- Vision & Eye Care
All About Eyestrain: Symptoms, Causes and Ways to Prevent It
About the Author
Daughter of Maat is an ophthalmic technician and has been examining patients on a daily basis for over 18 years.
She has had rigorous training under the supervision of an ophthalmologist and specialized in the cornea, cataracts, and retina as well as how systemic disease effects the eye. She is certified by JCAHPO as a Certified Ophthalmic Assistant.
If you use a computer all day like I do (all of us writers seem to be glued to our computers), you’ll most likely suffer from eyestrain at some point. Many people suffer from it constantly.
Working in ophthalmology, the most common complaint that I see daily is eyestrain. While some people have a medical reason for their eyestrain (macular pathology, cataracts etc.), most of us suffer from the common causes. Symptoms of eyestrain vary from patient to patient, but here are some of the most common:
- A burning Sensation
- A “pulling” sensation
- Irritation and redness
- Sensation of something in the eye (also known as a foreign body sensation)
- Headaches that begin in the afternoon
There are ways you can help prevent the common causes of eyestrain. Here are the most common causes and their remedies.
Several years ago, I was examining a patient who complained that her eyes would dry out after she used a computer for about 45 minutes. She said she didn’t understand why, but it was not only a nuisance, but painful as well. Figuring it was possibly due to a needed change in her glasses prescription, I proceeded to refract her (test her for glasses).
It’s a force of habit for me to tell my patients to blink during this test, because we don’t blink when we concentrate. We don’t realize it, but the brain becomes so preoccupied that it forgets to tell the eyes to blink, whether voluntarily or involuntarily.
When I told the patient to blink, she took her head out of the phoropter and asked, “What does blinking do?” I was dumbfounded. I thought the reason for blinking was common knowledge, but many patients have asked me the same question throughout my career. I also realized most technicians don’t tell their patients to blink during a refraction!
Blinking is essential to good eye health and here’s why. Every time you blink, the eyelids force the tear film to coat the front of the eye. This prevents the buildup of debris and foreign material. A blink is, essentially, the eye's way of flushing itself. Blinking also re-hydrates the cornea.
The cornea is like a window for the eye. It gives you 70 percent of your eye’s focusing power. If it becomes dry, the window looks hazy, dirty or cloudy, which causes poor vision and a sensation of sand in the eye. When this happens, eyestrain is just around the corner. The eyes start to overwork themselves in an effort to clear the vision, leading to persistent tearing (epiphora), redness, sandy sensations and sometimes corneal erosion.
Use Artificial Tears
If you’re going to be reading, sewing, gaming, or using a computer for a long period of time, it’s a good idea to put in a few drops of a good artificial tear about five minutes before you start and periodically throughout the day.
Artificial tears stay in the eye longer than organic tears because their viscosity is thicker preventing them from evaporating. This won’t prevent you from having to take breaks, but it will alleviate irritation and keep the vision clear.
I have always recommended to all my patients that they take breaks at least every 45 minutes to an hour for about 15 to 20 minutes. This does a couple of things.
- First, it allows the eyes to blink. Once you stop concentrating the eyes go back to blinking regularly.
- Second, it also allows the eyes to focus on something at a distance which allows the lens to relax.
The lens gives the eye 30 percent of its focusing power and is the structure that does all the focusing. If you hold a book up with your arm for a long period of time, what happens? The muscle becomes fatigued and eventually the muscle becomes so tired it gives out.
The lens in the eye is no different than an arm muscle. The lens is suspended by little fibers known as zonules, which are teeny tiny little muscles. If they are in the same position for a long period of time, the result is eyestrain, which can manifest as pain, a mild discomfort or an inability to accommodate, or focus up close.
You May Need Reading or Computer Glasses
If you are farsighted, or over the age of 45, using reading glasses may be a necessity.
Hyperopic, or farsighted, patients have more difficulty accommodating for long periods of time, unlike their myopic (nearsighted) counterparts. Wearing reading or computer glasses may help to alleviate any eyestrain, especially if the patient is slightly hyperopic.
As we age, the lens of the eye ages with us. It becomes stiff, like the rest of our aging muscles. When this happens, the loss of flexibility leads to the inability to see up close, also known as the my-arms-aren’t-long-enough syndrome.
This is a natural process and happens to everyone eventually, even those of us who are nearsighted (although, it happens to us much later in life). Reading glasses help bring everything back into focus.
The Add-By-Age Rule
The power of reading glasses varies with age. As a technician, I was taught the ”add-by-age” rule, which is a guide to what power a normal, emmetropic (not requiring any glasses) would require at a given age. Here’s the rule:
Power of Reading Glasses Required
+1.25 to +1.50
+1.50 to +1.75
Patients with Cataract Implants (IOLs) or Cataracts
+2.50 or +2.75
Patients with Macular Pathology
+2.75 to +3.25
Keep in mind that this is merely a guideline. I highly recommend you check with your eye care provider in regards to the strength of reading glasses you may need. Always make sure you try the glasses on before purchasing a pair.
You may find that if you’re 45, and try on a +1.50 reading lens, it may not be enough. Always use the weakest strength you can get away with and still prevent eyestrain. Using a power stronger than you require allows the lens to atrophy more quickly, which causes the lens to harden and form a cataract.
You May Need Your Glasses Prescription Changed
If you already wear glasses like I do, you may need to get the prescription checked if you’re having problems with eyestrain.
An incorrect glasses prescription typically manifests as tired, red, itchy, and aching eyes, along with headaches that typically appear in the afternoon (if you wake up with headaches, your eyes are not the problem).
When you go to the doctor, make sure you tell the technician everything. If your eye feels weird when you sneeze let the technician know. You may unknowingly leave out a valuable tidbit of information that could change your diagnosis or the way the technician performs the refraction. See my hub Tips to Prepare for an Eye Exam for more tips on getting the perfect prescription.
If you wear bifocals, be sure to get them fit by a licensed optician. Eyestrain can easily be caused by a bifocal that isn’t set correctly in the lens or if the focal point is off-center. Glasses that are bent out of shape can also cause eyestrain.
Of course, you can’t prevent eyestrain completely, but with these tips, the frequency of its occurrence should be minimal. Always remember, if you have an eye problem, contact your eye care practitioner. If you get blown off by them, find another provider. They should always be happy to answer any of your questions no matter how insignificant they may seem.
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