Computer vision syndrome: prevalence and health impacts in America

Computer Vision Syndrome

According to the Computer Desktop Encyclopedia, Computer Vision Syndrome (CVS) is "A variety of problems related to prolonged viewing of a computer screen. Short-term effects include dry eyes, blurred vision, eye fatigue and excessive tearing. Long-term effects include migraines, cataracts and visual epilepsy. Some solutions are to keep reflections and glare to a minimum and to provide a non-fluorescent, uniform light source. Special lamps are available that maintain the proper light around the monitor and generate light at much higher frequencies than regular light bulbs"

With the ever increasing amount of time consumers are spending in front of their computer screens, this disability is considered on of the fastest growing work related health problems in the country today. For many Americans, the problem cannot be left behind at the office. Individuals come home, to spend time surfing the web, corresponding via email, and pursuing various computer-based entertainment functions. The digital world is swiftly becoming dangerous to the health and well-being of a great many Americans.

Scope of the Problem

According to a recent article in Occupational Hazards, there are more than 70 million personal computers in use in homes and offices across the United States. According to the American Optometric Association, nearly 90% of people who use those PCs for more than three hours a day suffer from eye trouble. In 1999, more than 12 million of them sought eye treatment, at a cost of more than $2 billion a year to health plans. Occurrence of the syndrome has already been measured at an increasing rate. According to MMR Magazine (2001), "... some 60 million or more Americans are said to suffer from computer vision syndrome... And the number is expected to grow, with 21 million children expected to use the Internet at home or in school by next year, suggests Better Vision Institute, a nonprofit organization in Alexandria, Va"

OSHA has also weighed in recently on the issue of CVS. The Occupational Safety and Health Administration recently published its final Ergonomic Program Standard, which identifies that employers must send symptomatic employees suffering from musculoskeletal disorder to an appropriate health-care professional. Under the new standards, CVS has been included as a repetitive stress injury that requires treatment by an optometrist. In other published studies, the American Optometric Association, more than 70% of computer workers suffer from computer vision syndrome.

At the root of all this expense is a familiar cast of discomforts:

Eyestrain (sore or fatigued eyes).

Headache.

Slowness in changing focusing distance.

Blurred vision after close-up work.

Eye irritation (burning, dryness, redness).

Contact lens discomfort.

Sensitivity to light

In addition to problems which prolonged computer use create with users vision, extended computer usage can also affect the posture, and therefore create disabling muscular and skeletal symptoms, including neck, back and shoulder pain. "Computer vision syndrome is the leading health complaint of office workers," says Jeff DeFazio, president and chief operating officer of Cable Car Eyewear.

Workers also are at risk from increased levels of discomfort from glare if they use a dark background display screen on their VDT. The resulting disparity between the dark screen and the glare of overhead lighting create can create ongoing eye strain. Other sources of extreme contrast differences between the VDT and other materials which the user handles at the computer workstation include white paper on the desk, light-colored desk surfaces, desk lamps directed toward the eyes, or desk lamps which illuminate the desk too highly.

Many experts expect CVS to soon surpass carpal tunnel syndrome as the most-common workplace health issue. In accordance with that unwelcome expectation, the insurance industry is warning employers to prepare for a wave of computer-related injury claims: repetitive stress of the eye muscles.

Moreover, the current trend toward doing nearly everything online will likely accelerate the occurrence of CVS. As more people use the Internet at work and at home, the problems of CVS are sure to increase at an accelerating rate. The repercussions could include higher health insurance premiums and HMO fees. CVS is a very real and growing problem for employers and employees.

A host of implications, in the form of lost productivity and absenteeism alone, are compelling affects of the syndrome and are some of the reasons which CVS is drawing so much attention.

According to Chambers (1999) "the Journal of the American Optometric Association cites recent studies by Dr. James Sheedy of the University of California at Berkeley, a principal investigator of CVS. Sheedy's research has shown that minor visual degradations can lower worker productivity from 4% to 19% on common office and work tasks. That could translate into an efficiency drop costing from $1,200 to $5,700 a year for a typical clerical worker with an annual salary of $30,000, or as much as $15,200 a year for an in-demand computer professional with a salary of $80,000. In all cases, the employer takes this "hidden" hit on productivity." recent study at the University of California Berkeley's (UCB) School of Optometry, funded by Viratec Thin Films, Inc. shed new light on what eye care professionals have long suspected, that a leading contributor to Computer Vision Syndrome (CVS) can cause loss of office worker productivity. Specifically, the study focused on the unwanted reflections from a computer monitor that adversely affect the ability of millions of computer users to read information. In reaching this conclusion, UCB researchers studied the effects of various computer display situations on the visual performance, including reading speed, accuracy, comprehension and acuity.

According to the study, subjects reported less glare and fewer CVS-related symptoms with displays that had a vacuum-deposit Optium (tm) coating by Viratec. They were able to perform visual tasks considerably faster and more accurately on these displays than on either uncoated or standard-coated VDT's.

Adding substance to previous anecdotal information, this research is the first to show a direct correlation between glare and reduced productivity," said Dr. James Sheedy, who established the VDT Eye Clinic at UCB's School of Optometry, where the study took place under the direction of Dr. Ian Bailey.

A survey of optometrists recently indicated that out of the 10 million eye examinations are given annually in this country, the majority of them are related to vision problems related to video display terminal (VDT) use. This condition most commonly occurs when the viewing demand of the task exceeds the visual abilities of the VDT user. The American Optometric Association defines CVS as that "complex of eye and vision problems related to near work which are experienced during or related to computer use."

Another aspect of the syndrome is that nearly 80% of our learning comes through the eyes. Therefore any vision difficulties will slow and impede everyday learning and comprehension processes that make for good on-the-job performance. As a result, CVS can become an accelerated problem in the business world. As a result the condition is being approached as a serious disorder with real, and financial bottom-line consequences for business.

Looking at the changing nature of the classroom, CVS could pose an upcoming threat for students at all levels of education. Because the internet is being used increasingly for school projects, and word processing tasks, today's students are being exposed to VDT at levels which today's working adults did not experience. The body of research on CVT has not been accumulated sufficiently enough to project what could be the result of increased computer usage at early ages, and whether or not the symptoms of CVT are cumulative. However, if early usage adversely affects the users ability to use computers, when today's students reach working age, the problems could cascade into significant obstacles to worker productivity.

Ergonomic

Because researchers have come to understand the physiological dynamics of CVS they have defined some ergonomic countermeasures. While these suggestions do not eliminate the problem entirely, they can alleviate some of the symptoms by disrupting the processes that led to them.

Placing computer screens slightly below eye level

Situating seats and desks to keep 20 to 26 inches between employees and their screens. While this is the natural focusing distance for eyes, this cannot be attained for laptop users.

Arranging reference material close to monitors and at the same level to reduce the amount of continual refocusing.

Advising employees to keep PC monitor contrast and brightness at lower levels

Installing glare screens on monitors.

Introducing appropriately placed lighting that does not cause random reflections on screens.

Office ergonomics are proving to be an effective defense against CVS, but the sheer prevalence of computer-oriented jobs, combined with ever more time spent in front of the screens, often makes it necessary to provide specifically designed protection for heavy-duty PC users.

Personal Protection at Eye Level

CVS creates special needs for people who wear prescription eyeglasses or contact lenses. Most prescription lenses are designed to help people read print, but they are not specifically designed for computer work. Bifocals also complicate matters by forcing wearers to look at the screen through the bottom of the lenses, causing additional ergonomic challenges as they crane their necks to the point of backache. So eyeglass wearers should consider getting an extra pair of eyeglasses designed for the right kind of focusing.

Prescription eyeglass wearers have had an additional resource available to them to fight advantage against CVS over the past few years. Their optometrists could prescribe lenses with special color filters that counteract the effects of CVS by screening certain light wavelengths, radiation, and electromagnetic fields which come from computer screens. Progressive employers who utilize a high number of computers in their offices have been quick to see the benefits of this filtering technology, and many cover the costs of eye examinations and these glasses to make sure employees can do their work without problems. Uvex Safety had become one of the first producers of protective eyewear for the workplace, and they have been among the first to offer this option to employer. The company recently introduced a family of nonprescription eyewear called "PCvision, which uses a new variant of filtering called enhanced visual amplification (EVA) lens technology."

Another company is Cable Car Eyewear, which offers its I-Optix Computer Eyewear collection, which uses a "patent-pending lens technology to reduce the glare from ambient light sources while increasing the crispness of screen contrast and eliminating color distortion." The I-Optix line includes several Computer Readers eye glasses for people who wear reading glasses while using a computer. Cable Car's I-Optix Computer Glasses are non-magnifying to accommodate people who do not need corrective vision eyewear.

Reducing Glare

Taming glare is the second approach which a company can take in order to reduce the likelihood of CVS amongst its employees. Many of these solutions are low to no cost, and they can significantly reduce the likely hood of CVS.

Situate the computer so the screen is perpendicular to windows and not directly below overhead light sources.

Use a glare screen

Use a flat-screen monitor, not one with convex screen.

Avoid using light-colored backgrounds or patterns on the screen, and stick with dark characters on a white field.

Clean the monitor and glare screen regularly

Have a complete eye exam by a qualified professional at least every two years.

If you experience pain, flashes of light, floaters, blind spots, or blurred vision, make an appointment immediately.

When you buy eyeglasses, tell your optometrist about your computer use patterns.

Position task lighting so it illuminates the document, not your computer screen. If you can see the light reflected when you look at the screen, move the light farther back or to a different angle to the screen.

Nutrition

Just as an athlete in training has different nutritional needs than the person who works in an office, the person who sits behind a VDT for many hours each day has increasing levels of nutritional demands on the tissues, muscles and nerves in his or her eyes. Recent research has identified a small collection of nutrients which are essential to eye health. Proper eye nutrition can even reverse degenerative eye diseases. In order to ward off the onset of CVS, nutrition can be used as a preventative measure.

TheraLife Inc., a leader in the discovery and development of cutting-edge drug enhancement technologies, recently announced that the company's new oral TheraLife Eye (R) formulation can bring relief to as many as 60 million computer users who suffer from CVS. According to the announcement,

In the past two decades, computer use has grown dramatically. It is estimated that there are more than 100 million Americans using computers on a regular basis. With the advent of our becoming an information society, we are paying a price in our eyesight and vision health," said Dr. Jeffrey Anshel, a renowned Southern California optometrist. "Because computer use is such a highly demanding visual task, vision problems and symptoms are very common and growing in complexity. Most medical and government studies indicate that regular computer users report substantially more eye-related problems than occasional users. Computer screen glare, a vertical work surface, a rapidly flickering screen, lack of sufficient contrast, unnatural eye positioning, and greatly reduced blinking all contribute to CVS," said Dr. Anshel.

Dr Anshel continued in his endorsement for the product, and said that the best available treatment for CVS-related dry eyes is TheraLife Eye. The nutritional supplement is designed to be taken orally and they contain all natural ingredients which contribute to the nutritional well-being of the eye. Lily C. Yang, Ph.D., TheraLife CEO and President says that "Unlike eye drops, TheraLife Eye enables the eye to secrete natural salt-based tears, rapidly relieving the discomfort of dry eyes and eye fatigue. The product's effectiveness in treating dry eyes has been scientifically substantiated in a Phase IIb clinical trial."

Some of the nutrients included in the TheraLife Eye formulation are in the table below.

Beta-Carotene

An antioxidant that can be converted into Vitamin A, which is crucial for healthy eyes, bones, hair and skin. It protects the brain cells from free radical damage, and maintains eye structures such as the retina.

Bilberry

This herb helps the eyes and cardiovascular system by stimulating and increasing overall circulatory health.

Chrysanthemum

This is an "eye-brightening herb" that is often used in conjunction with Fructus Lycii to treat eye conditions. It improves blood circulation, has antibacterial and anti-inflammatory affects.

Copper

Required for red blood cell and hemoglobin formation and acts in enzyme systems.

Fructus Lycii

Known as the "eye-brightening herb," it is used for poor eyesight, eyestrain, cataracts, glaucoma, and other eye disorders. The fruit provides antioxidant protection for the eyes against free radicals.

Natural Vitamin E

It protects cell membranes, proteins, fats, and Vitamin A from destructive oxidation. Vitamin E preserves Vitamin A in the eyes, protects red blood cells, and boosts the nervous system and immune system.

Riboflavin (B-2)

This vitamin is necessary for healthy eyes and skin.

Selenium

An antioxidant that stabilizes vitamin E

Semen Cassiae

This herb has anti-histamine like properties to treat itchy, red and painful eyes.

Vitamin C

An antioxidant that inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C helps to maintain bones, teeth, hair, nails, and blood vessels. Works together with Vitamin E and Beta Carotene to deactivate free radicals.

Ten years ago, the most rapidly increasing depilatory condition was the carpel tunnel syndrome, which was the result of increasing levels of repetitive motion in the hand and wrist. CVS has become the most rapidly rising syndrome for the early 21st century. By adapting our work and living environments to those factors which create the problem, we can prevent this condition from become a significant health risk.