The Differences Between Myopia, Hyperopia, and Astigmatism
Myopia, hyperopia and astigmatism are common vision problems, not eye diseases. In each one, light doesn't focus exactly on the retina, the light-sensing layer at the back of the eye. Myopia (nearsightedness) blurs things far away. Hyperopia (farsightedness) makes close-up work harder. Astigmatism blurs or distorts vision at all distances. An eye exam finds all three, and all three can be corrected.
Many people have more than one. Here is how they differ, what to watch for and how we correct them.
What is myopia (nearsightedness)?
If you have myopia, you see close objects clearly, but things far away look blurry. It usually happens because the eyeball is a little too long. Light focuses in front of the retina instead of on it.
Myopia can make it hard to read road signs, see the board at school or recognize faces across a room. It often starts in childhood and gets worse as kids grow.
Watch for:
- Trouble reading road signs or seeing things far away
- Squinting
- Eye strain or headaches
What is hyperopia (farsightedness)?
With hyperopia, the eyeball is shorter than normal or the cornea is too flat. Light focuses behind the retina. Distance vision may be fine, but close-up work takes extra effort.
Young eyes can often focus through mild hyperopia. That extra effort can still cause tired eyes or headaches when reading, and a school screening can miss it. Our post on how often you should get an eye exam explains why.
Watch for:
- Straining to see close objects clearly
- Eye discomfort or headaches after reading
- Frequent blinking
What is astigmatism?
Astigmatism happens when the cornea, or the lens inside the eye, is shaped more like a football than a basketball. Light focuses at more than one point, so vision is blurry or stretched at all distances. Many people have astigmatism along with myopia or hyperopia.
Watch for:
- Blurry or distorted vision at all distances
- Frequent changes in your glasses prescription
- Trouble driving at night
Read more in our post on correcting astigmatism without surgery.
Myopia vs. hyperopia vs. astigmatism at a glance
| Myopia (nearsighted) | Hyperopia (farsighted) | Astigmatism | |
|---|---|---|---|
| What looks blurry | Things far away | Things up close (and sometimes far away) | Things at all distances, often stretched or doubled |
| Where light focuses | In front of the retina | Behind the retina | At two different points |
| Usual cause | Eyeball a little too long | Eyeball a little too short or cornea too flat | Cornea or lens shaped like a football |
| On your prescription | SPH is a minus number, like -2.00 | SPH is a plus number, like +1.50 | A CYL number and an AXIS |
What is myopic astigmatism? What is hyperopic astigmatism?
These names describe astigmatism that comes with nearsightedness or farsightedness. An eye with astigmatism focuses light at two points instead of one, so eye doctors name it by where those two points land.
- Myopic astigmatism is astigmatism plus nearsightedness. Light focuses in front of the retina, so things far away look blurry and may look stretched. In simple myopic astigmatism, one point lands on the retina and the other in front of it. In compound myopic astigmatism, both land in front of it.
- Hyperopic astigmatism is astigmatism plus farsightedness. Light focuses behind the retina, so close-up work is harder and your eyes may tire. In simple hyperopic astigmatism, one point lands on the retina and the other behind it. In compound hyperopic astigmatism, both land behind it.
- Mixed astigmatism means one point lands in front of the retina and the other behind it.
You may see wording like "myopia of both eyes with astigmatism" or "hyperopia of both eyes with astigmatism" on a visit summary or insurance form. It means you are nearsighted (or farsighted) in both eyes and also have astigmatism. It is a common focusing problem, not an eye disease.
How to read your glasses prescription
- SPH (sphere): a minus number means nearsighted. A plus number means farsighted.
- CYL (cylinder): the amount of astigmatism. It can be written as a minus or a plus number. If this box is blank, there is no astigmatism to correct.
- AXIS: a number from 1 to 180 that tells the lab which direction the astigmatism runs.
For example, -2.00 -1.00 x 180 is myopic astigmatism: nearsightedness plus astigmatism. +1.50 -0.75 x 090 is hyperopic astigmatism: farsightedness plus astigmatism.
How is each one corrected?
Glasses
Glasses are the simplest option, and they work for all three. If you also need help up close, multifocal lenses can correct more than one distance. See our designer eyewear.
Contact lenses
Soft contacts correct myopia and hyperopia. Toric soft lenses correct astigmatism. Scleral lenses can help with higher astigmatism or an irregular cornea. Learn more on our contact lens page.
DreamSculpt™ Ortho-K
Custom lenses worn overnight gently reshape the cornea, so you see clearly during the day without glasses or contacts. DreamSculpt Ortho-K is used for myopia, and it can also help slow myopia in kids. It is available at every office except Riverdale. Learn more on our DreamSculpt Ortho-K page.
Slowing myopia in children
If your child's nearsightedness gets worse each year, ask about myopia management. Options include DreamSculpt Ortho-K, MiSight soft lenses and myopia-control glasses.
LASIK and PRK
LASIK and PRK use a laser to reshape the cornea. They can reduce or remove the need for glasses. Like any surgery, they carry some risk, so talk it through with your eye doctor. We don't perform surgery in our offices. If you're interested, we check whether your eyes are a good fit, refer you to a trusted surgeon and care for you before and after. Read what happens at a LASIK evaluation.
Glasses or contacts?
Glasses are easy to care for and carry a lower risk of eye infection. They also protect your eyes a little from wind and dust.
Contacts give you a more natural field of view and aren't noticeable. They need careful cleaning to avoid infection. They may not be the best choice if you have dry eyes or work somewhere dusty.
Many people use both. Some people need correction all day. Others only need it for reading, computer work or driving. Your eye doctor will help you decide.
Healthy habits for your eyes
- Wear sunglasses. Choose full UV protection, even on cloudy days. Too much sun is linked to cataracts and macular degeneration.
- Rest your eyes from screens. Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds.
- Eat for your eyes. Leafy greens, carrots and fish give you vitamin A and omega-3 fatty acids, which support eye health.
- Stay active. Exercise improves blood flow, and that helps your eyes, too.
When should you see an eye doctor?
Book an exam if:
- it's been more than a year since your last one
- you have trouble seeing far away or up close
- you get headaches or eye strain after reading or screen time
- your child squints or struggles with reading
Call us right away or go to the emergency room for sudden vision loss, a curtain or shadow over your vision, new flashes and floaters, or a painful red eye with blurry vision.
How we do it at Bolt Eye Group
Every exam includes a careful check of your prescription and a full eye-health check. Every patient also gets retinal photos and corneal topography for a $39 imaging fee. Topography maps the shape of your cornea, which matters for astigmatism and for fitting specialty lenses. It also screens everyone for keratoconus.
We see patients at Canton, East Cobb, Lawrenceville and Riverdale, GA, and Johnson City, TN.
We accept VSP, EyeMed, Davis Vision, Spectera, Medicare and major medical plans, including Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna and Humana.
Frequently asked questions
Can I have myopia and astigmatism at the same time?
Yes, and it's common. One pair of glasses or contacts can correct both.
Can I have hyperopia and astigmatism at the same time?
Yes. Astigmatism often comes along with either myopia or hyperopia.
Does myopia get worse over time?
It often gets worse through childhood and the teen years. That is why we check kids' eyes every year and offer myopia management.
Is astigmatism a disease?
No. It is a common focusing problem. Sometimes astigmatism that keeps changing is a sign of keratoconus, which is why we map every patient's cornea.
What is the difference between myopia and astigmatism?
Myopia makes things far away blurry because light focuses in front of the retina. Astigmatism blurs or stretches vision at every distance because the cornea or lens is shaped more like a football, so light focuses at two points. Many people have both, which is called myopic astigmatism.
What is hyperopic astigmatism?
It is farsightedness plus astigmatism. Light focuses behind the retina at two different points, so close-up work can be blurry or tiring and vision may look a little distorted. Glasses or toric contact lenses correct it.
What does “myopia of both eyes with astigmatism” mean?
It means you are nearsighted in both eyes and also have astigmatism. It is a common focusing problem, not a disease, and glasses or contact lenses correct it.
Book an exam at your nearest Bolt Eye Group office
Blurry far away, up close or both? Book an exam at Bolt Eye Group in Canton, East Cobb, Lawrenceville or Riverdale, GA, or Johnson City, TN. Find your office and book online.