Exophoria/Accommodation Spasm/Astigmatism - What should I do?

@Dominic do your symptoms happen, or happen as badly, even with reading paper books and e-readers?

Dominic Then I saw another eye specialist (very reputational, expensive and hard to get a consulation with) who completely denied all the previous diagnosis

Classic :-(

I understand your despair but this should be a warning when you think about eye surgery. I know nothing about strabismus surgery but I have experience with other forms of "minor" surgery. For instance, I had seven operations at my toes due to ingrown nails. They caused permanent damage and turned out to be completely unnecessary. I would consult a million specialists before going down that way…

Dominic I bought a cheap pair of glasses correcting my astigmatism (-0,25 on left and -0,5 on right eye)

I have -0.25 astigmatism in my left eye. I tried glasses and letters appeared neater and bolder, but that did not make any difference in terms of eyestrain / neck pain. Most doctors won't give you a prescription for that condition.

xelaos Do you have some issues with you jaw?

I have had jaw manipulations several times but I did not notice any improvement of my eye condition. I also started wearing a mouth guard three years ago because I was grinding my teeth at night. That is hopefully going to be helpful in the long run to preserve my teeth, but I never observed any correlation with my eye problems.

ryans olks who also had all "our" symptoms gone with neck chiropractic care.

I have seen chiropractors and osteopaths for twenty years. No progress as to eyestrain. Recently I have moved away from chiropractors and whenever I have a problem I see a physiotherapist or an osteopath.

Dominic Hi! Yes, my problems also started when I bought a new laptop - LG Gram 17.

How long ago was this? Do you mean that before buying that laptop you had zero issues?!?!?

Dominic When the first two are more undestandable as they are close to brain and eyes, getting warm palms and feet is quite a mystery.

I gave in using prismatic lenses after three days. I had pain everywhere. It started with my neck, then my arms - both biceps and triceps, then elbows and wrists, and it finally propagated down to my ankles. On my last day I also developed a piercing headache on the top of my left eye and eye burning which I never had before. It took me 8-9 days without glasses to recover decent vision at near. This is a fresh story. Last week.

Dominic I had a consultation with an oral surgeon as I cosindered my wisdom teeth as potential culprit, but he ruled it out.

I got rid of my wisdom teeth ten years ago. No change in my eye sensitivity afterwards, and my issues have got worse and worse for the past four years.

Mrak0020 Whatever damage eyes are taking, it can be accumulated. The best thing to do is avoid accumulation by all costs. Probably it is not a significant damage and can easily be healed with time. More damage you take, more time you need.

I agree with these statements. Now I am using my laptop at native resolution (first time ever on any computer) and the latest version of Windows 10 and I am doing better than months ago. I have no idea what I did to improve. I am a very bad sleeper and never found a correlation between eyestrain and lack of sleep, but perhaps adding several hours of sleep for some weeks has helped?

Mrak0020 One of my eyes was hit by a laser

I had a laser accident too twenty years ago. Those days I was not using screens but studying on paper became really problematic as the hit eye would pour tears and hurt all the time. After a few days I went to an eye doctor who confirmed there was a scar in my left eye, but told me it was superficial and would most likely heal on its own. He prescribed eye drops and glasses for myopia. The eye got better and the glasses quickly began giving me headaches. The next doctor I saw told me not to wear glasses anymore as they were an over-prescription. I guess, if you have a trauma you need to give time to the eyes to heal.

@Dominic Perhaps you can ask your doctor if it could make sense to take a Visual Evoked Potential test. Here for example they explain a bit about the technique.

I took the tests twice at a distance of one year. The first test was negative. The last one evidenced some mild dysfunction of the retina, but I have not discussed the results yet. Also, I get from talking to optometrists and orthoptists that borderline results have to be taken with grain of salt. I guess it is a very pushed technique and, although not new, still in the research phase. In any case, there is currently no cure if a dysfunction is found.

Dominic Any chance your eyes are really tired - sort of eye breakdown - and you need to take a pause?

Do you ever get double vision? What about watching TV? Do you struggle converging at any distance or only at near?

Another thing I thought of giving a go to is CBD oil but so far I have not met a doctor willing to prescribe it. In fact, my GP and neuro-ophthalmologist were not even aware that this product existed.

Dominic It looks like your condition has degenerated very quickly if you were sort of symptoms-free one and half year ago. I have been hanging in here forever compared to you. I read online and I was told by one optometrist and one orthoptic that there is a sort of breakpoint, past which rest is the only solution and recovery can really take months without doing any close-up work. It is similar to a nervous breakdown. You do not know if/when you recover. I will confirm with my specialists out of my curiosity as well. I am due to see all of them in September for another round of consultations.

I have no idea what the degree of your heterophoria is and I am not a trained specialist. However, I hope you ponder well on your idea of having a surgery. Sorry for being very direct, but after what you experienced (multiple pair of glasses, vision therapy) where do you get the confidence that a surgery will solve your issue? Also, at least in my case I do not think that esophoria is the principal culprit. That is what my orthoptists believe too. You know that there are people with severe heterophoria or strabismus who just get tired at the end of a day of computer, whereas in front of certain displays I develop symptoms instantaneously with a mild heterophoria? One of my orthoptists has exophoria and her symptoms are completely different from mine. She can use any phone and any monitor. She only gets tired more quickly that the average person. Both my orthoptists say I should strengthen my vergence and do all I can to have my eyes in the best shape, but are not confident that my symptoms can diminish by more than 10-20% by doing vision therapy. Please stay away from surgeons and medicines unless at least 50 doctors tell you it is the only way out :-)

ryans This confirms my fear that heterophoria is not my only / main problem. Since I have nothing else to focus on, though, I try to make my eyes as "robust" as possible.

By the way, can you pinpoint this study by Neurolens? Thanks.