Asthenopia: Eye Strain Causes and Treatment
Asthenopia refers to eye strain characterised by symptoms such as blurred vision, headaches and burning eyes, often triggered by prolonged near work.
Things worth knowing about "Asthenopia"
Asthenopia refers to eye strain characterised by symptoms such as blurred vision, headaches and burning eyes, often triggered by prolonged near work.
What is Asthenopia?
Asthenopia (from the Greek asthenes meaning weak and ops meaning eye) describes a condition of excessive eye strain accompanied by a variety of symptoms affecting the eyes and head. Symptoms typically occur after prolonged near work, such as reading, writing, or working on a screen. Asthenopia is not an independent disease but rather a symptom complex indicating overstrain of the visual system.
Causes
The causes of asthenopia can be divided into two main groups:
Accommodative Causes
- Refractive errors such as farsightedness (hyperopia), nearsightedness (myopia), or astigmatism that are uncorrected or inadequately corrected
- Overloading of the ciliary muscle, which is responsible for focusing at different distances
- Presbyopia (age-related loss of near focusing ability), in which the natural lens loses its elasticity
Muscular and Binocular Causes
- Heterophoria (latent squint): a hidden misalignment of the eyes that is continuously compensated by muscular effort
- Disorders of eye muscle coordination and binocular vision
- Insufficient convergence ability during near work
External and Environmental Causes
- Prolonged screen use (Computer Vision Syndrome)
- Poor lighting conditions or glare
- Dry eyes (sicca syndrome), often caused by reduced blinking during screen work
- Incorrect reading distance or poor workplace ergonomics
Symptoms
The symptoms of asthenopia are varied and may occur individually or in combination:
- Burning, stinging or watering eyes
- Blurred or double vision, especially during near work
- Difficulty focusing, particularly when switching between different distances
- Headaches, often above the eyes or at the forehead
- Neck and shoulder pain due to compensatory postural changes
- General fatigue and difficulty concentrating
- Sensitivity to light (photophobia)
Diagnosis
Asthenopia is diagnosed by an ophthalmologist or a qualified optometrist. Common examinations include:
- Visual acuity testing for near and distance vision
- Determination of refraction to identify refractive errors
- Assessment of accommodative amplitude and endurance
- Evaluation of binocular vision and eye muscle balance (heterophoria testing)
- Assessment of tear film quality to rule out dry eye syndrome
Treatment
Treatment is directed at the underlying cause:
Optical Correction
- Adjustment or new prescription of glasses or contact lenses to correct refractive errors
- Specialised computer glasses for screen work
- Prism lenses in cases of heterophoria to relieve the eye muscles
Behavioural and Environmental Measures
- Regular breaks following the 20-20-20 rule: every 20 minutes, look at something 20 feet (approx. 6 metres) away for 20 seconds
- Optimising workplace ergonomics: correct screen distance, adjusted screen brightness, avoidance of glare
- Use of lubricating eye drops (artificial tears) for dry eyes
- Improvement of workplace lighting
Therapeutic Measures
- Vision therapy (orthoptic exercises) for problems with binocular vision or convergence
- Treatment of underlying dry eye disease by an ophthalmologist
Prognosis and Prevention
The prognosis of asthenopia is generally good when the underlying cause is addressed. With consistent correction of refractive errors, regular breaks, and ergonomic workplace adjustments, symptoms can be significantly reduced or completely resolved. Regular eye examinations are particularly recommended for individuals who spend many hours per day working on screens.
References
- Rosenfield, M. - Computer vision syndrome: a review of ocular causes and potential treatments. Ophthalmic and Physiological Optics, 31(5), 502-515 (2011). PubMed PMID: 21480937.
- American Academy of Ophthalmology (AAO) - Asthenopia. EyeWiki. https://eyewiki.aao.org/Asthenopia (accessed 2024).
- Sheedy, J.E., Hayes, J., Engle, J. - Is all asthenopia the same? Optometry and Vision Science, 80(11), 732-739 (2003). PubMed PMID: 14627938.
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