can be used to offset it, why isn’t the ciliary spasm that would induce not trigger the myopia calibration? In other words, far sighted people with good accommodation range can compensate for their hyperopia, but doing so should trigger the myopia progression (due to ciliary spasm) that should counter the hyperopia progression.

Why doesn’t this occur? It seems that this should be a self-correcting issue until hyperopia becomes too far for accommodation.

I have a theory as to what’s going on, but wanted to see what others though about this seemingly paradoxical situation with far sighted people.


I think it does, that’s why the average hyperope has only a +0.50 prescription at age 20. Higher hyperopia typically occurs in rural areas where people don’t go to school. Runaway hyperopia is uncommon and would probably occur with over-zealous plus prescriptions (stronger glasses every six months.) Very high plus prescriptions (+25) used to be common because people would have the lens of their eye surgically removed.

Hyperopes tend to slip through the cracks --they have a hard time reading in school but they don’t get diagnosed until late in life when presbyopia kicks in and they can’t accommodate anymore.


I think this is using a threshold of +2 for hyperopia, so by the time kids are 15 years old only 1% have hyperopia (compared with 8.6% of six year olds.) So most of them are getting emmetropized (presumably through cilliary spam and the same environmental factors that are giving most kids myopia.)

According to Otis Brown (from my memory, can’t find the link) students entering the US military service academies with 20/20 vision are likely to develop enough myopia by the time they finish four years to disqualify them from being pilots, and in general to graduate with vision good enough to become a pilot requires entering the academy with hyperopia of +1.

I think militaries around the world have been relaxing the standards required of soldiers for the last 100+ years because so many people are getting myopic that they can’t find enough people to serve with 20/20 or better vision.