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high_hyperopia [2026/07/26 15:36] – Scott Larsonhigh_hyperopia [2026/07/27 18:07] (current) – Scott Larson
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 - **≥+5.00 D** is the most widely used cutoff for "high hyperopia" in pediatric amblyopia and strabismus research.[2][3] - **≥+5.00 D** is the most widely used cutoff for "high hyperopia" in pediatric amblyopia and strabismus research.[2][3]
 - **≥+4.00 D** is used in some epidemiologic studies as the threshold for "moderate to high hyperopia".[4][5] - **≥+4.00 D** is used in some epidemiologic studies as the threshold for "moderate to high hyperopia".[4][5]
-- **≥+7.00 D** is often used to define the extreme end of the spectrum, particularly in the context of structural conditions such as **nanophthalmos** and **posterior microphthalmos**.[6][7]+- **≥+7.00 D** is often used to define the extreme end of the spectrum, particularly in the context of structural conditions such as **nanophthalmos** and **posterior [[microphthalmos|microphthalmos]]**.[6][7]
  
  
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 ===== Structural Ocular Conditions ===== ===== Structural Ocular Conditions =====
  
-**Nanophthalmos** — Extreme hyperopia (+8 to +25 D) due to a very short axial length with normal cornea and lens size. Associated with angle-closure glaucoma, thickened sclera, and uveal effusion.[5][8] +  * [[nanophthalmia|Nanophthalmos]] — Extreme hyperopia (+8 to +25 D) due to a very short axial length with normal cornea and lens size. Associated with angle-closure glaucoma, thickened sclera, and uveal effusion.[5][8] 
- +  * Posterior [[microphthalmos|microphthalmos]] — Short axial length with normal anterior segment dimensions. Associated with macular folds (papillomacular folds) and high hyperopia, but lower rates of angle-closure glaucoma compared to nanophthalmos.[5]
-**Posterior microphthalmos** — Short axial length with normal anterior segment dimensions. Associated with macular folds (papillomacular folds) and high hyperopia, but lower rates of angle-closure glaucoma compared to nanophthalmos.[5]+
  
 ===== Genetic Syndromes Featuring High Hyperopia ===== ===== Genetic Syndromes Featuring High Hyperopia =====
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   * [Down syndrome](https://www.openevidence.com/rare-disease/down-syndrome) (trisomy 21)   * [Down syndrome](https://www.openevidence.com/rare-disease/down-syndrome) (trisomy 21)
   * [Fragile X syndrome](https://www.openevidence.com/rare-disease/fragile-x-syndrome)   * [Fragile X syndrome](https://www.openevidence.com/rare-disease/fragile-x-syndrome)
-  * [22q11.2 deletion syndrome](https://www.openevidence.com/rare-disease/22q112-deletion-syndrome) (DiGeorge/velocardiofacial syndrome)+  * [[digeorge_syndrome|22q11.2 deletion syndrome]]
   * [[leber_congenital_amaurosis|Leber congenital amaurosis]]   * [[leber_congenital_amaurosis|Leber congenital amaurosis]]
   * [[achromatopsia|Achromatopsia]]   * [[achromatopsia|Achromatopsia]]
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   - Sprunger DT, Lambert SR, Hercinovic A, et al. Esotropia and Exotropia Preferred Practice Pattern. Ophthalmology. 2023. [[https://pubmed.ncbi.nlm.nih.gov/37839895/]]   - Sprunger DT, Lambert SR, Hercinovic A, et al. Esotropia and Exotropia Preferred Practice Pattern. Ophthalmology. 2023. [[https://pubmed.ncbi.nlm.nih.gov/37839895/]]
   - Zhou S, Pardeshi AA, Burkemper B, et al. Refractive Error and Anterior Chamber Depth as Risk Factors in Primary Angle Closure Disease: The Chinese American Eye Study. J Glaucoma. 2023. [[https://pubmed.ncbi.nlm.nih.gov/36728083/]]   - Zhou S, Pardeshi AA, Burkemper B, et al. Refractive Error and Anterior Chamber Depth as Risk Factors in Primary Angle Closure Disease: The Chinese American Eye Study. J Glaucoma. 2023. [[https://pubmed.ncbi.nlm.nih.gov/36728083/]]
-  - Relhan N, Jalali S, Pehre N, et al. High-Hyperopia Database, Part I: Clinical Characterisation Including Morphometric (Biometric) Differentiation of Posterior Microphthalmos From Nanophthalmos. Eye (Lond). 2016. [[https://pubmed.ncbi.nlm.nih.gov/26742865/]]+  - Relhan N, Jalali S, Pehre N, et al. High-Hyperopia Database, Part I: Clinical Characterisation Including Morphometric (Biometric) Differentiation of Posterior Microphthalmos From Nanophthalmos. Eye (Lond). 2016. [[https://pubmed.ncbi.nlm.nih.gov/26493039/]]
   - Jonas JB, Aung T, Bourne RR, et al. Glaucoma. Lancet. 2017. [[https://pubmed.ncbi.nlm.nih.gov/28577860/]]   - Jonas JB, Aung T, Bourne RR, et al. Glaucoma. Lancet. 2017. [[https://pubmed.ncbi.nlm.nih.gov/28577860/]]
   - Jacobs DS, Afshari NA, Bishop RJ, et al. Refractive Errors Preferred Practice Pattern. Ophthalmology. 2023. [[https://pubmed.ncbi.nlm.nih.gov/37839893/]]   - Jacobs DS, Afshari NA, Bishop RJ, et al. Refractive Errors Preferred Practice Pattern. Ophthalmology. 2023. [[https://pubmed.ncbi.nlm.nih.gov/37839893/]]