Brian Spittle, OD
November 13, 2012

About Dr. Brian Spittle

Life is a whirlwind.  Rarely is there a moment where we find ourselves sitting quietly with nothing to do.  We rush to get ready in the morning.  We rush to work.  We rush home—exhausted and with burning eyes.  Some of that burning sensation may be from driving wide-eyed while weaving traffic. 

The reality is that the burning likely started hours before while at work.

Many of us work in corporate offices where the air is dry and recirculated.  We all stare at one or two computer monitors all day.  And after you add stress and some dehydration to the mix, you have a recipe for visual fatigue.

For many years, the classic recommendation from your optometrist has been the “20/20/20 Rule.”  The recommendation is that every twenty minutes you should look twenty feet away for twenty seconds.

 Basically, you should give your eyes a break every twenty minutes.  Over the course of an 8-hour workday, that would be 24 breaks.  When combined with the occasional artificial tear, the recommendation works.  Nevertheless, it sounds hokey and does not address the root of problem.  The more birthdays that tick by, the more common these problems become.

Birthdays?  Absolutely. 

As we age, changes happen to our bodies.  Hormone levels fluctuate.  Hydration needs change.  Years of stress begin to manifest (think: wrinkles).  The anatomy inside the eye also begins to change as we approach 40. 

Combine aging with the environmental stresses we place on our bodies and you have a chronic problem.  It will quickly become apparent why everyone involved is frustrated.  Day in and day out, we find ourselves counseling patients on lifestyle changes that until recently have been the only meaningful advice we have to offer.

Obviously you just need a vacation!  Most of life’s issues are resolved by a cruise or a trip to the beach, including stressed-out eyes.  For a host of reasons, it took time for us to realize that what we were telling patients—visual fatigue—was more than just dry eye and inflammation.  The conversations have always been centered on taking a break, using artificial tears, and reducing inflammation. 

What many of us did not take the time to reflect on were those people who have no visual fatigue issues.  They typically work somewhere other than in front of a computer.  In other words, the demand on their eyes is less than those who have problems.  Rather than writing a prescription for a vacation, perhaps we should reduce the burden on the visual system.

If reducing the demand on our eyes becomes our plan, why not try bifocals?  Ouch!  Bifocals?  Can we say “Grandma?”  But hold on. If we can ignore the word “bifocal” for a moment and think about what those lenses really do, the idea will start to make sense. 

Historically speaking, bifocals are eyeglass lenses with the line near the bottom.  Everything above the line is for seeing far away.  Everything below the line is for seeing at near—specifically about 18-20 inches.  The point of the lens is to relieve the strain on your eyes, but after seeing thousands of patients, I can tell you almost none want bifocals.

Never fear!  Come to find out, an alternative has been on the market for several years.  Contact lenses!  Not just any contact lens will do.  There is an entire category of soft (and hard) contact lenses on the market that are designed to replace bifocal glasses—bifocal contact lenses!  We call them multifocal lenses because they do more than bifocals, but the concept is pretty much the same.

Multifocal contact lenses come in several flavors depending on the needs of the patient.  Originally they were only made in moderate and high amounts of near magnification and marketed to folks in their late 40s and older. 

Today, they also come in low magnification versions for “emerging” or borderline need.  These newer, low-powered lenses were slow to gain traction because we had the mentality that bifocals were for old people.  In reality, thousands of people under 40 have visual fatigue and these lenses consistently reduce complaints about work-related fatigue.

As our approach and thinking changes, we are finally realizing that stressed-out and fatigued patients are complaining about reduced quality of life.  The point of any medical device, prescription, or surgery should always be to improve quality of life.  Even though many of these patients do not fit the bifocal stereotype, maybe we should embrace the technology for what it is—a convenient and effective strategy for making life better.


All views expressed in this article are those of the author(s) and do not necessarily represent the views of, and should not be attributed to, CooperVision, Inc. or any of its affiliates.