By Nathan Bonilla-Warford, OD
Prescribing ophthalmic lenses to patients challenged by computer vision syndrome will enhance their vision while expanding the services your practice offers.
Peopleuse computers and digital devices more than ever before. More than 75 percent of all jobs in the US involve some computer use. This heavy computer use is causing problems for patients that optometrists are uniquely trained to treat. Not only does managing Computer Vision Syndrome improve the quality of life of our patients, but it is good for the optometric practice, providing increased revenue, patient satisfaction and improved reputation.
Computer Ophthalmic Lens Options
Computer lenses are available from a variety of manufacturers. Some are fit and ordered like PALs; others are fit as near variable focus lenses.
Zeiss Gradual RD
Essilor Computer Lens
Essilor Anti-Fatigue Lens (0.60D Add)
Prio Computer Lens
The American Optometric Association defines Computer Vision Syndrome (CVS) as “a group of eye and vision-related problems that result from prolonged computer use.” CVS is a repetitive stress injury. The most common symptoms of CVS are eyestrain, headaches, blurred vision, dry eyes and neck pain. These are caused by prolonged accommodative and vergence demands, unstable tear film and inappropriate bodily posture assumed by patients as they use the computer.
CVS is common, as suggested by the fact that a Google search for Computer Vision Syndrome turns up over 1 million results. It has been estimated that over 90 percent of people using computers three hours a day or more have CVS symptoms.In fact, research by Jim Sheedy, OD, PhD, suggests that one-out-of-six patients receiving eye examinations has a computer-related vision problem. As computer use increases, so do CVS complaints. Many of the patients that I see report using computers and other digital devices 10 or more hours a day. These patients are much more likely to have CVS-related complaints that affect their productivity and comfort.
Optometrists are well positioned to provide excellent care for patients with CVS symptoms. We understand visual function and ocular physiology. We also have a thorough understanding of optics and the manufacture and proper adjustment of eyewear.These skills allow optometrists to provide the best care for patients and be well-compensated in return.
Consider the Benefits of Treating CVS
- Increased professional services: The proper diagnosis and treatment of CVS requires a thorough history and exam of the eyes and visual function of the patient. These clinical services are frequently above and beyond the basic exam. Associated conditions, such as dry eye syndrome or convergence insufficiency, may require multiple visits that are billable to medical insurance with the appropriate ICD9 code.
- Premium lens sales: Today, many lenses are designed specifically for computer use and are more profitable than historical alternatives. Once patients understand that lenses can provide large intermediate viewing area, while allowing some distance and near, they see the obvious advantages over single-vision prescription lenses and over-the-counter readers.
Multiple-pair sales: As useful as computer-specific lenses are, they are not intended for activities that require distance vision such as driving and watching movies. For everyday life, patients require additional eyeglasses such as premium progressives and prescription sunglasses, increasing the average revenue per patient.
Increased patient loyalty: In our fast-paced culture, patients are accustomed to the bare-minimum level of satisfaction, especially in health care. When you take time to find out about their everyday work environment and offer solutions that improve their quality of life, they appreciate it. They will be much more likely to return for further care.
Increased word of mouth: Many patients work in office settings and have similar visual problems. When a patient struggling with CVS sees the improvements resulting from your care, they are likely to share with others, resulting in a steady stream of new patients.
Treating computer vision syndrome
Educate yourself. With increased awareness of computer vision syndrome, there are many options for learning about its management. You can learn about the current research on CVS by attending continuing education courses offered at national and state optometric meetings. Ophthalmic labs and lens manufacturers have information about CVS that they’d be happy to share. Online, you can find published research and management guidelines. And don’t forget to ask your optometric colleagues what is working for them.
Order yourself computer glasses. I am firm believer that the best way to understand a product or service is to try it yourself. After researching computer-specific PALs and near variable focus (NVF) lenses, order a pair for yourself. Many manufacturers allow for a complimentary job for the doctor. Test out the lens during administration time.Many optometrists love their computer eyeglasses so much that they like wearing them during patient care as well.
Ask every patient how much time they spend on computer/digital devices.If you have not done so already, add a question to your medical history form that asks patients how much time per day they spend in front of the computer. This is addition to asking their profession.Some offices have a separate form specifically forCVS complaints that includes type of digital device usage, screen distance, lighting, etc. I have a conversation about CVS with every patient who answers that they spend more than three hours per day in front of the computer. If they are experiencing CVS symptoms additional testing and management is performed.
Educate about why PALs are not ideal for computer use. Most patients simply do not know that there is an alternative to PALs for computer use. When you dig deeper and ask about excessive head movement, near strain, and that small “sweet spot,” many patients will frequently admit that this is frustrating for them. Explain that PALs are fantastic for the supermarket, but are not designed for heavy computer use. Tell them a new lens option would be better for them.
It is not all about eyeglasses: visual ergonomics. Although appropriate eyewear is certainly an important element of managing CVS, it is just one component. All patients will benefit from improved visual ergonomics, lighting and reminders that brief visual breaks are a necessity. Some of these things are beyond their control, but developing good visual habits will serve them well in any environment.
Develop a short script. In a busy practice, optometrists are leery of starting a long discussion during exams. Refine your presentation about CVS to what works for you. I tell patients in professions such as computer programing and engineering that our eyes are not suited for the effort of prolonged computer use. For them, computers are an occupational hazard, and CVS is the result. They are not going give up the computer, but they can take steps to make themselves more comfortable and productive when using it. Conclude with a prescription for a specific lens as opposed to a vague recommendation for “computer glasses.” If this is not your usual style, read Prescribing from the Chair, by Review of Optometric Business professional editor Mark Wright, OD.
Second-Pair Discounts. In this economy, many patients are hesitant to purchase another pair of eyeglasses that is not for general use.In our office, we take advantage of lab discounts and offer 50 percent off a second pair of eyeglasses. This is a great incentive, and we have increased our multiple-pair sales since we began this promotion.
Get the word out! Let your patients know that eyestrain and headaches from computer use are treatable! Educate in your office with brochures, internal signage or videos. Provide information on your web site or through social media avenues. When you get out in the community, consider promoting computer vision care at health fairs, business organizations or through speaking engagements. It is so common that most people will make an instant connection: You can solve a problem that will improve their quality of life.
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Nathan Bonilla-Warford, OD,of Bright Eyes Family Vision Care in Tampa, Fla., is a graduate of Illinois College of Optometry. He is a member of the American Optometric Association, and is currently immediate past president of the Hillsborough Society of Optometry, as well as chair of the Children’s Vision Committee of the Florida Optometric Association. To contact him: Doc@BrightEyesTampa.com.