Reading an eye chart mounted or projected on a wall is a standard part of every visit to the optometrist today, but it wasn't always that way. Centuries ago, practitioners struggled to measure vis ...View Article
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Posted on 12-04-2014
When we last met, I stated that the human visual system was not designed for the amount and kind of close work that is so common in modern society. Perhaps some explanation is in order. First and foremost, our visual systems are designed for action. In fact, the primary purpose of the visual process is to direct action. Conversely, movement is critical for the health and development of the visual system. Also, our visual systems were designed for doing things in three dimensions. The third important aspect is the fact that we are meant to vary our looking distance, shifting from near to far, to in-between. It is not particularly good to spend long periods of time staring at one thing like a book or computer screen.
New research shows the importance of spending time outdoors as a factor in preventing nearsightedness. Most of these studies interpret the findings as demonstrating the importance of sunlight. I think natural light is important, but I think the big issue might be the open space of the outdoors. The visual system is stifled by the closed space of the indoor environment. The lack of open space for us to look out into adds to the stress of all the close work we do.
Much of what we do every day all but eliminates movement, three dimensions and varying our looking distance. Most modern close work involves sitting still and reading. Many visual problems involve stress on the visual system that results from excessive, though clearly necessary, close work and the struggle to meet the unnatural demands on the visual system. The real culprits are the type and quantity of close work/activities that pervade modern life.
The fact that so much of what we do today involves prolonged interaction with flat things is a big piece of the puzzle. People long ago probably did a considerable amount of close work: gathering and preparing food, making tools and clothing, etc. However, those activities have two aspects that are quite different from our modern activities. One is that the activities of the past involved movement of, at the very least, the hands. I think the more important aspect is that today’s activities are flat. Books, computers, televisions, hand-held devices of all sorts - FLAT. I believe that the brain is frustrated by this because it wants 3-D. Excessive interaction with flatness is fatiguing and stressful to the brain. Or perhaps it just makes the brain lazy in certain ways. Either way, it is causing visual problems of epidemic proportions - especially nearsightedness, and possibly many cases of dry eye.
The most common response to visual stress related to close work is nearsightedness (myopia) - the inability to see past a certain distance without artificial lenses. But here’s the catch: nearsightedness is not the problem per se. Nearsightedness is often a symptom of the problem. The problem is an inability to adequately handle the demand of close work. There are various other conditions that result from visual stress. Most are more complex and subtle than nearsightedness, and may actually include nearsightedness. It is likely that a standard eye exam will ignore much of this (with the exception of the nearsightedness), leaving patients to manage the situation on their own.
Doctors all too often merely address the symptoms - nearsightedness, dry eyes, headaches, eye fatigue, etc. Just as often, they might say that the symptoms are unrelated to the visual system. Many continue to claim that excessive close work has no impact on the visual system. Don’t take anyone’s word for it; do your own research. And when your symptoms are either brushed aside or left unresolved, don’t give up. It usually requires a more in-depth evaluation and a doctor who understands how people really use their visual systems, to come up with an answer that will really work. Vision therapy and proper lenses can go a long way. Find a behavioral optometrist near you next time you’re thinking about your vision and what might be possible.
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