A young woman Internet Web site designer visits her optometrist complaining of headaches, dry eye and fatigue. She tells the doctor that when she goes home after work all she feels like doing is sitting on the couch with her eyes shut. Her problem? 'Computer Vision Syndrome,' a result of the long hours she spends at her computer.

"I am seeing more and more patients coming in complaining of the same problems, that at the end of the day they don't want to get off the couch," says optometrist Dr. Robert Davis. In fact, he says, each month he treats close to 25 additional patients for CVS.

How it shows itself

'Computer Vision Syndrome' is defined by the American Optometric Association as that "complex of eye and vision problems related to near work which are experienced during or related to computer use." It refers to a number of symptoms common among computer users. These include:

• tired eyes,
  
• watery eyes,
  
• blurred vision,
  
• double vision,
  
• eye irritation,
  
• headaches,
  
• neck and shoulder pain,
  
• general fatigue,
  
• dry eyes,
  
• burning eyes,
  
• red eyes
  
• and difficulty in focusing.

And for those who spend more than three hours a day working at their computers, these symptoms are precursors of more far-reaching problems of low morale and reduced productivity. Laboratory studies cited in articles appearing in the Journal of the American Optometric Association indicate that even small amounts of visual degradation can reduce productivity anywhere from 4 to 8 percent.

Both the American Optometric Association and the National Institute of Occupational Safety and Health (in a 1994 survey) estimate that close to 90 percent of the 70 million U.S. workers who use computers will experience eyestrain and vision problems. A recent survey of ISHN readers found that 92 percent use personal computers at work. AOA says approximately 14 percent of patients who visit their optometrists do so because of computer-related eyestrain.

There is no scientific or clinical evidence that the computer causes any long-term damage to the eyes, says Prevent Blindness America, a volunteer eye health and safety organization. There is no hazardous radiation (x-rays) or non-ionizing radiation (ultra-violet rays). Even the electromagnetic emissions from computers is "well below levels of concern," the organization says.

Yet, the external symptoms of CVS claim one million new patients every year and that number is on the rise, studies say. In 1992, 10 million people sought treatment for these symptoms, one study found. Another survey, conducted by Cosmo Salibello, O.D., F.A.A.O. and Erik Nilsen, Ph.D., indicates that in 1995, 15 million people complained of computer-related vision problems. This study was funded by PRIO, a manufacturer of computer simulators used to diagnose CVS.

The rise in complaints is not surprising. Whether at work or at home the computer plays a significantly more important role in life today than ever before. Yet for all the ease and speed computers have brought into the workplace, they also have created new work environments with physical and visual demands. According to Dr. James Sheedy, O.D., Ph.D., who writes frequently on the subject, CVS has its roots in both environmental and physiological factors.

How we work

Tod Turriff, director of eye safety programs at Prevent Blindness America emphasizes the environmental factors. He says that vision problems occur more frequently in computer users either because of an improperly designed workstation, an uncomfortable chair, incorrect seat height, glare from the computer screen or improper work habits. Although Turriff agrees that physiologically "our eyes are not designed to do the types of things we're doing," he says his organization's position is that if you modify the environment to make it more comfortable for the eye and the body, it will greatly reduce chances of CVS symptoms.

Take for instance symptoms like dryness and irritation. Normally, blinking helps cleanse and lubricate the eye. Computer viewing reduces your eyes' blink rate to about one-third the normal rate of 14 times per minute, according to Bausch and Lomb, a manufacturer of eyecare products. Also, if your computer screen is higher than it should be, the eyes open wider causing greater tear evaporation than, say, when you are looking down while reading and the eyes are half-shut. As a result, Turriff says, adjusting the distance and head position can eliminate the problem.

Employer awareness

Are eye exams and specific glasses for computer use covered by employers? Although the percentage of employers who purchase vision care plans that address CVS needs are still very small, there is a growing awareness of the problem, says Richard W. Steere, vice president, sales division, for Vision Service Plan, a vision care plan provider in Rancho Cordova, CA. According to Steere, "It is definitely an education process and then a budgetary decision on the employer's part to fund this care." Steere says two major phone companies already provide this benefit as a supplement to their standard VSP benefit. It includes coverage for a supplemental exam and extra pair of glasses if the patient needs mid-range correction for use on the computer.

Combating CVS symptoms

Based on our research and talking with experts, here are some tips on how to prevent computer vision syndrome:

• Keep your computer screen slightly below eye level -- about 10-20 degrees -- so that the center of the screen should be four to nine inches below your eye level.

• Maintain 20-26 inches between your eyes and the computer.

• Reference material should be placed close to the screen and at the same level.

• Maintain your screen at maximum contrast and moderate brightness.

• Clean the screen with a screen cleaner. A dirty screen makes it difficult to see.

• Modify lighting to eliminate glare and reflections -- use blinds, hoods, micro-mesh filters and non-reflective furniture.

• Take frequent mini breaks -- try looking away from your computer to give your eyes a rest.

• When your eyes begin to feel dry, blink rapidly to re-moisten them.

• Make an appointment with your eye doctor. But gather some data before the visit. For example, which of the eyestrain symptoms are you experiencing and when and how frequently do they occur.