Hypermetropia

Considerations

Hypermetropia is the result of a short eye. It results in being 'long sighted'. The eye must accommodate to see at distance. A degree of hypermetropia is physiological in children and tends to increase until the age of eight, to then decrease until stability is reached around the age of 25. However children affected by excessive hypermetropia need early diagnosis to prevent strabismus and/or amblyopia and reading difficulties.

With marked hypermetropia the eye cannot accommodate for near vision. The co-existence of hypermetropia and presbyopia means that an even stronger refractive correction is needed. The required lenses are convex.

Hypermetropia is easily missed, for instance in the young adult applicant who may still manage to accommodate to 30 - 50 cm. Hypermetropia may result in asthenopia (eye fatigue) and difficulties to sustain focus.

Hypermetropia can be detected by testing at distance while wearing a convex lens (power DS +1.0 to DS + 2.5) placed in front of the eye. The hypermetropic eye will still be able to see normally at distance. The emmetropic eye will have reduced vision in this situation as it has been made short-sighted.

Information to be provided

A special eye report must or should be provided in the following circumstances:

• As required in the Timing of Routine Examination GD [PDF 500 KB];
• On the first occasion that an applicant presents with uncorrected distance visual acuity of 6/60 or worse in either eye;
• On the first occasion that an applicant presents with contact lenses;
• On the first occasion that hypermetropia is suspected;
• On the first occasion that an applicant presents with uncorrected near vision that does not meet the uncorrected vision standards;
• Every five years if an applicant has uncorrected distance visual acuity of 6/60 or worse.

Disposition in case of hypermetropia

An applicant with hypermetropia of DS+6 or more should be considered as having a condition that is of aeromedical significance.

An applicant with hypermetropia of less than DS+6 dioptres who meets the vision standards uncorrected may be considered as not having a condition that is of aeromedical significance if:

• There is no evidence of asthenopia;
• The muscle balance (phoria) is within acceptable limits.

An applicant with hypermetropia or less than DS +6, who only meets the vision standards and / or the phoria acceptable limits while using spectacles, may be considered as having a condition that is not of aeromedical significance if the certificate is endorsed with:

• Distance spectacles must be worn; or
• Distance spectacles must be worn, contact lenses permitted (if using contact lenses); and
• Spare spectacles must be readily available.

An applicant with hypermetropia of less than DS+6 and presbyopia (see also subchapter 3.10.8 Presbyopia) who only meets the vision standards and / or the phoria acceptable limits while using spectacles, may be considered as having a condition that is not of aeromedical significance if the certificate is endorsed with:

• Bifocal spectacles must be worn; or
• Bifocal spectacles (Varifocal spectacles permitted) - if using varifocal spectacles; or
• Contact lenses must be worn (if using contact lenses), and look-over spectacles must be readily available; and
• Spare spectacles must be readily available.

This ME should refer readily to CAA for advice in case of doubt or difficulty interpreting the eye report.