Opinion

Bill Harvey: Multi-solution purposes

Bill Harvey
There are rarely any problems for which there is a single remedy

There are rarely any problems for which there is a single remedy. This is particularly so in the case of vision and visual symptoms, with the expression of the symptoms so intertwined with individual expectation and life demands.

We have all heard much recently, and no doubt will continue to hear, about digital eye strain. This blanket term is now an accepted description coined to cover the variety of symptoms increasingly being reported by patients related to increases in near work load, usually digital screens of some sort, and often in environments less than amenable for ocular comfort.

Symptoms typically include the asthenopic (ocular and periocular discomfort, possibly frontal headache), postural (occipital and upper spine ache) and ocular surface-related (grittiness, burning sensation). The adoption of increased screen viewing times, often at reduced working distances and often in variable ambient lighting and humidity, gives rise to decreased blink rate and incomplete blinking (often causing evaporative dry eye), increased accommodative and convergence demands (in some cases decompensating existing exophorias), and greater awareness of any uncorrected refractive error or inadequately or balanced existing correction.

A number of commercially available and soon to be made available products are aimed at addressing this concern. These include spectacle lenses and contact lenses which offer some, albeit small, near assistance by means of a low power addition or a spread of the points of focus. These may well have some benefit for those adopting a sudden increase in near work, but surely their use needs to be as part of a battery of recommendations if they are to have any impact on the symptoms. Digital eye strain prompts us to address the tear problems, visual health concerns, adverse environment, any binocular instability and refractive correction suitability. Unless all are assessed and advised upon, I fear the term digital eyestrain will merely become a marketing ploy for an individual product.