I was plagued by chronic eye strain for almost half a decade. It started when I had a full-time deskbound job. First it was dry eyes then it worsened into severe eye strain, blurred vision and nausea. I am myopic and had no issue with my spectacles prescription while schooling. - Was diagnosed with convergence insufficiency, accommodative lag and reduced accommodative amplitude. Went through 2 years of office and home-based vision therapy with different optometrists but to no avail - Tried prism spectacles and anti-fatigue/progressive glasses prescribed by optometrists but found it nauseating and not very helpful - Started having severe bouts of vertigo - Had to change my job as eye strain was extremely distressing and fogs up your mind - Visited many specialists including in the field of neuro-ophthalmology but all told me that I was fine and I just needed rest - Was introducted to traditional chinese medicine (TCM) i.e. acupuncture and herbal medicine. Went through 2 years of TCM which definitely helped to alleviate symptoms but still had good and bad days - Explored different monitors, phones and e-readers and their settings such as refresh rates, blue light, PPI, IPS vs VA panels, contrast levels I was utterly convinced that I'll have to learn to manage the symptoms as long as I am having a deskbound job. Finally found an optometrist who studied my condition and told me that my current prescription was over-corrected for myopia by 0.25 SPH. Mentioned that my eyes were sensitive thus a 0.25 SPH makes a huge difference. They updated my prescription for myopia and astigmatism and all became well. I couldn't believe I went through all of this, spent an exorbitant amount of money (vision therapy and TCM were not cheap), missed out on work promotion, to arrive at the fact that my prescription was slightly off. I figured the uncorrected refractive error coupled with the near vision demands during work might have compounded into a binocular vision disorder. I know this might not help everyone here but I would just like to share my experience to help whoever I can. Hit me up if you have any questions.

[unknown] yeah, I am now able to use my devices, Samsung S20FE, ASUS eye care monitor series and Kobo Libra 2 for much longer periods now.. Will try to gradually test out reading for longer. [unknown] hi there, Previous rx - Right: -275 Sph/-0.50 Cyl/76 axis. Left: -300 Sph/-1.00 Cyl/86 axis Corrected rx - Right: -275 Sph/-0.25 Cyl/65 axis. Left: -275 Sph/-1.25 Cyl/85 axis I didn't suspect that my prescription was off as many optometrists that I visited would tell me it is correct. I do think that innately my eyes are weaker in sustaining during near vision tasks especially with digital devices (as compared to print) thus the typical optometrists' correction may not be right for me. While I am able to use digital devices with less symptoms now, my optometrist suggested a separate pair of computer glasses with -250 sph (both left and right) to further ease any eye strain. Seems that with -250 sph, I would already have 20/20 vision but typical optometrists' correction tend to go for sharper and clearer far vision which causes issues in near vision for me. Not sure why though.

Uncorrected refractive error

degen

Bumping this post as there was a delay on my end in approving it.

Clokwork

degen I was unable to approve it. I kept getting an error.

ryans

Very interesting @Edithda. There is another post similar to this about a small astigmatism correction.

Both your posts make it clear to me that although some optometrists say 0.25 is "imperceptible", it definitely can be.

Are you able to use any digital device now?

Mrak0020

ryans I can't imagine how they can be imperceptible, when I was trying different glasses to fix my very small astigmatism first time in my life, 0.25 were oh so perceptible. I even ended up with contacts instead of glasses 'cause contacts were easier for my vision to perceive than eyeglasses, with the same prescription.
I walked one day in contacts, took them off and never wore them again.

Mrak0020

Edithda WOW. Just. Wow.
This is a proof of how much troubles accommodation can bring.
Greetings with this finding, it seems you had few years of hell but it is better late than never.

Dominic

Edithda As my 0.25 astigmatism makes a difference as well, your story seems very interesting for me.
Could you specify the difference between your wrong and correct presciption?

Overcorrection of myopia worsening the symptoms also makes sense for me. Occasionally I used to wear glasses with small myopic correction (0.5 and 0.25), but since my problems with bad devices appeared and I completed my vision therapy I've been not able to wear them anymore as they give me an immediate headache similar to one I get from devices.

Mrak0020

Dominic You may also find this info interesting. On one eye I have 0.5 or 0.75 astigmatism based on auto refractometer, and 1 vision based on visual test. I have no idea how to correct astigmatism when it is both untraceable with test and 0.75 with refractometer. Whatever contacts my ophthalmologist tried on this eye, my eye said "no" - I felt worse not better.

bkdo

Mrak0020

This is so strange, I had the same experience as well. I have astigmatism, but I rejected any kind of correction every time during the eye exam. I wonder if it’s worth it to get lenses that correct the astigmatism & see if it just takes time to get used to them or something.

Dominic

Mrak0020 I think people are more sensitive to astigmatism correction than spherical one. That's why many opthalmologists don't add small cylinder unless it's clearly needed. My astigmatism glasses also give me a slight headache and sometimes eye strain, but they lessen my other symptoms I usually get from devices. I can say it converts my symptoms. One of my hypothesis is that devices somehow impairs my accommodation ability and when I wear small astigmatism correction it eases the process of accommodation for my eyes (this is why small astigmatism up to 0.5 is usually not corrected because your accommodation skills compensates for astigmatism), so I feel a partial relief, but it's still not the source of my problem as headache and potential nervous system overload persist.

By the way, have you tried to directly cure your potential spasm of accommodation by cyclopegic eye drops? Just to see if it changes anything in your symptoms?

Edithda Thank you for your prescription. Do you think it's more astigmatism or spherical correction that makes a difference for you?
You mentioned your convergence insufficiency. Do you remember if you were also diagnosed with exophoria or another kind of heterophoria?

martin

Edithda So you still have some issues, but they are more bearable? You didnt go from "migraine within seconds" to "problem free", right?

Mrak0020

Dominic I've never tried to use cyclopegic eye drops, as it never came to my mind.
I have no prior experience with correcting my astigmatism, but here is a full story of this single correction attempt.
Astigmatism found: somewhere in 2018-2013, don't remember exactly.
Days when my eyes were tired from 15 hours screen time per day, since 2013: zero
Do I feel my astigmatism in daily life: no. I feel it only when I look with one right eye
How I do perceive my vision on a daily basis: as 1 (perfect). Sometimes very slightly below

When all this unexplainable phone eyestrain started this autumn, I went to optics to correct my astigmatism and see how it goes. I can't find prescription and measurements from October, but here are measurements from November (subjectively there was something wrong with my eyesight at the moment):
Left eye vision test: 1
Right eye vision test: 0,4
Left eye: sph +0,25 cyl - 0,75 ax 122
Right eye: sph +0,25 cyl - 1,75 ax 84

Correction attempt in October: one lens solely for the right eye (worse one). Left eye rejected any correction
Wearing lens all the day: moderately ok, no problems with eyesight, no red eyes, some spatial disorientation due to image distortion by lens.
Wearing lens later with the phone:

Spasm/pressure was almost not present on the right eye
Right eye tried to focus maybe 50 times in a row on the phone, just like camera. It was so very noticeable. It eventually failed to find a focus, got tired, unfocused and rejected any further attempts to focus.
Results were the same when I looked with one eye or with both eyes
Right eye turned absolutely red in 20 minutes. I could attribute that to lens but it was ok all day and started when I took the phone. And also it happened before with no lens.

Correction attempt was made prior to finding phone influence on my binocular vision. When I tried to correct BV at the very beginning with stereograms, I got an unexplainable result: not only my spasm was gone but also my right eye became almost as good as the left one for a few hours.
My phone made things much worse since October, and I can't check that magical effect further.
Maybe when all this madness stops, and my eyes are fine, I will try to do exercises and see what will happen to my eyesight.

Dominic

Mrak0020 I see you got glasses for small farsightedness. Is it your actual refractive error or your opthalmologist just prescribed plus power to ease your accommodation?

One of my orthoptists gave me glasses with cylinders and plus power (even if I'm not hyperopic) and it felt worse than glasses with cylinder exclusively.

I don't know if you have an option of making a cheap pair of glasses, but if I were you, I would also try to make glasses with half of your cylinder like -0,5 and -1 and see how it works.

When working with stereograms, were you using your convergence(crossing your eyes making an inward movement) or divergence?

Mrak0020

Dominic those are measurements on refractometer (not a glasses prescription), and I never noticed any small farsightedness but I also never had eyesight troubles to investigate them, so I know little about my vision so far 🙂
I decided to stay away from the glasses for now, as it seems comparable to taking vitamin D with calcium to make bones stronger when a wolf is eating your leg. I want to stop the wolf.

I was looking at parallel stereograms that presumably diverge eyes. As the pressure from the screen reminded me of cross-eyed stereograms where eyes excessively converge.
I also tested myself with the Brock string in the middle of a weird eyestrain from my safe screen, that happened few days ago, and found out that my convergence was jumping: eyes crossed at the focal point then moved closer, then crossed again at the focal point then moved closer and so on. Seems that phone pushes my convergence to excess and leads to later convergence excess when I focus everywhere else.

Dominic

Mrak0020 Yeah, I know about the wolf, but after many months/years of fighting this problem you can just be extremely exhausted like I and many of us are now.

This what you have just written is a vital info for me as I'm recently torn between spasm of accommodation and exophoria. They are mutually exclusive in terms of treating them and I don't believe both of them affect my symptoms.
I remember when doing vision therapy convergence exercises became quickly very easy, but I always had problems with divergence. Eye specialists who carried my office exercises didn't care about divergence as it was only convergence taking part in near tasks which I've had issues with.
The thing is that spasm of accommodation often goes along with esophoria (inward movement), not exophoria which I have. That's why most of eye doctors I saw immediately bet on convergence insufficiency not even thinking of SoA.
Please, remind me, are you diagnosed with exophoria/esophoria or not?

Mrak0020

Dominic Yeah, I know about the wolf, but after many months/years of fighting this problem you can just be extremely exhausted like I and many of us are now.

Sure, I understand you completely.

Dominic Please, remind me, are you diagnosed with exophoria/esophoria or not

I've never been to full optometric examination, so not. On both ophthalmological examinations this autumn I noticed the following. They do a very basic test for eye crossing. You sit on a chair and look at the wall trough some glasses with different images for both eyes. You see something like this on a wall:
This cross should be in a middle of a circle and not outside. In both cases I saw a cross in a middle of a circle, but it was slightly leaning to the right. It doesn't seem to bother ophthalmologists, you pass the test if the cross is within the circle. I have no idea what I would see under normal conditions, as my convergence is doing all kinds of weird things now.

I also suspect that all this may lead also to accommodation spasm: it seems that I overworked my eyes and sometimes image is less clear than it should be when I look with only one eye. But it seems that for me accommodation spasm is the recent consequence of everything that happened to my eyes within last few months, unlike convergence excess. Convergence excess was a very first symptom. I even had double vision somewhere in October before I realized what happened to my BV and fixed it slightly.

I do not know for sure what is going on and I can't advice you, but I would try tracking what your convergence is doing normally, when you look at the screen, and after you look at the screen.

Also if you've been doing convergence exercises and your convergence is also affected by screens... well... that could explain what went wrong with the exercises. For me any convergence exercises were a no-no, I tried only divergence (and still managed to overwork my eyes).

What you said about accommodation spasm is new to me, I didn't know it goes along with esophoria.