o.d. to o.d.
Computer Vision Syndrome
Are we giving this condition enough attention?

BY NEIL B. GAILMARD, O.D., M.B.A., F.A.A.O., Chief Optometric Editor

As optometrists, we've been aware of computer vision syndrome for a long time. Even before computers existed, we always associated the nature of a patient's vision problem and the correction of that problem with the visual task that she regularly performed.

By asking, "How do you use your eyes?" we know how to prescribe. We've always taken unusual posture, working distance and head position into account when prescribing multifocal glasses. And we know that one lens prescription may not meet all of a person's visual needs. We also know that small vision problems can produce big symptoms when a patient places great demand on her visual system.

Have we been slacking?

So I'm wondering if we've become complacent about the management of computer-related vision problems. Have we elevated the management of computer vision syndrome to the high level of visibility it deserves in our practices? Are we educating our patients about it one at a time?

Because computer use has become so commonplace in the work environment, and because prescribing for special tasks is a natural part of our work, I think optometrists may be missing a big opportunity to help patients. It's one of those specialty areas that we think we're covering -- but are we really?

Question your own practices

Ask yourselves these questions:

• Have you selected a specific computer/office progressive lens as the brand of choice for your practice? Several leading lens manufacturers are producing these specialty progressives. They're a dream to wear in the office environment because they correct the intermediate and near zones perfectly with wide visual areas and no distortion.
  Are you prescribing a lot of them? Do you and your staff know exactly how to prescribe, measure, order and fit them? Sure, patients could "get by" with a separate pair of single vision near only lenses -- but isn't our job to recommend the best first? Don't those patients who spend hours every day on a computer deserve to know what's available?
• During your routine case history, do you specifically ask every patient about his computer use -- both on the job and at home? Those who respond that they use the computer frequently are candidates for special nearpoint testing and education about computer lenses. We shouldn't wait to hear complaints. Even in the absence of complaints, presbyopic computer users may benefit from the pure convenience offered by computer progressives.
• Do you have educational brochures about computer vision syndrome on hand to give to patients and do you do this regularly? These are available from the American Optometric Association and from lens manufacturers.
• Have you held staff meetings to train your technicians and opticians about computer progressives? They should all understand how these lenses differ from regular progressives and how they benefit patients.

Just let your patients know

I know many patients will balk at the cost of a separate pair of computer glasses -- and that's normal and expected. It's not a rejection because I'm not advocating "selling" computer glasses, but rather simply informing appropriate patients that special lenses are available, and that they could provide more comfortable vision for long-term computer use. Those who want or need this type of lens will let you know.