So i received my Quadro RTX 4000, and out of the box, this card is certainly usable, the image quality is "different" its not bad/worse, just different, but it feels its still slightly less flat, it doesnt cause me eyestrain/dizzyness and im glad to be able to finally use a somewhat recent GPU.
I saw several posts about a program called NvColorControl
https://ledstrain.org/d/1048-new-graphics-card-rtx-3090-gives-eyestrain/5
https://ledstrain.org/d/1119-g-sync-laptop-zero-eye-strain-from-gaming-tons-from-regular-use-help/20
I ran it with the settings "NvColorControl.exe 10 RGB 2" and the image looks the same as my Quadro K4200 now. From what i understand about reading the instructions from Vinz80 is that setting "2" is disabling the state for Nvidia to enable the dithering, if thats true then that would mean Nvidia is just enabling dithering for everything even if the monitor has a true 10bit panel.
I still need to test it under Windows 10 to see if NvColorControl helps, but on my Windows 7 installation it made a huge difference.