Ophthalmic Lenses

Computer Eyewear: Provide Relief from Computer Vision Syndrome

By Teresa Narayan, OD

Offering patients relief from computer vision syndrome is a premium service that reflects well on your practice. It also yields multiple sales.

Time spent on computers, whether lap- or desktop, and using our omnipresent digital devices like smartphones and tablets, means many tired eyes. If you aren’t already screening and providing solutions for computer vision syndrome, now is a good time to start. Understanding the signs of computer vision syndrome and educating your patients about this condition, and the eyewear options available to bring relief, adds up to a practice builder.

Teresa Narayan, OD

Shoreline Eye Associates, P.C.

East Haven and Guilford, Conn.

University of Missouri St. Louis College of Optometry
Class of 2009

Locations: 2

Doctors: 1 MD practicing at one location; 1 OD (Dr. Narayan) practicing at the other.

Support Staff: 9 including technicians, opticians, front desk staff and billing staff

Comprehensive Examinations: 3,500 annually

Identify Patients in Need of CVS Relief

Since almost everyone is a computer user these days, identifying those who could benefit from computer eyewear requires more than just “Do you use a computer?” I generally start with a conversation during the history portion; obviously we cover blurred vision, but I also make sure to ask about burning eyes, eyestrain and headaches–all potential symptoms of CVS. After the examination of the patient’s eyes, I ask about how their eyes feel after computer use, especially if their eyes are dry, if they have binocular vision problems, if they have uncorrected astigmatism or if they need any sort of add. Many patients will say something along the lines of “My eyes get tired, especially at the computer, but that happens to everyone so I didn’t bring it up before.”

Ask Questions to Gauge Need

Ask patients: “How many hours a day are you on the computer? How many hours do you stare at any screen (including tablets, phones, etc). Do your eyes burn or get dry? Do you get headaches around your forehead or temples, especially when on the computer? Do you have to take off your glasses to see the computer clearly? Do you have to move in or out to see the computer clearly? Do you have to tilt your head up or down to see the computer clearly? Does the glare from the screen bother you? How is your home or office workstation set up–how far do you sit from the computer, how high up are you ? What kind of screen are you looking at and how big is the screen? Is the contrast and size of the font adjustable?”

Our intake form currently just has a blank for occupation and another blank for patients to tell us about their hobbies. My experience has been that patients do not like filling out paperwork, so if you overload them with questions, they will be skimmed and many will be left unanswered even if the patient is having symptoms. I’ve found it more efficient to keep the intake form to just the basics and ask the questions in the exam room as they become relevant.

Help Patients Relax Tired Eyes at Office

Lenses are now available that work as optical “relaxers” during a long day at the office.

One such product is Shamir Relax, a fatigue relief lens. Designed to ease the strain associated with with prolonged accommodation, the lens incorporates extra ADD power in the lower part of the lens. That means the eye muscles don’t have to work as hard at accommodation.

Relieving this strain may leave many of your office-bound patients feeling more energized and refreshed at the end of the day. –ROB Editors

Have the Conversation

The script would change a little depending on the patient’s needs, but here is a general template. I usually keep it pretty short in the exam room since our opticians are so knowledgeable. I just try and make sure that they know what I recommend and let them take care of the details in the optical. I might say: “Based on today’s examination, it looks like you would benefit from a pair of computer glasses. Your type of prescription is often more bothersome at the computer or in any situation where you are really exercising your focusing system. Having this correction as a separate computer pair will bring the screen into focus without having to strain or tilt your head. Your eyes will be able to relax and you should be able see more clearly at the computer and reduce your eyestrain. I would also highly recommend an anti-reflective lens which will cut down on the glare from the screen.”

Most Common Patient: Baby Boomer in the Office

As I mentioned before, anyone who is a computer user could potentially benefit from computer eyewear, but if I had to choose the most common patient it would be the older professional who uses a computer at work. These people spend many hours at the computer and often struggle with their presbyopia by making the font bigger, sitting further back, or tilting their head without knowing that there might be a better option. An investment in something that would make their daily work life much more comfortable is usually an easy decision once the benefits are clearly laid out.

No Additional Instrumentation Necessary

There are special devices designed to specially measure computer vision but they are generally specific to one lens design so I have found them limiting and do not use any special instrumentation. The biggest element in diagnosing the need for computer vision is a thorough history that involves probing about potential CVS symptoms. In addition to gathering a thorough patient history, a good refraction, accommodative testing, binocular vision testing and dry eye assessment (even mild dry eye is easily exacerbated at the computer) is likely all you will need to diagnose the need for computer eyewear.

Offer Eyewear Solutions

There are many options for computer eyewear, but we usually stick with the Essilor Computer or Nikon Online designs as both have made patients very happy. The total for the lenses including anti-reflective (which is a must for computer glasses) retails for around $375. We probably sell about 15 a month with that number growing as patients become aware of the option. If a patient is not interested in a separate computer pair–usually because of cost concerns–then we try to get them into a digital progressive lens with a wide intermediate zone such as the Varilux S Series, the Varilux Physio Enhanced or the Hoya ID Lifestyle.

Offer Second-Pair Discount

We don’t offer a special computer eyewear discount, but we offer 20 percent off all second pairs. Many presbyopes think that the only computer option is a standard progressive. Once they are aware of the possibility and benefit of computer eyeglasses and the opticians tell them they can get a discount,
they begin to seriously consider it. A patient interested in a second pair of prescription sunglasses may be better served by getting photochromic lenses for their first pair and having the second pair be computer glasses. The total cost will be slightly more for the patient but they will have more versatility with that combination.

Train Opticians to Assist in Providing CVS Solutions

Our opticians definitely take charge regarding computer eyewear since they are the most knowledgeable about the new lens types on the market. I mention the benefit of computer eyewear in the exam room and then the patient goes out to the optical and hears the same message from the optician so it is really reinforced. The opticians wear progressive lenses and have computer eyewear for themselves and are experts in explaining the pros and cons of each lens type to the patient. They go through all the options together so that the patient is able to understand how computer eyewear can benefit them.

Don’t Forget About Other Solutions, In Addition to Eyewear

While computer eyewear can certainly help reduce symptoms of CVS, I make sure to also touch on other factors that can help improve patient comfort at the computer. Ergonomics and optimal workstation set up is important as is appropriate lighting. I always tell patients to take frequent breaks at the computer, the 20-20-20 rule is easy to remember: Every 20 minutes take a 20 second break and look at something 20 feet away. Also there are computer programs to control the contrast of the screen which can help a lot with glare-induced headaches–f.lux is a great one that is free for Windows.

Provide Computer Vision Syndrome Solutions: Action Plan

Diagnosing CVS and the need for computer eyewear first starts with a thorough history. Although it takes an extra couple of minutes to delve into those questions, the benefit to the patient and to your practice is worth it.

Selling computer eyewear requires that patients know about the option! Many patients don’t realize that there is anything other than standard progressives. Likewise, many patients assume that their discomfort at the computer is a given and they don’t know that specialized eyewear could relieve some of their symptoms. I’ve had patients rave about their new computer eyewear and lament that it was never offered to them in the past.

Rely on your opticians to take care of the details. Just plant the seed about the option and benefit of computer eyewear in the exam room and then send the patient to the optical to hear all the details. I recommend lens types and lens treatments but don’t mention specific designs. A well-educated optician will look at the patient’s Rx, frame choice and lifestyle needs to choose the best lens for the patient.

Aid patients with slight prescriptions: low plus, uncorrected astigmatism, etc., may not feel the need for glasses for most activities, but the prescription could help at the computer, especially with an anti-reflective treatment. Ask these patients extra questions about how their eyes feel after computer use and whether the glare from the screen bothers them.

Related ROB Articles

Be an Expert in Treating Computer Vision Syndrome

Treat Computer Vision Syndrome with the Right Ophthalmic Lenses

Protect Patients from Eye Strain with Glare-Free Reading Eyewear

Teresa Narayan, OD, is an associate at Shoreline Eye Associates, P.C., in East Haven and Guilford, Conn. To contact: teresanarayanod@gmail.com

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