Vision problems surfacing around computer work

Solutions are either optometric or environmental

Computer vision syndrome is a health problem that surfaced in the 1990s as computer use became prevalent in the workplace and home. In the year 2000, it is becoming a common complaint.

It’s difficult to know exactly how many people suffer from computer vision syndrome, but a survey by an optical company found that 43% of the people who spend four or more hours a day working at a computer had symptoms. In another survey, 60 million people said they suffered from eyestrain, eye fatigue, or glare-related headaches while using their computer.

According to the St. Louis-based American Optometric Association, eye and vision problems are the health-related problem most frequently experienced by people who work at a video display terminal. "There are probably 100 million computers in use now, and eyes by far are the greatest source of problems for computer users," says Kent M. Daum, OD, PhD, associate professor of optometry in the School of Optometry at the University of Alabama at Birmingham.

The symptoms for computer vision syndrome are eyestrain, headaches, eye fatigue, blurred vision, dry, irritated eyes, and back and neck ache. "Most of these symptoms could be caused by an underlying vision condition that needs correction, or they could be caused by something wrong in the work environment. Very often, it is a combination of the two," says James Sheedy, OD, PhD, a clinical professor at the University of California, Berkeley School of Optometry. In the majority of the cases, proper intervention can relieve the symptoms, he says.

The good news is that the problem does not cause any permanent eye damage. "It’s kind of like having a stone in your shoe; you can walk with it, but it is a nuisance," says Robert Newcomb, OD, director of clinic at The Ohio State University College of Optometry in Columbus. The bad news is that it can hamper work performance.

The No. 1 reason to prevent or reverse computer vision syndrome is that people feel better, says Sheedy. The second reason is that they will perform better. While permanent eye damage may not occur, an awkward posture at the computer due to vision problems could contribute to long-term back and neck problems, he says.

Optometric vs. environmental

People experiencing any of the symptoms for computer vision syndrome should see an optometrist to determine if the symptoms are being caused by optometric problems or environmental problems. It could be that their eyes are out of focus and they need glasses to see clearly at a short distance, or they could have ocular alignment problems, in which the right eye doesn’t point at exactly the same location as the left eye, explains Newcomb.

Dryness of the cornea often occurs when people become interested in their computer work and their blink rate goes down or they do not blink completely.

If a person is not under good regular eye care, he or she should make an appointment with an optometrist. Otherwise, the environment would be the place to begin an investigation of the problem.

One of the most common environmental culprits is lighting, says Sheedy. Most work sites have bright overhead lights or bright open windows. Because people look at a computer screen horizontally as opposed to looking down at the desk, the glare is in their field of vision and causes discomfort. (To learn how to test for environmental problems, see article on p. 84.)

Other environmental factors that could result in computer vision syndrome symptoms are lack of air currents in high-rise office buildings and a computer monitor that is too high or is near a window so there is reflective light. "I ask if they experience the symptom at home as well as at the office when working at a computer screen. An ocular problem is going to occur at home as well as at the office," says Newcomb. (To learn the recommended components of an eye examination for computer vision syndrome, see the Editor’s note at the end of this article.)

When computer users wear their reading glasses at a computer terminal, they often must get in an awkward position to see because reading glasses are designed for viewing material at a distance of about 16 inches and a viewing angle of 25 to 30 degrees. The computer screen is typically viewed at a distance of 24 inches and at an angle of 10 to 20 degrees. "People often get in an awkward position to see, which leads to neck or back problems," says Sheedy.

People will inch closer to the screen and tip their chin up to see what is going on, and that will cause back and shoulder problems, agrees Daum. "Special glasses for the computer are really ideal, because they allow you to get a natural distance of what the computer is designed for," he explains.

Glasses can be designed to help with more than just focusing or ocular alignment; they also can help with glare. A tint, anti-reflection coating, or ultraviolet radiation filter can be put on the lenses, says Newcomb.

Moving the computer away from the window or angling the screen also can eliminate glare, as can turning off some of the fluorescent lights in an office, says Daum. For minor problems with dry eyes, computer users can purchase artificial tears at a drugstore.

Prime candidates for computer vision syndrome are those who spend four to five hours on a computer each day, says Newcomb. However, it is not only related to the amount of time spent on a computer, because tolerance levels are different. Some people can only work at a visually intensive task on a computer for 10 to 15 minutes, while others can work 12 hours a day, says Sheedy. "Everyone has their point at which their visual system starts rebelling a little bit at the load they are putting on it," he explains.

[Editor’s note: The American Optometric Association offers a vision fax sheet titled "Recommended Components of an Eye/Vision Examination for Video Display Terminal Operators." To obtain a copy, call the association’s VisionFax Information-on-Demand Service at (800) 365-2219, ext. 329. Request document 0004.]