Computer Vision Syndrome is nothing new. It’s been around since the 1970s, but today’s situation is a whole new virtual ballgame.
Fortunately, we have an ever-expanding selection of digital spectacle and contact lenses that can be used to bolster the oculomotor system.
As Bob Dylan said, ‘The times they are a-changin’. Indeed, they are and indeed they have. A few years after Bob penned these words, Alvin Toffler, author of the best seller Future Shock (1970) stated that “Future shock is the shattering stress and disorientation that we induce in individuals by subjecting them to too much change in too short a time”.
Fast forward 50 years and we see the effects of change pervading our lives.
If for example, you follow the various social platforms, you’ll note increasing discussions, questions, observations, anecdotes and evidence surrounding changes invoked by COVID-19 and the toll of repeated lockdowns – visually and otherwise.
COVID-19 sped up our reliance on digital devices for work and leisure. Anecdotal reports of an increase in myopia progression during the pandemic have now been scientifically validated1 and a new term ‘quarantine myopia’ has become part of the lexicon.
By asking the right questions you will soon find out that many people experience symptoms of asthenopia, but don’t mention it up front
PREVENTION IS BETTER THAN CURE
The accommodative-convergence system can only take so much abuse before it runs into trouble. Potential early warning signs can manifest as symptoms of blurred vision, diplopia, headaches, dry or watery eyes, neck pain and at times, migraines and nausea. If not dealt with effectively, these issues can develop into debilitating problems and structural change, as well as under performance at school, work and more.
Whether the patient sitting in front of you is a primary school child, a teen student or adult, all can benefit from the advances in, and advantages of, so called digital/ computer lenses.
The old adage ‘prevention is better than cure’ applies here more than ever, and is no more clearly seen than in the rapidly evolving arena of myopia control/ prevention. Today we can include lenses developed, tested and marketed specifically for myopia control in the gamut of digital lenses. We will however, focus on specific digital designs in this edition.
Digital lenses can be seen as bolstering the oculomotor system, which ideally prevents symptoms and/or allows people to enjoy visual activities for longer periods of time. That doesn’t mean we should extend our cycles of concentrated near vision. Whether a person is reading from a book, Kindle or tablet; gaming, using a smartphone, engaging in tasks with fine detail, or working at a computer, regular breaks – including gazing at distant objects – are part of our visual and general hygiene. Walking around, getting some water or a meal are better than slugging back the energy drinks and eating take-out fast food at your workstation 24/7.
POSTURE, WORKING DISTANCE AND TAILORED PRESCRIBING
When prescribing digital lenses, it’s essential that we take individual working distance, posture and the type of near visual tasks into consideration.
These vary considerably between users and the type of device used; for example, a younger person may hold their smartphone at 20cm, whereas a presbyopic adult may hold their phone or tablet at 30 to 60cm. These different user behaviours have created challenges for lens designers and dispensers alike, as Nicola Peaper, National Sales and Professional Services Manager at Rodenstock Australia, explains. “When computer lenses were first introduced, they tended to be intermediate/near lenses with two larger working areas of specific powers and a short corridor tying them together. This was fine for last century working conditions where one screen and near paperwork were the main office tasks. Now we have multiple screens at different distances in different gaze directions, including smart phones at distances closer than 40cm that need to be considered. The challenge is developing a lens that gives enough width of vision at many different distances, while maintaining the ‘correct’ ergonomic head position.”
In practise we see that someone working on a large screen or multiple displays may have their screen positioned as far as 80cm, while still needing to see other things in the 20cm to 80cm range and beyond. Such things are also influenced by body type; those with shorter arms usually hold things closer than people with longer arms.
When prescribing and dispensing Ms Peaper advises, “When calculating the power needed to see a screen, it is vital to remember how much the patient’s residual accommodation is used to focus at that distance. It is not a simple one formula calculation. For multiple screens side-byside and stacked vertically, a ‘corridor’ lens design will not always work and a ‘boost’ lens may be indicated. Consider calculating the power for the middle of the furthest screen and use the boost for closer visual tasks.”
WRAPPING IT UP
Engage your patients, discuss the issues and address specific needs. By asking the right questions you will soon find out that many people experience symptoms of asthenopia, but don’t mention it up front. Some people assume that headaches and sore, dry eyes are normal. For those who have not worn spectacles before, alleviating them of these symptoms by prescribing digital lenses will surely result in a patient for life and plenty of positive referrals. For existing spectacle wearers, doing so can pave the way for prescribing multiple pairs of spectacles, targeted for specific uses.
In addition to spectacle lenses, there are now a variety of multifocal contact lenses in traditional designs as well as Extended Depth of Focus (EDOF) varieties; some of which are marketed specifically for digital eye strain. Essentially, any lens that reduces accommodative-convergence demand can be a winner, be it a spectacle or contact lens. William Tse, General Manager of SEED Contact Lens ANZ, offered this advice when it comes to contact lenses. “Consider using a low add EDOF design, which can be useful for those who suffer from accommodative stress due to excessive use of digital devices, mostly involving close-up reading. Relaxing the vergence system can improve reading speed and reduce issues of refocusing from near to far, among other things.”
Toffler also said that “Change is not merely necessary to life – it is life”. Embrace change, prescribe digital lenses and do what you can to make people’s lives easier. Check out the following fantastic options available from our partners and suppliers.
- Wang J, Li Y, Musch DC, et al. Progression of Myopia in School-Aged Children After COVID-19 Home Confinement. JAMA Ophthalmol. Published online January 14, 2021
Hoya Workstyle V+
Hoya’s Workstyle V+ is specifically designed to alleviate eye strain for presbyopes while at work or at home.
With iD Workstyle V + Space, Screen and Close, Hoya offers outstanding customisation to meet each patient’s working conditions and enhance posture while using laptops and screens.
A key feature of the iD Workstyle V+ Space, Screen and Close designs is Hoya’s patented Binocular Hamonization Technology, which performs individual calculations, ensuring the correction is appropriate at each point of the lens and exactly measured according to the needs of each eye.
Combine the new Sensity 2 Light reactive and Diamond Finish Bluecontrol Coatings with these advanced lens designs to provide a digital solution for all age groups.
Contact: Hoya Account Manager
Hoya Sync III
Hoya Sync III is designed to relieve the symptoms of digital eyestrain via a near boost in the lower portion of the lens. Children and young adults through to pre-presbyopes will benefit from this advanced lens design.
Hoya Sync III is further enhanced with the company’s patented Binocular Eye model. With the option for individual fitting parameters and three boost zone options of +0.57, +0.95 and +1.32, this lens helps to prevent or relieve eye strain, enhancing visual comfort during prolonged up-close activities.
The Ultra Boost zones provide extra accommodation support for a viewing distance of 20cm and closer, enhancing visual comfort, specifically for smart phone use.
Contact: Hoya Account Manager
CR Surfacing Anti-Fatigue Lenses
CR Surfacing Laboratories’ Anti-Fatigue lens design was developed to give welcome relief to hard-working eyes in the digital age. Ideal for short-sighted people who wear their glasses all day, this lens design incorporates a slight additional power at the bottom of the lens, supporting the ciliary muscles to readapt when shifting focus between different distances. The design relieves symptoms of digital eye strain, such as red, tired and dry eyes, blurred vision, and headaches. For maximum visual comfort and blue light protection, CR Surfacing recommends its Anti-Fatigue lenses with Satin Blue coating.
Contact: CR Surfacing (AUS) 03 8795 9111
Rodenstock Ergo lenses
Workplaces today place great demand on your patient’s eyes. The constant need for them to focus on monitors, desks and colleagues at different distances means a single vision lens will not suffice. Subconscious changes made to posture have to be compensated for, and often result in pain that is difficult to locate. Rodenstock Ergo computer lenses relieve your patients from stressed eyes, which will also help ease tense neck and shoulder muscles.
Available in three variations:
- The Ergo Book is ideal for short vision distances of between 40 to 60cm but allowing up to 1 metre with vertical movements of gaze. Perfect for laptop computers and tablets,
- The Ergo PC gives the widest area of clear vision at a medium distance up to approximately 1.20 metres and allows a monitor to be seen in total clarity and without strain with an ergonomic head and body posture, and
- The Ergo Room allows for relaxed vision, free from fatigue indoors with comfortable vision zones from the reading area up to four to five metres.
Contact: Rodenstock Account Manager
Shamir Vocational Digital
Designed for office environments, Shamir Vocational Digital lenses are ideal for focussing on near and mid distance work. The lenses come with three dynamic shifts – 0.75, 1.25 and 1.75 – and help alleviate computer vision syndrome, providing crystal clear vision for printed pages, computer screens and more.
Shamir Vocational Digital is perfectly paired with Shamir Blue Zero, a lens material with built-in protection against blue light. It also provides 100% protection against UV400. Shamir Blue Zero has no blue residual finish or annoying reflections.
Contact: Shamir Account Manager
VSP Unity Relieve
Unity Relieve lenses help your single vision patients combat digital eye strain from device use. This unique design has the familiar feel of a single vision lens. Using a three-pronged approach to reducing eye strain, it provides unrestricted distance vision, a slight power boost in the near, and targeted blue light defence, using TechShield Blue, to reduce the symptoms of digital eyestrain and fatigue.
Unity Relieve is designed to be easily customised to each patient’s unique visual needs rather than their age group. A personalised fit means better results and a superior patient experience.
Contact: VSP Optics (AUS) 1800 251 025
VSP TechShield Blue
TechShield Blue is an anti-reflective coating that combats digital eye strain by reducing exposure to blue light wavelengths by as much as 85%.
Visual performance is enhanced, and front and backside reflectance is reduced. It is also scratch resistant and repels dirt, oil and water.
Backed by a two-year warranty, TechShield Blue is available in single vision 1.50 stock and select grind lens designs.
Contact: VSP Optics (AUS) 1800 251 025
Zeiss SmartLife Digital
Zeiss SmartLife Digital lenses are sharply focused on the use of digital devices such as smartphones. Special optimisation of the near zone considers the typical movements of the eyes and the shorter reading distance required when using these devices. One of the distinct features of Zeiss’ digital range is its large range of addition powers; +0.50D, +0.75D, +1.00D, and +1.25D.
This design optimally supports the ciliary muscle, therefore making it easier for the wearer to focus their vision in the near and distance ranges, which may help prevent symptoms of fatigue.
Combine Zeiss digital lenses with Zeiss DuraVision BlueProtect coating, which is designed to reflect a portion of high-energy blue light while maintaining transition of good blue light required for normal colour vision and wellbeing.
Contact: Zeiss Account Manager
Eyezen is the clear choice to relax eyes and reduce digital eye strain. These lenses are available with Essilor Blue Light filter technologies; Smart Blue Filter, Blue UV Capture or Crizal Prevencia coatings.
Using DualOptim Technology, Eyezen Start’s ‘dual aspheric zones’ enhance acuity, especially for digital devices, by maintaining the wearer’s prescription across more of the lens. It requires no power boost to reduce visual fatigue with better comfort, contrast and clarity for single vision wearers.
Eyezen Boost lenses have a power boost to support accommodation for patients who need help viewing handheld and portable digital devices. Three different boosts +0.40D, +0.60D and +0.85D easily cover the needs of younger patients with accommodation issues, whether they require a distance prescription or not.
Contact: Essilor Account Manager
Pulseo lenses are optimised for use with multiple digital screens, aiding focusing when switching from near and middistance vision. Activ’ Boost technology helps Pulseo reduce visual fatigue by aiding accommodative effort when using digital devices for extended periods of time.
This lens accounts for near convergence with an inset that varies according to the patient’s prescription. Consequently, the patient experiences easier focusing and improved comfort for near vision tasks. An extra Boost at the bottom of the lens assists accommodation. Available in three versions; +0.30D, +0.60D and +0.90D.
Contact: OSA Account Manager
Nikon Relaxsee Neo
Relaxsee Neo uses Nikon’s unique ‘twin technology’ to provide clear, sharp vision without compromising performance. Using two zones, it offers stress-free near vision and sharp distance vision to help relieve digital eye-strain, especially for non-presbyopes. Relaxsee Neo’s power options ensure a match for all wearers to help provide comfort and relief when using hand held and portable digital devices.
Relaxsee Neo is available in +0.50D, +0.75D, +1.00D and +1.25D power options in clear, polarised and Transitions GEN8. Nikon recommends the use of ECC Blue UV or SeeCoat Blue UV to provide improved contrast by lowering blue light transmission. To ensure optimal results, measurements for pantoscopic tilt, wrap angle and back vertex distance are required.
Contact: Nikon Account Manager
JP Optical 21 Ray
JP Optical offers several progressive lenses designed specifically for computer and office use. These lenses offer enhanced intermediate and near viewing zones, at the expense of distance utility.
JP Optical lenses also come with 21 Ray – a unique, patented coating that reflects approximately 50% of near-infrared light, thereby reducing its absorption by the eyeball in the wave band of 780nm to 1400nm. 21 Ray also blocks harmful blue and UV light.
Contact: JP Optical (AUS) 0414 585 487
Opticare Blue Guardian
Constant exposure to harmful UV rays can lead to several eye problems. There is also the risk of further damage to the eyes for people who frequently use devices with digital screens that emit blue light. These conditions, when combined, make for an extreme mix that may negatively impact vision.
Opticare offers Blue Guardian, a blue light-blocking lens with UVA and UVB protection. It is available in Sunmatic, apt for outdoor use, and in Clearpro Relax, great for frequent computer users.
Contact: Opticare (AUS) 1800 251 852
Innovation may have led to the dramatic increase in screen time, but innovation also holds the key to combatting its effects.
Biofinity Energys contact lenses deliver all the benefits of Biofinity, enhanced with a unique optical design ideal for both on-screen and off-screen activities. This monthly replacement contact lens is designed to help your patient’s eyes better adapt so they can seamlessly shift focus between digital devices and offline activities for a more comfortable wearing experience.
Contact: CooperVision Account Manager
Screen time can mean discomfort for our contact lens wearers,2 as looking at digital screens can cause blink rates to be 60% less and thus dry out the eyes.3,4
The Acuvue Oasys family of contact lenses provides exceptional comfort while using digital screens, computer screens and digital devices.1
This Acuvue Oasys family of contact lenses was built to help with the feeling of tired eyes due to digital device usage.1,5 They were formulated with an internal wetting agent to help maintain a stable tear film and reduce dryness symptoms caused by exposure to digital devices.1,5
Contact: Johnson & Johnson Vision Account Manager
- JJV Data on File 2020. ACUVUE OASYS Family Digital Device Claims.
- Kojima T, Ibrahim O, Wakamatsu T, et al. The impact of contact lens wear and visual display terminal work on ocular surface and tear functions in office workers. Am J Ophthalmol 2011;152:933-940.
- Tsubota K & Nakamori K. Dry eyes and video display terminals. N Engl J Med 1993;328:584-585.
- Patel S, Henderson R, Bradley L, et al. Effect of visual display unit use on blink rate and tear stability. Optom Vis Sci 1991;68:888-892.
- Ruston, D. Computers, comfort, and contact lenses. Optician. 2006;6072(232).
SEED 1dayPure EDOF
SEED 1dayPure EDOF is a one-day multifocal soft contact lens with new innovative optics designed to give extended depth of focus for presbyopia management.
In particular, the Low Add design of the 1dayPure EDOF lens can be useful for those who suffer from accommodative stress due to excessive use of digital devices and computers without noticeable visual loss. The use of 1dayPure EDOF with Low Add will help the wearer by reducing the eye’s accommodative efforts. By providing a wider depth of focus range, the perceived image quality is improved across various distances, from near to far.
Visit: SEED www.seed-anz.com