My symptoms:
Instant eye discomfort with near distance work (books and eye contact too!), eye strain that develops into a headache within an hour and body fatigue. Can't tolerate glare at all (using only TN monitors or Skinomi matte filters). Hate bright light (tho not light sensitive). Can't tolerate high contrast (washed out colors are better, thus another win for TN panels). 20/20 vision (no blurriness, no double vision)
Not my symptoms:
Vertigo, nausea, confusion, migraines, flicker, night driving, daylight, led light (as long I don't try to focus to read something)
1. Dasung (e-ink) paperlike
Too much glare on it, unless you are a truly photosensitive person, this is not the fix
2. BVD (vertical prism)
I was diagnosed with vertical misalignment and at this point it is kinda visible that one eye is higher (even the wrinkles on my forehead follow the pattern). I was given 0.5 Down prism in one eye and 0.75 out in both (I think BO prism is always prescribed with vertical ones). I did feel a relief with these glasses, however they introduced a new type of strain, the eye with the down prism felt like polling to the side. Headache pills do not help me with those headaches. Later I learned the relief I got was from the BO prisms, not the vertical one. Will get to this later.
So unless you have Vertigo, nausea, migraines I do not think vertical prism is the fix. Another dr. said that so many people have the vertical misalignment but that our vision evolves to cope with it
3. Neurolens
I took the test, the machine detected me having "convergence excess" and that I'm not a candidate for the progressive lenses. The exam itself was covered by VSP insurance, so I would encourage you to take the test, but not necessarily buy the lenses (which are ~$700). The previous 20+ optometrists visits failed to diagnose me with "convergence excess"! I think the lenses are needed only if you need prisms for both near and distance.
4. Lutein and the other eye vitamins/minerals (MacuShield)
They are needed for glaucoma patients, but they do not prevent it. No difference at all using them
5. Dry eyes / drops
They are definitely part of the symptoms but not the cause. I have tried restasis, cyclosporine, steroids, gel, night ointment, naphcon a
All of them felt useless, tho from time to time I do use preservative free eye drops
6. Blue light blockers
Needed only if you have problems with falling a sleep. Melatonin production issues. Some glasses can't even have the anti-glare + blue light coating at the same time, so I always pick the anti glare one. Tho most of my glasses have it, I love the gunnars yellow tint, and their RX is 2-4times cheaper than buying RX in office
7. Horizontal prism
…I finally found a good optometrist (after 20+ different ones over 9 years). She could not properly diagnose me based on the standard tests, but based on my symptoms she gave me +1.0 BO prism in one eye, I love those glasses (have them 6+ months), finally feels like my eyes are not struggling as much to focus, however it's still far from normal, I still get tired and the glasses do not help at all if there is glare (aka can't work under normal conditions, must be in a dark room). I tried lower +0.5 BO prism too, but it useless…waiting on a new pair to try +1.0 in both eyes and potentially try +0.75 in both (the prism value is a sum from both, can be prescribed in one eye or a split)
...she referred me to a surgeon, he was definitely the most knowledgable person that has seen me.
He was able to explain that I have "convergence excess". I have developed it my mid 20s (now mid 30s) from too much focusing on near work. My eyes cross inwards (tho this is not visible), this unnecessary flexing of inward muscles is causing the strain. In a nutshell he said I'm not a candidate for a vision therapy (besides strain I have 20/20 vision), that my BO prism prescription will keep rising. Once I get to +4 that I can become a candidate for a botox. Botox for strabismus that is injected in the eye to weaken the muscles, not the one in the forehead for wrinkles/migraines. And that will need to repeat that injection every 3-6months :S Not a candidate for it now, as if I get it now, then that will overcorrect my eyes and instead of inward it will became outward problem.
@martin I think you had mentioned you have the same diagnosis, do you have BO prisms? What's the rate of increase?