I have been away for quite some time, and I have not read the whole thread – guess why? Eyestrain! I will try to catch up. Meanwhile, I would like to report what I learnt in the past 6 months.
First, let me recall my symptoms, which are extreme sensitivity to modern lighting - mostly LEDs but also some fancy fluorescent overhead lights - and eyestrain using modern devices / OS.
I visited a few specialists, coordinated by a neuro-ophthalmologist and an orthoptist.
The neuro-ophthalmologist did not find anything anomalous in my eyes and prescribed electrophysiology tests to try address my sensitivity / intolerance to LEDs and bright lights. Electrophysiology tests check to see how well the visual nerve pathway sends the electrical signals needed for vision. These tests measure electrical activity that occurs in the eye when looking at something (I pretty much copy-pasted this, as I am not an expert). The tests lasted a couple of hours and consisted in following lights of different colours, brightness and flicker moving left to right and vice versa within a half-sphere slightly larger than my head. The tests were carried out in both daylight and dark conditions. The response was that my eyes (retina – if I recall correctly) work fine in daylight conditions but are not great in the dark. This may be the reason why I suffer of poor balance at night-time. I was recommended to try to increase the intake of vitamin A and I am due to re-take these tests in a year time. These tests ruled out the need for an EEG under trigger, according to the neuro-ophthalmologist.
The orthoptist assessment was fatigable convergence and slightly reduced positive relative vergence range at near. For the first month, I carried out jump convergence exercises and positive relative vergence exercises (cat stereogram). Next, maintaining the previous exercises, I began using a 35^ prism for vergence training. I made quick progress and became more serious with my routine. About 2 months into visual training, my eyes were assessed orthophoric at distance with a 4^ esophoria at near, and normal ocular movements. My fusional amplitudes were found much improved (1^ BI to 45^ BO for distance, and 1^ BI to 45^ BO for near) with respect to when I first saw the orthoptist (sorry, I have no notes of what the initial state was). I kept pushing with the exercises, training my convergence with a 45^ BO prism (instead of a 35^ one) and my divergence with 4^ BI prism. A month later (in total three months of training), I was judged “in spec”. I was invited to stop using prisms but keep doing the other exercises. I should have a new assessment in 6 months to see if I have maintained my achievements without doing further prism exercises.
Both the neuro-ophthalmologist and the orthoptist said that my symptoms are typical of people who undergo a concussion. They warned me that visual training would not solve my problem entirely. That sounds accurate. After the initial horrible symptoms that developed upon returning to a Windows laptop, I feel better. I am not saying that I am happy of the situation, but I can handle long days at the display. Unfortunately, I am still terribly hurt by LEDs. Looking at a display under directional LED overhead lighting is devastating and makes the display feel an almost unusable device.
I am currently seeing a specialist on dry eyes as well to see if using artificial tears helps. Work is in progress. I would like to report one detail. Following meibography test to inspect the meibomian glands in the eyelids, I was recommended to use a hot band around my eyes for 5-10 minutes once or twice a day. After about 5 days of treatment, my eyestrain and neck pain skyrocketed, and I was unable to do any computer work. Actually, I could hardly do anything as the general discomfort was extreme. It took me a while to figure out that the hot band was to blame. I also had to stop using a naturopathic sleeping pill (opiate ingredient likely to blame) because after a couple of days my eyes became extremely dry and my vision very blurry. These to give an example of how sensitive my eyes are.
I am also working on improving my posture and I am doing neurorehabilitation (a typical exercise consists of wearing a band with a narrow LED beam on my head, pointing the beam to the centre of a dart target, closing my eyes, turning my head to one side and trying to hit back the centre of the target while keeping my eyes closed - this is super-challenging). Long-term I would like to return using a monitor (I have been on a laptop since 2010!). Everything seems to help just a little, so the idea is to approach the problem from all possible sides.
The summary is that I am trying to do all I can and I am hanging in here, because the alternative is quitting my job and I do not want to imagine the other consequences.