I have the same issue with my MBP 2018. Its not about the glossy IPS screen , but I believe the dithering that causes these issues. I tried connecting the output to TN, OLED monitors but without much respite. I have tried other laptops such as Yoga and Surface which also have similar issues. Some blame the new generation Intel UHD chipset for this. My respite has been a pre-2016 HP Elitebook with the previous generation Intel HD chipset that I can work for hours without any problems. I upgraded the laptop's original TN panel with a new IPS panel and have no isssues whatsoever. In summary, irrespective of the LCD screen/technology the underlying temporal dithering in these new generation machines are troubling anyone with borderline sensitivity - who got away in the past but future looks bleak!!
Macbook Pro 2015 is perfect but Macbook Pro 2016 and after cause problems
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I have MacBook Pro 2017. It causes severe symptoms with default setup in 20 min. Now I have it almost usable — not as easy for eyes as old laptops, but tolerable.
1) Main tune is SwitchResX app (20$). It allows you to set screen to "Million of Colors" (instead of billion) and 1440x900 resolution (not scaling ratio, but real 2x resolution reduction: you will see pixels again). Laptop is still absolutely usable for any kind of work with these settings (I'm designer). Without this app next 6 items make not much difference.
2) Turn off touch-bar: it has very low PWM frequency (I use free MTMR app instead. It allows you to use gestures for tuning brightness and volume with no display at all). Turn off keyboard backlight for the same reason
3) I always have brightness on 70-100% to avoid main display using PWM (as per notebookchek.net tests). Not sure this really changes something, but I do it. For dimming display I use free QuickShade dimmer app
4) I have matte screen protector for reducing glare
5) I have "computer glasses" (Zeiss) for reducing blue light. The do it gently not making all your work yellow. Night shift is always off — I feel that it makes it worse for my eyes, not better
6) Font smoothing is off
7) Color profile is set to a bit lower contrast
Hope this may help
poliakov Main tune is SwitchResX app (20$). It allows you to set screen to "Million of Colors" (instead of billion) and 1440x900 resolution (not scaling ratio, but real 2x resolution reduction: you will see pixels again).
Very interesting, thanks! In the past I benefited from reducing the resolution. The display would pass from unusable to usable for how long I wanted. What do you mean with "not scaling ratio"? Do you think decreasing the resolution helps because it reduces dithering?
On the colors. Many years ago I had two (nominally) identical monitors connected to two different equipment. One monitor was absolutely no problem, the other was giving me eyestrain within seconds and the eyestrain would last for days. Those days, the only difference I could come up with between the PC setups was the screen colors. Could you please elaborate on this, if you know more? How can setting million versus billion colors make a difference in your opinion? Thanks!
Yes, I think that "decreasing the resolution helps because it reduces dithering". But I have no knowledge in the area, sorry. I just turn the switch and feel less pain. All people here have very different health conditions and I cannot guarantee that my solution will work for anyone else. But give it a try, SwitchResX has 10 days trial.
What do you mean with "not scaling ratio"? — When you change resolution in macOS Settings app, you change only the size of elements on the screen. It is always 2880x1800 native retina resolution.
I have a 2015 13inch MBP and it causes the same issues for me, migraine headache and other such symptoms for a few days after use, I have the free version of switchresx but it doesnt have the option to reduce the color depth as its already at 'millions' does paying for it unlock additional settings as in thousands / millions / billions etc?
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bowenjin I’m in the exact same situation. I can use my MBP 2015 with zero issues, but anyt other model after that year causes the same symptoms that you mentioned.
I’m curious: do you also have eye strain with the new iPhones at all? I personally can’t use the OLED models due to PWM, and the XR/11 are no better (No idea why though, they have LCD screen but still cause issues). If I had to guess, it’s almost like they took whatever dithering method they were using on recent Mac hardware and copied it to the latest iPhone LCD screens 
Lauda89 i am using an iPhone X with zero issue even without glass (0.5 astigmatism).
Do you have any benefit from a 0.5d correction?!?!
At first glance the iPhone X looked perfect to me but after a few minutes of testing in a shop it would cause scaring long-lasting symptoms. Same with Samsung S10. Not mere eyestrain, more like a seizure.
bkdo do you also have eye strain with the new iPhones at all? I personally can’t use the OLED models due to PWM, and the XR/11 are no better
I have not been in a phone shop for ages, at least a year. Back then the only phone which looked fine to me was the iPhone XS, no clue why. It was too expensive to take a risk though.
Maybe you can watch the infrared sensor through a camera to see if it's on? I looked at my TV remote with my smartphone's camera, and saw a light whenever I pressed a remote button. It looked like a small LED.
How's this for a good one... my PERFECT Macbook Pro 2013, that I have used without ANY problems for YEARS, along with 2 x Dell 23" CCFL LCD monitors, has "gone bad" on me.
Most bizarrely, I packed up the macbook, monitors, cables (ie everything) and brought it all home so I could 'work from home' under our local Covid19 lockdown. I plug it all back together and all of a sudden I'm experiencing insidious low level headaches and eye strain. Now this is a setup that has proved utterly faultless for me over the years. I've tried no lcd lights on, different angles, distances and various permutations such as resetting the PRAM. The OS does not appear to have had any recent updates either.
I've now completely reinstalled the laptop to an older OS - High Sierra - and, well, the problems are still evident. So I'm at a loss...
Fortunately my good PC is still workable so I am able to be productive. The thing is I experienced a similar situation with my PC (but not laptop) a while back. Things came right - around about the time I got my prescription updated - so maybe my prescription has changed??! But I don't totally buy that. Then it was PC bad, laptop good. Now it's laptop bad, PC good.
Either way, I cannot get my eyes checked due to the COVID lockdown and probably won't be able to for quite some time. All told, I'm completely bamboozled by all of this.
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Seagull is your lighting situation at home different?
@AgentX20 I would ask you the same question. I could not believe how much difference the lighting makes until I took my device home from work. At home I am okay except for the long-term damage from office work. In the office I cannot concentrate, I get eyestrain and neck pain within minutes, and I need to keep taking breaks and look elsewhere. It feels like gasping for air. I suspect it is a combined effect of fluorescent and LED light coming straight from the lamps into my eyes and offensive light reflected by the glossy screen. The visual experience looking at the screen is very different in the office and at home. It is like two different displays.
AgentX20 So I'm at a loss...
I experienced the same. Months into my new job under the overhead lighting I described above, my phone started looking bad. Earlier I could use it as long as I wanted. I blamed an auto update but now I am not sure anymore. I think my eyes accumulated so much stress from trying to cope with the new lighting, that at a certain point I developed some undiagnosed condition. I say undiagnosed because I visited multiple ophthalmologists, an orthoptist and a neurologist. I had even a brain NMR taken. No one found a worsening of my eyesight. They could only witness eye twitching, which has become an inseparable companion under those lights. This to say, it does not mean that your prescription needs an update. It could be else which goes unnoticed by doctors. I do not know how to call my symptoms, I just know I am "allergic" to certain lighting conditions which are fine for most people.
AGI Not really with the iphone X. I had a big improvement with my notebook (Dell latitude E5550 W10 1809). Now I can use it all day with zero issue, before the correction I had low eye strain with it (usable but not totally fine)! Unfortunately I couldn't try the MBP 16" with the correction because I sent it back before I get the eyeglass! I am planning to try again the MBP 16" 2020 at the end of the year, it's should have the mini led display also.