There is no question that the use of video display terminals is pervasive in the United States,  whether it is job related tasks such as word processing or data entry or whether it is use of use of video display terminals for internet surfing and video games.  Consequently people are spending a large part of their day in front of the computer.  Along with this increase in time has come an increase in ocular complaints among our patients.  People may experience and complain of foreign body sensation, fatigue, and eye strain.  They may experience glare, pain, redness, double vision or even headaches.  The problem is significant. These computer related symptoms come up often in our eye exams.  The longer one sits at the computer or the video display terminal the worse their symptoms tend to be.  We recommend that our patients take frequent short breaks from computer use such as five minutes per hour in addition to infrequent longer breaks.  Patients are encouraged to blink voluntarily.

Artificial tears are another key treatment for patients who have ocular complaints during video display terminal use.  We recommend frequent use of artificial tears.  Single vision computer glasses have been found to be helpful and are often more comfortable than bifocals or progressive lenses depending on the type of computer work.  If multifocals are necessary, it has been shown that lenses that cover the area from up close to 2 meters tend to be more comfortable than others.  Given the nature of the work, spectacle design and fit needs to be modified on a patient by patient basis and this is something with which our Licensed Dispensing Optician is very familiar.

Careful examination of the eye and the eye muscle balance is also important.  Frequent breaks from video display terminal work and other near work may decrease incidences of accommodative spasm and visual fatigue.  Numerous studies have shown that placing the monitor below the horizontal plane of the eye increases visual comfort.  High monitor placement is associated with eye strain and eye discomfort.  About 10-20 degrees below the horizontal plane is often appropriate.  Also, placing the display terminal 50-70 centimeters away allows for some physiologic resting levels of eye balance.  From a stand point of ocular comfort, we recommend anti-glare filters over the VDT screens.  The type of monitor is important as well: High resolution monitors are better tolerated.  Screens with dark characters against a light background are recommended also.  You should regularly clean dust particles from the surface of the video display terminal.  We recommend also video display terminals with high refresh rates.  High refresh rates correlate with lower perceived screen flicker and have been shown to improve higher amplitude and blink rate compare to lower rates.  Liquid crystal displays (LCD’s) have extremely high refresh rates and are very well tolerated.  Decrease in glare and illumination from bright overhead lights or windows are important to improve comfort as well.  Constant brightness as opposed to bright and dim spots is preferable.  We also recommend background brightness should be three times greater than the ambient lighting. 

By offering these hints, we hope that we can help alleviate daily irritation for a large number of our patients who enjoy the use of computer screens in their personal or occupation related tasks.  If we can be of further assistance, or if the symptoms do not improve, please feel free to contact us through our website or our telephones.

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