Computer Vision Syndrome

Computer Vision Syndrome has become an epidemic. The majority of people in the world now own some sort of device which is stared at for more than 1 hour a day. It did not used to be like this. Thus more and more patients are having one or more of the below symptoms. These symptoms can lead to chronic pain if untreated.

Computer-related Vision Symptoms and Common Diagnoses

Symptom Category	Symptoms	Diagnosis
Asthenopic	Eyestrain	Binocular vision
	Tired eyes	Accommodation
	Sore eyes	Dry Eye Syndrome (DE/DES)
Ocular surface–related	Dry eyes	Dry Eye Syndrome
	Watery eyes	Dry Eye Syndrome
	Irritated eyes	Dry Eye Syndrome
	Contact lens problems	Dry Eye Syndrome
Visual	Blurred vision	Refractive error
	Slowness of focus change	Accommodation
	Double vision	Diplopia usually due to DES
	Decreased ability to read close	Presbyopia
Extraocular	Neck pain	Presbyopic correction
	Back pain	Computer screen location
Psychological	Shoulder pain Head Pain Sadness, irritability Increased worry; increased fear Insomnia	Headache, Migraines Depression Anxiety Multiple causes

Computer Vision Syndrome (CVS) is diagnosed when a patient has one or more of the above ocular complaints as a result of operating a computer and looking at a computer monitor for 3 or more hours per day. is generally referred to as “Computer Vision Syndrome” (CVS) is a repetitive strain disorder with studies estimating that 90% of the 70 million U.S. workers using computers have CVS and this percentage continues to rise.

Non-ocular symptoms include headaches, pain in the shoulders, neck, or back. As diverse as the symptoms are, they may be related and can be subdivided into to three potential pathophysiological causes:

1) Ocular surface mechanisms: studies have shown that people blink less or not fully when staring at something, especially the computer or device. This decreases the ability of the eylids to lubricate the cornea and contract the muscle of Riolan located around each Meibomian Gland that milks out a bit of oil into the tear film with each FULL BLINK. If one does not fully blink, the oil is not pushed out/milked out and the Meibomian Glands begin to get backed up. When the Meibomian Glands get backed up, they begin to dilate and then atrophy: scar tissue starts to form and the die and disappear forever. It is a terrible thing as these precious Meibomian Glands prevent one for ever feeling their eye and their loss can lead to chronic eye pain. I see it every day in my office and it can be debilitating.

2) Accommodative mechanisms

3) Extraocular mechanisms.

Best Treatments:
A multidirectional approach combining ocular therapy with adjustment of your workstation are needed.

The following have been shown to be the most helpful to decrease symptoms.

1. Proper lighting
2. Anti-glare filters,
3. Ergonomic positioning of computer monitor
4. Regular work breaks may help improve visual comfort: close your eyes everytime you load a new page. Take a full blink or hard blink ever 5-15 minutes.
Wash your face with warm/hot water at every bathroom break trying to gentle massage your close eyelids at the base of the eye lashes and take extra hard blinks after applying the warm water: or use a warm towel to put on your eyelids even for a few seconds.

5. Lubricating eye drops
6. Be sure to check your glasses Rx every year.
7. Special computer glasses also help relieve ocular surface–related symptoms.

Computers, iphones, ipads, cellphones have become an irreplaceable necessity in our lives at work and home. That is becoming true for our kids as well. I tell all my patients who are children that if they are trying to become a doctor, lawyer, scientist, president, or cure cancer, they can uses devices as needed. But if they are facebooking, playing video games, checking news, gossip, they are wasting one of the most precious gifts we were given: non-painful eyes and vision. Do not take it for granted. Stop the devices unless truly needed!