HISTORICAL PERSPECTIVE ON CHARACTERISTICS OF A HYPERMETROPIC EYE
By C. H. BROWN, M. D. 1921

Hypermetropia may be looked upon as a congenital defect, in fact the statement has been made that all babies are born hypermetropic. It is supposed to be due to an arrested development in the formation of the eyeball, which may vary from the slightest degree to an extreme condition of smallness.

The hypermetropic eye differs somewhat from an emmetropic eye, and the following have been enumerated as some of the characteristic points of an eye suffering from this defect. The eye is said to look smaller, but this is a change that is not always noticeable, although as a matter of fact the ball is smaller than the normal eye in all of its dimensions, but particularly anteroposteriorly. The lens and iris advance forward, which makes the anterior chamber shallower. The pupil is small and contracted.

The ciliary muscle, by reason of its action on the accommodation, upon which the eye depends for whatever clear vision it may enjoy, is much larger and more fully developed than in emmetropia, this development being particularly noticeable in the anterior portion, which is composed chiefly of circular fibers, and is due to the constant strain imposed on the accommodation by the hypermetropia.

On account of the constant relation existing between the accommodation and the convergence (as has been fully explained in the previous chapters) this excessive accommodation is apt to cause an excessive convergence, the
result being a case of convergent strabismus.

In hypermetropia of high degree, the optic nerve is diminished in size and contains a less number of fibers, which accounts for the lessened acuteness of vision so often found in these cases.

In this defect the face is said to have a characteristic flat appearance, the nose depressed, orbits shallow, and the distance between the eyes to be increased. It should be remarked, however, to the optometrist that these points are often absent, and that there may be no distinctive features apparent in the face

It is not unusual to find a hypermetropic eye disposed to astigmatism. ________________________________

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