Reading glasses for patients < 40

[DOCTORSAIB]

Hi everyone,

I worked as an ophthalmic tech for some years before starting medical school. During my time as a tech, young patients (ie. NON-presbyopics) would come in after seeing an optometrist thinking they needed to wear reading glasses. Upon further questioning, they would say "I told my optometrist that I get blurry vision after reading and working on the computer so he/she told me I need reading glasses." From my training, these people sound like they have dry eyes, if anything. Is there something that I'm missing/don't understand that warrants giving these non-presbyopic patients reading glasses?

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[DOCTORSAIB]

Hi everyone,

I worked as an ophthalmic tech for some years before starting medical school. During my time as a tech, young patients (ie. NON-presbyopics) would come in after seeing an optometrist thinking they needed to wear reading glasses. Upon further questioning, they would say "I told my optometrist that I get blurry vision after reading and working on the computer so he/she told me I need reading glasses." From my training, these people sound like they have dry eyes, if anything. Is there something that I'm missing/don't understand that warrants giving these non-presbyopic patients reading glasses?

60 views and NO replies....sheesh. Maybe I should have posted this in the optometry forum.

 

[Richard_Hom]

"...Is there something that I'm missing/don't understand that warrants giving these non-presbyopic patients reading glasses?

Dear doctorsaib,

I guess you should have posted on the optometry forum. This subject isn't much studied but has many opinions.

The notion that presbyopia is the only cause for blurry vision at near while using a computer is rather limited. Dry eye syndrome (375.51) may be a cause as would accommodative insufficiency, convergency insufficiency, etc. When it comes to the "functional aspects" of vision, optometrists are probably more focused on this aspect of vision than "structuralists" (ophthalmologists).

I would attack this complaint from various angles. It could be a dry eye and it could also be a binocular vision problem.

Richard Hom,OD,FAAO

 

[cpw]

chances are they were given glasses for the specific working distance of their computer. By having glasses made for this specific distance it can combat some of the asthenopia (eye-strain , headache, fatigue) of a patient with these type of complaints. Their problem could be any of the ones Dr Hom listed above. Without seeing each patient individually, it's hard to name it as one specific thing.

 

[mdkurt]

Hi everyone,

I worked as an ophthalmic tech for some years before starting medical school. During my time as a tech, young patients (ie. NON-presbyopics) would come in after seeing an optometrist thinking they needed to wear reading glasses. Upon further questioning, they would say "I told my optometrist that I get blurry vision after reading and working on the computer so he/she told me I need reading glasses." From my training, these people sound like they have dry eyes, if anything. Is there something that I'm missing/don't understand that warrants giving these non-presbyopic patients reading glasses?

Optometrists tend to focus on relaxing accommodation to prevent visual discomfort, whereas this concept really isn't touched on too much in ophthalmology. We're taught that the eye is built to accommodate and doing so won't hurt it. I like to try artificial tears first, because it strikes me (and the patient) as the most logical and easiest first step in therapy. I don't know who is right or wrong.

 

[JennyW]

Optometrists tend to focus on relaxing accommodation to prevent visual discomfort, whereas this concept really isn't touched on too much in ophthalmology. We're taught that the eye is built to accommodate and doing so won't hurt it. I like to try artificial tears first, because it strikes me (and the patient) as the most logical and easiest first step in therapy. I don't know who is right or wrong.

If a patient has an amplitude of accommodation of 8 diopters, but they are running around using 2 or 3 of it all day simply looking at a computer, asthenopia is likely to result. COnvergence also plays a large role.

Most ODs take the philosophy that while the eyes CAN accommodate, they're not really built for that. Eyes are supposed to focus far, and point far. Not focus close and converge (which is what we do in our society.)

I can lift 50 pounds. But I can't carry 50 pounds around all day and that's essentially what you're asking your eyes to do when looking at a computer screen for 8 hours a day. (I'm talking accommodation here, not EOM convergence)

For patients that complain of transiet blurring throughout the day absent any sense of asthenopia, artificial tears usually work. If transient blurring occurs WITH asthenopia or if asthenopia occurs at the end of the day, then low powered reading glasses will usually work.

Jenny