A Guide for People Researching Eye Strain: A followup on The Real Cure for Eye Strain

During the past decade, on consulting multiple doctors, I realized that they were unable to cure my eye strain because of a lot of incorrect information floating around. This in turn, was possibly affecting the direction of research, because researchers probably didn’t know what to analyze.

Rather than begin with commonly propagated notions about the cause and cure of eye strain, a better way to begin, is by speaking with people who have experienced severe eye strain. It’ll help dispel a lot of the myths, when they tell you what solutions didn’t work.

Before proceeding, please read The Real Cure for Eye Strain to obtain some context.

Chart. Image attribution: Unsplash

My tips for researchers

Find a way to measure strain of the intraocular and extraocular muscles

It is necessary to find an objective method of measuring the various stages of severity of eye strain. These objective metrics need to be correlated with subjective feedback from the test subjects and compared with a control group. If there are mismatches, then a better method needs to be invented/innovated. This needs to be done under baseline conditions, and during variation of various test parameters. In subjects with chronic strain, at least the spasms of the inferior oblique muscles are somewhat easily detectable. The sharp, stabbing pain at the superior oblique, lateral and superior rectus are also important.

Name and quantify the various stages of eye strain

There are various stages. One is when the healthy eye begins to water a little, and there are reflexes where the tired eyes try to gently close, as a message to the person, to stop straining the eyes. People tend to ignore this and continue torturing the eyes. Then there’s the stage where the forehead muscles are tensed and pain (which people call “headache”). There’s another stage where the front of the eyeballs have a burning feeling. This is a severe stage. Then there are sharp stabbing pains around and behind the eyeball. This is an acute or chronic stage. In the chronic stage, even the cheek muscles are strained. There are possibly more severe stages, as experienced by Jack.

Know what factors affect the strain

Existing research on myopia and eye strain could be seriously flawed due to neglecting certain important parameters listed below. At least in my experience, eye strain is affected by:

• Sleep duration (specifically, not getting uninterrupted sleep for an age-appropriate duration)
• Food (proteins giving muscle endurance, and how various foods affect the digestive system, causing sleep loss)
• Age
• Spectacle lens-type (plastic vs. glass)
• Duration of strain
• Nature of strain (watching a movie, driving, reading a book, looking at a digital screen etc.)
• Duration and quality of rest
• Naps
• Lens misalignment
• Wrong prescriptions
• Angle of viewing (also take note of which muscles get to relax while the subject reads when lying down)
• Brightness
• Blink rate
• Muscle tension
• and perhaps other medical conditions.

Measure these with and without using aids like eye drops or spectacles. Check and find out how natural, commonsense methods can reduce strain.

The response from the subjects would also depend on their ability to comprehend and honestly respond to the test questions. Tests need to be done in-vivo, even if done on animals. The observations need to be noted everyday for a few years at a stretch. Sleep duration, interruptions in sleep and the type of edibles consumed (the quality and whether it was properly cooked/baked/fried) needs particular attention (because it affects sleep quality and muscle endurance). You also need to check for your own biases. For example, contrary to published research, I’ve noticed that it’s not the screen’s light at night that affects sleep loss. It’s the degree of enthusiasm a person has in pursuing the activity on the phone/computer that affects it. Even late at night, if I promptly switch off the phone/computer the moment I start feeling sleepy, I’ve had no problem going to sleep. What did affect the sleep cycle, was eating something late night, and eating food (even at daytime) that was not cooked well.

Check and quantify if and how parts of the eye are affected by strain

These include the intraocular muscles, extraocular muscles, other facial muscles that support the eye muscles, eye lens, pupils and cornea. It would also help to check if there are variations or swelling that affect the shape or size of any part of the eyeball, especially in cases of chronic strain. I would not be surprised if constant tension on the eyeball could be one reason for progressive myopia, and torsion could be the cause of astigmatism.

Measure the extent and rate of recovery when strain causing situations are removed

Remember that the rate of recovery differs. People with mild strain recover quickly, but people with severe strain can take months or years to recover. This can help avoid pointlessly prescribing spectacles to people who don’t really need spectacles. It can also help organizations and schools create guidelines that prevent people from overworking and damaging their eyesight. Normal vision is too precious a gift to ruin.

It may also be possible to re-design computer work in a way that does not require us to focus our eyes at a single location for too long.

Obtain statistics on normal sighted people too

Perform large-scale surveys on normal-sighted people. Check how many of them in rural and urban populations, have slight myopia, hypermetropia, astigmatism or any other eye issues, and are yet able to lead normal lives without requiring spectacles or medical intervention. Check for how many years the situation remains unchanged (or how and when it changes). This will help create a baseline and help provide deeper understanding into when medical intervention is really necessary and when it can be avoided. For example, it’ll help gauge if it is normal for one eye to be of a slightly different power than the other eye. It’ll help understand how eye power varies over the course of a day and returns back to normal, without any severe or long-lasting consequences.

Establish guidelines for spectacles

Measure how poorly aligned spectacles/lenses affect strain. Check how the position of the focal point of the spectacles affects strain. Objectively verify how distortions caused by lens-types affect the amount of adjusting that the eye muscles need to do (you’ll need test subjects with chronic eye strain to get measurable results). Quantifying the minute light distortion among various lens types at various radii and angles from the focal point, will also help (perhaps using lasers could help verify this). Establish guidelines for opticians and spectacle manufacturers to follow. Many of them are amateur/irresponsible enough to not even take any measurements when they take an order for spectacles. Some even try to force improperly aligned lenses onto their customers. Some people’s ears are not at an equal height, so it’s necessary to design frames to account for it so that the spectacles aren’t tilted. It’s necessary to establish strict rules for opticians to measure the dimensions of the subject’s face and position the lenses at the correct focal point, at the right angle and distance from the eyes.

Establish guidelines for eye tests

The results from the studies above, can help establish guidelines for what questions doctors need to ask a patient. The one fundamental question I’ve noticed that’s lacking, is that doctors don’t bother asking and verifying if the patient is getting sufficient sleep, rest and nutrition. It would help to do more groundwork to help identify the right tests to do and identify the various stages of strain and know the causes. This can help avoid a lot of pointless tests (there are certain tests being done unnecessarily even though no symptoms are observed). There also needs to be a mechanism to periodically check and correct problems and alignment issues with the frames that hold trial lenses (some such frames are vertically tilted too much, causing a distortion that leads to a wrong prescription) and perhaps even the computerised eye test equipment.

Explore the creation of a support system

It’s not just offices that need guidelines to help people take rest and get proper sleep and “have a life”. Even schools need to have a support system that allows kids to not have to wake up too early for school or stay awake too late while preparing for exams. Sufficient time needs to be given for kids to play without straining their eyes on phones or computers. If they didn’t get proper sleep at night, they should be allowed a nap during daytime. The larger part of the support system comes from families. People need to be educated on how to cook food properly (since bad food causes sleep loss). People need to reduce their dependence on fast food or unhealthy or adulterated food. The knowledge gathering, education and building of this massive societal support system is a crucial step in helping with “prevention is better than cure”.

Know the source of funding

Know who is funding your research. Make sure it is from an unbiased source that actually cares about people’s health and wishes that people can enjoy normal vision. Also, be aware of how large the industry is, and whether there are any biases that prevent establishing the right guidelines that help patients, rather than drive people to make purchases that don’t really help them recover.

Most importantly, don’t forget to think out of the box and look for other causes/factors/cures. If you discover that any of my assumptions were incorrect, do let me know (after thoroughly verifying it). As a person of science, I’ll be happy to correct myself.