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Posted on 11-30-2015
All eye care providers are accustomed to seeing people complaining of dry eye. There are various causes of dry eye – poor tear production, excessive tear evaporation or poor tear quality. Treatments include nutritional supplements to improve tear quality, artificial tears and other eye drops/ointments to reduce symptoms, and tear duct plugs to stop tears from draining away from the eyes.
As it turns out, many cases of dry eye result from visual stress, not by the causes listed above. People who spend their workday at the computer or desk are under persistent visual stress. The human visual system was not designed for this kind of workload. Not everyone is symptomatic, but people are often unaware of the toll this takes on their visual systems. Many do exhibit symptoms like eye fatigue, headaches, neck aches, dry eyes, etc.
A very common story
Sandy, a 25 year old woman, recently out of college and working long days at a computer in a windowless room contacted me from out-of-town. Sandy was extremely uncomfortable and frustrated when we first met. She had already asked numerous doctors to solve her visual complaints. The only doctor who had any kind of answer, provided her with plugs (Sandy refused to use eye drops) to stop her tears from draining.
Sandy still had frequent headaches, eye discomfort/fatigue and double vision when we met. She also had trouble seeing in the distance, and her eyes still felt extremely dry on a consistent basis. Plus, people kept asking her why she was crying because her tears, now unable to drain properly, were constantly running down her cheeks. Sandy clearly didn’t have any problem producing tears. Maybe something else was causing her dry eye sensation. And what about all her other complaints?
Sandy’s eyes were physically healthy, she was able to see almost 20/20 at distance and near and had no prescription lenses. Her right eye did not see quite as clearly as her left eye. She demonstrated eye teaming difficulty, unstable focusing and eye movement deficiencies at her normal near working distance.
Remember, Sandy is a college graduate and a dedicated employee. She made it to where she is by hard work and perseverance. It is very likely that her visual conditions were present well before she became symptomatic, quite likely beginning at an early age. She pushed through and succeeded despite the fact that her considerable visual issues were never diagnosed. She needed someone to dig deeper in order to understand the causes of her complaints and symptoms, and provide treatment that would properly address all the issues – not just the most obvious symptom – dry eyes.
In Sandy’s case, all it took was the proper lenses. However, these lenses were not your everyday compensating lenses (usually referred to as corrective lenses). These lenses are what Dr. Robert Kraskin referred to as counter-stress lenses. I prescribed these lenses in glasses form for Sandy to use while at the computer, since all the close work she was doing was clearly triggering her complaints and symptoms. Counter-stress lenses change the way the brain and body respond to visual demands in a way that reduces the visual system’s workload.
It is likely that Sandy’s situation would have improved even more had she been able to try vision therapy, but she lived too far away and her schedule was too busy. Thankfully, the lenses had enough of an impact to stop her headaches and double vision almost immediately. All of her symptoms, including her nearsightedness and dry eyes, were gone within a week. Counter-stress lenses change the instructions to the brain, leading to more efficient use of the visual process. I describe this as using lenses to stimulate change from the inside out, rather than from the outside in. Counter-stress lenses don’t do the work that the brain cannot do, which is what most lenses are designed to do; they promote changes that enable the brain to change how it is doing things. This helps train the brain to use the eyes more efficiently.
Dry eye can be a result of tear-related issues. However, as behavioral optometrists have known for a very long time, dry eye can be caused by visual stress as described above. I think it is important to rule out visual stress as a cause before assuming there is something physically wrong. If you are someone who does a great deal of close work and suffers from dry eyes, be sure to consult a behavioral optometrist before settling for treatments that only consider symptoms without considering all the possible causes.
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