COMPUTER VISION SYNDROME
1. If I just had my eyes examined, why do I need a separate computer evaluation?
Unfortunately, an eye exam can be a (5) five minute face to face with a doctor or a (40) forty minute face to face with a doctor. The minimum test required by state law varies from state to state and by type of eye care practitioner. Ophthalmologists have no minimum requires exam (this does not imply a lesser exam). If you do not specifically tell your doctor about your computer related problems, that doctor may or may not ask you especially if it's a (5) five minute exam. A comprehensive exam should include probing questions about your computer use if there is a problem and address them on a general level that should solve most peoples difficulties. Some computer related problems require a more sophisticated battery of tests that you will find in a normal comprehensive eye exam.
2. I get headaches and loose concentration by midday. I work in data entry. What can I do?
You first need a comprehensive eye exam, by an eye doctor that has both a functional and medical orientation. A doctor with either one orientation or the other might miss the problem. Make sure the Computer evaluation addresses working distance to the computer monitor, key board and other items you are viewing, lighting, ocular muscle strength, appropriateness of prescription, and ability to sustain focus and fixation at the working distance you need. Wet refraction may be necessary and dilated fundus evaluation must be performed. Additional test may be performed.
3. I have Macular Degeneration and it is getting difficult to read my e-mail. What can I do?
Assuming you are corrected appropriately for your monitor, you can contact your browser provider ask them to increase your e-mail font size. In some instances reversing your contrast will help. There are software programs that are for low vision computer users as well.
4. What is involved in a Computer Vision Evaluation?
A Computer Vision Evaluation starts with probative questions about your workplace environment, if you are wearing corrective lenses for the computer, what your symptoms are, how long can you work before they start, how intense do they get, how long does it take to get to maximum discomfort, as well as other specific questions. Assuming you have a correct distance and or near pair of glasses, testing should be done at the distance you are normally working. Testing for muscle strength, muscular sustaining ability, agility to change fixation, focus sustaining ability, agility in changing focus, natural ocular posture at your working distance, and the evaluation of prism, are a starting point for testing. An extensive tear film evaluation may be needed, pupil evaluation, and depending on age, tests for latent hyperopia, cataracts, retinal disorders, and optic nerve problems should be performed. A discussion should include possible changes in workplace conditions, possible changes in distances to the monitor and other objects being viewed, duration of sustained computer use, blink habits, he need for possible eye exercises when warranted, and the need for eye wear specific to workplace demands. Special tints and coatings for glare must also be discussed. As you can see, this is not the kind of evaluation that ca be done during a standard comprehensive eye exam especially when the entire exam takes (5) five minutes face to face with the doctor.
5. Within twenty minutes of viewing my computer, I get a headache, words jump, and then I get double vision. I am ready to quit my job. What is going on and what can I do?
You need to get a comprehensive eye exam and then get a computer evaluation from an eye doctor that routinely does the testing mentioned in answer #4.
6. Does medical insurance pay for this type of evaluation?
Some vision plans cover a computer related eye exam and offer eye wear for the computer. It has been my experience that these companies don't pay sufficiently to allow the doctors to give a comprehensive computer evaluation. In general, if there is a medical condition that relates to your symptoms, medical insurances pay so long as the conditions are not specifically excluded.
Frequently Asked Questions
1. How long does it take to get used to new contact lenses if you have never worn them before?
Depending on your eye sensitivity and whether you have soft or rigid gas permeable (RGP) contact lenses, your eyes could adjust to wearing contact lenses from a day to two weeks. Some people find that their eyes never adjust, but that's quite rare. [top]
2. Can a contact get lost behind my eye?
No. At worst, you might have trouble finding it under the lid; if need be, you can have your eye doctor help you get it out. [top]
3. When am I old enough to wear contact lenses?
That depends on how responsible you are; this decision is best made jointly between you, your parents and your eye doctor. Please see our Contact Lenses for Kids article for more information. [top]
4. What kinds of contacts are available?
Contact lenses come in different material types, replacement schedules and wear schedules. Plus, many special kinds are available.
Material Types: soft, RGP
Conventional soft contacts last about a year; conventional RGPs last several years.
Frequent or planned replacement contact lenses last one to several months.
Disposable contacts last from one day to two weeks.
Wear Schedules: daily wear (the ones you take out at night) and extended wear (the ones you can sleep in).
Special Contact Lenses: bifocals, colored contacts, ortho-k contacts (correct your vision even when you're not wearing them), special-effect contact lenses, torics for astigmatism and UV-blocking.
5. Are disposable contact lenses worth the extra money?
Many doctors highly recommend both disposable and frequent replacement contact lenses: they are an excellent choice health-wise, because there's less chance for protein and bacteria to build up on them.. [top]
6. Where is the best place to buy contact lenses?
You should order contact lenses from your eye doctor. Make sure the lenses are put on your eyes each time you get a new pair of lenses. We do not live in a perfect world and sometimes lenses come in incorrect or defective.
7. My doctor refused to give me my contact lens prescription. Is this legal?
Laws on this issue vary from state to state. Some eye doctors feel that if they give out contact lens prescriptions, certain patients would stop going in for regular eye exams, which not only determine prescription changes, but can also catch serious diseases in their early, more treatable states. Ask us about New Jersey laws if you live in New Jersey.
8. Can I wear contacts if I have bifocal eyeglasses?
Yes. There are a few options.
The best option for good clear vision is distance contact lenses and a pair of reading glasses.
The second option is monovision. Here you give up some distance vision and some reading vision and in exchange you have one pair of lenses only. This can be dangerous, as you loose depth perception and that can cause accidents.
There are modified monovision techniques that incorporate a third lens for distance or sports or the use of a bifocal contact for one of the eyes depending on personal needs.
The last option is the use of bifocal contact lenses. Most soft lenses are fair at best although some gas permeable bifocal contacts are good. [top]
9. Why did my doctor tell me to come back after he has already fitted me with my contacts?
It depends on the type of lenses you are wearing and your wearing schedule (overnight wear vs. continuous wear up to thirty days).
In general 3-7 day initial contact lens checks are ordered because we wants to be sure that you're not having any problems, such as an improper fit or a change in vision, and that you are cleaning your and caring for your lenses properly.
If it's about a year later, it's to check whether your prescription has changed and to check for any diseases which are best treated in their early stages.
1. Do you accept Medicare?
Our office does accept Medicare. If a medical problem exists, the visit should be covered at 80% of Medicare's usual and customary. Normally a Low Vision evaluation does not occur unless a medical condition has caused a major change in ones visual ability. The use of Medicare Insurance for routine eye care is illegal.
2. Does Medicare pay for a Low Vision Evaluation?
Each provider or carrier for Medicare has different policies regarding Low Vision Evaluations. In New Jersey, a Low Vision Evaluation as such is not a covered procedure.
3. If I need low vision aids, how expensive can they get?
Low Vision aids can vary in price from a few dollars to a few thousands of dollars. Items that routinely run under a $100, are high quality hand magnifiers (not available in standard stores), clip-on loops and magnifiers, and full spectrum bulbs. Items costing a few hundred dollars include specialty tinted lenes, high power low vision glasses including magnifiers and telescopes and lighting fixtures. More sophisticated telescopic systems and closed circuit TVs can cost thousands of dollars.
4. Does Medicare pay for the aids?
Medicare does not pay for Low Vision Aids.
5. My Ophthalmologist told me there was no additional help for me. He said I can not see the big E on the chart. I want to read. What can be done to help me?
For starters, you need a thorough eye evaluation that focuses on finding your maximum standard vision. Next you need a Low Vision Evaluation to determine where your best usable vision is. This evaluation must include your goals and a realistic assessment of those goals. If reading is important, the trial use of varying magnifiers at specific working distances taking into consideration field of view and lighting must be attempted before the infamous words "nothing more can be done for you" should be uttered.
6. What are the state vision requirements to drive?
In New Jersey, to maintain your standard driver's license, you must be correctable to 20/50 in only one eye. The other eye can be totally blind. At present, there are no visual field requirements. This means you can be totally blind in one eye and only see half the world in the other eye and as long as it sees 20/50, visually, you can maintain your license. Depth perception and color vision are not a requirement for a driver's license in New Jersey.
Having said this, driving should not be based on minimum standards only. If you do not meet the minimum requirements you should turn in your license if your doctor has not told you to do so. Your greatest responsibility on the road is to others around you.
7. Will I need therapy to learn how to use my new aids?
As low vision aids become more complex and sophisticated, the difficulty in using them increases. As optical powers increase, and the field of view decreases, the need for new scanning strategies increases. Low vision rehabilitative therapy will assist in giving you the
strategies you need to function optimally with your aid.
8. Will Medicare pay for the therapy?
Yes. In the late 1990's codes were established by Medicare specially to assist individuals with visual disabilities to learn to function with aids and to function more safely in their environment.
9. I am poor and can not afford these services. What can I do? And can you help?
Each state has programs set-up to assist individuals of limited means. In New Jersey, State run Medicaid and the NJ Commission for the Blind and Visually Handicapped can help. I have been a Panel Member of the NJ CBVH for over 18 years. I also accept Medicaid.
10. My child has a Low Vision problem. Can he be helped?
There area number of diseases that affect the visual system of infants and children. Infantile Cataracts, traumatic cataracts, Glaucoma, Metabolic diseases, Stargardts Disease (a form of macular degeneration in children), Albinism, Nystagmus, and Retinitis Pigmintosa are but a few of the diseases affecting infants and children, potentially creating vision threatening conditions.
1. What is involved in a Sports Vision Evaluation?
Sports Vision Evaluations concentrate on the visual skills needed to function in general and specifically in the sport the athlete is engaged in. Eye hand and foot coordination, speed of reaction time to visual stimuli both static and moving, glare recovery time, color vision and color discrimination under pressure and timed, dynamic visual acuity, depth perception static and dynamic, and peripheral awareness are to name a few of the tests.
Testing occurs at two levels. Testing and treatment is performed on children and adults with visual deficits that can be brought to normal and so enhance sports abilities. We also evaluate and train athletes with normal and superior skills the an eye on increasing the level of visual performance beyond normal.
2. What sports rely heavily on vision?
All sports rely on vision to some extent. Sports that have a moving object that has to be interacted with generally require most visual skills. The faster the object moves, the more visual distracters, the smaller the objects, the larger the area the object can move, as well as rapidly changing lighting conditions have a major input on vision. The same sport can be played at a variety of levels of ability and therefore have varying degrees of visual demand.
3. How did Sports Vision Get started in the United States?
Optometry has been interested in visual function and visual performance for well over 75 years. Protective eye wear had been an issue long before OSHA came out with standards for lens quality. Racket sports and golf have created severe eye injuries for years. In the early and mid 1960's the East German Olympic Organization started looking at ways to enhance athletic performance. One of the many areas they worked with was vision. At or about the same time United States Air Force was looking at ways to use eye tracking to enhance fighter pilot performance. By the mid to late 1970's the United States was starting to look at athletes visual performance skills seriously. By the early 1980's the American Optometric Association started a Sports Vision Section. Other Sports Vision Organizations arose with a few years of that date. The American Optometric Association sports Vision Section was involved in evaluating and treating U.S. Olympic hopefuls and team members. I was proud to be a member of that early group and was Membership Chairman for the Sports Vision Section for a while. With time the Olympic process became more and more commercial and the AOA decreased its involvement in the US Olympics and concentrated on the US Special Olympics and then The International Special Olympics. I again was fortunate to have been involved in the International Summer games in Hartford Conn. and the winter games in Toronto, Canada in the late 1980's. Today, many professional athletic teams have an Optometrist on staff or consulting to help with visual performance issues.
4. What can you do with the information you obtain in a Sports Vision Evaluation?
The information obtained from a Sports Vision Evaluation can help in giving appropriate eye wear including anti reflective lenses for glare, light sensitive lenses for changing lighting conditions and general sensitivity, and in some cases contact lenses that enhance contrast. Training when appropriate can increase speed of reaction, increase awareness, enhance depth perception and improve visualization skills to mane a few.
5. Can you enhance some ones visual skills if they already have good skills?
My experience with US Olympic Athletes, College sports teams, and professional athletes has shown me that regardless of your baseline skill level, with enhancement training these athletes improved. There are always exceptions to every rule and observation.
6. Can children or adults with Cerebral Palsy be helped?
For a number of years I had the pleasure of working with the US and International Special Olympics. For the past (15) fifteen years I have worked with patients with varied neurological disorders. In must cases, visual function has been improved to observable levels.
7. Does medical insurance pay for the evaluation or training?
No insurance company will pay for sports vision enhancement. If a medical condition is found, the evaluation may be covered. Likewise, if a medical condition requires vision therapy, it may be covered. Each insurance plan is different as to what is covered.