The College of Optometrists

I REALLY FIND HARD CONCEPT TO GRASP CAN ANYONE HELP ME TO UNDERSTAND LATENT HYPEROPIA/ PSEUDOMYOPIA. THANK YOU.

Many children are born longsighted - and this usually grown out of by the age of 5 or so (emmetropisation).

Some children remain long sighted and get so used to accomodating to compensate that they see normally and well. Sometimes, they may even have distance blurring and on examination - they seem myopic. This is simply because their ciliary muscles are cramped and over compensate for the degree of hyperopia. This is pseudo myopia. They just cramp their ciliary muscles all the time and this makes them seem myopic (you could say this is excessive ciliary tonus).

It is associated with 'blurring vision' and a subnormal acuity -the subnormal acuity seems to help induce the over-accomodation.

This is an indication for cycloplaegic refraction. A useful tip is to remember that a +1.00 add should blur back the final visual acuity.

Some of these people develop a super-accomodative range, and they keep this until well into presbyopia -hence the need for different reading adds for different people the same age.

Latent hyperopia, is a concept that says that the normal tonus of the ciliary muscle actually keeps the crystaline lens slightly flexed.

This 'degree' of flexture gives a habitual focus to the eye of the eyes anatomical focus plus the lens flextures' focus. The lens flextures' focus is a form of accomodation that is not 'visible' during a regular eye exam. It is 'latent' (or hidden) - and only made visible by cycloplaegic or when the person is asleep.

The latent hyperopia can vary in amount and can cause asthenopia and other problems (including squint).

A sign of troublesome latent hyperopia would be esophoria, asthenopia at near, poor binocular vision functions and suppression. etc.

I hope this helps you =steve

Thank you very much steve.