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CVS requires multifaceted treatment
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It’s 11 p.m. and I’ve been on my computer for the past few hours. All in all, it is a pretty typical evening: checking e-mails, preparing lecture materials and working on editorials. While I feel as though I could go on, there is one limiting factor – my eyes. Maybe it’s the late hour or pre-presbyopia (read denial) or the fact that I’ve been staring at a computer monitor for so long. Regardless, one thing is evident. Computers are pretty visually demanding. While this may not seem like a particularly profound statement, it is reason to take pause. It is a reason to consider the far reaching aspects of computerization, the impact they have on our patients’ lives and, therefore, our practices.
Computer vision syndrome a common malady
The Occupational Safety and Health Administration estimates that approximately 130 million working adults spend at least 3 hours on a computer each work day. It is also estimated that nearly 1 billion people worldwide access the Internet daily, many for personal and leisure purposes. Given these staggering statistics, it is no surprise that the American Optometric Association reports that nearly one in every five visits to the eye doctor is driven by computer-related visual symptoms. In fact, so common are the symptoms that we’ve actually given it a name: computer vision syndrome (CVS).
CVS is proving to be a complex entity. We know that CVS is at least partially ergonomically driven. The distance, angle and orientation (susceptibility to ambient glare) of one’s monitor can influence patient symptoms. Hardware considerations, such as the size, contrast and resolution of the monitor also play a role. Add in software application considerations, and it’s understandable why CVS is so prevalent.
Computer, visual system both at fault
However, implicating the computer environment as the sole etiology for CVS is an oversimplification. The visual system itself is an important variable as well. As optometrists, we recognize the human visual system as an incredibly sophisticated, yet finicky apparatus. We witness this daily as imperfections in refractive status, accommodation, convergence and tear film result in visual symptoms. Also consider the unyielding demands of computer viewing, and it’s easy to see why CVS has become so prevalent.
In addition, given the multifactorial nature of CVS, its management is not always simple. Managing CVS is often a matter of orchestrating ergonomics, hardware/software and vision correction.
Optometry well equipped to address CVS
Arguably, no one is better equipped to address the complexity of computer vision syndrome than optometry. Our physiologic optics training provides a fundamental understanding of the relation between accommodation and convergence and how it is influenced by various stimuli (such as computer viewing). We understand the subtleties of ocular surface disease and the impact an aberrant tear film has on optical clarity. We know optical correction – the plethora of ophthalmic and contact lenses available for managing CVS. Perhaps, most importantly, we recognize the solution is not always as simple as an add power of 1.50 D.
CVS is not only among the most frequently encountered problems optometrists face today, it is, by all predictions, only going to increase in prevalence over time. As primary eye care providers, it is a perfect opportunity to diagnose, research, educate and manage – all in the name of enhancing patient care.