Hello, Thank you for the question.I am Dr.A.S.Desai and I look forward to assisting you .
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thanks for taking your time
Your symptoms may not be due to dry eyes since you have not got the desired relief with lubricating eye drops.
yes, the last doctor said my eyes appear in good condition but appear slightly dry. I am in very good health.
It is very uncommon for near prescription to change frequently as it usually takes a year or two to change. The standard ophthalmic teaching states that very frequent change in presbyopic glasses should raise a suspicion of open angle glaucoma. I am to believe that you have been examined and tested for this too.
yes, all eye doctors I have been to have said I have no signs of glaucoma
If not open angle glaucoma, the other likely possibility of your eye symptoms is convergence insufficiency. This can occur due to weakness in the extraocular muscles which are responsible for all eye movements.
what is the recommended treatment for convergence insufficiency?
would it be unusual to have no eye pain until 44 years old?
Convergence insufficiency( CI ) can be treated with appropriate glasses ( which you have already been given), eye exercises by an orthoptist, weak prisms if there is significant double vision.
I have no problems with my vision and I don't seem to have any of the symptoms of adult onset confergence insufficiency (blurred vision, dizziness, disorientation, double vision, or difficulties adjusting to their bifocals or reading lenses).
I can see everything perfectly sharp with my progressive glasses. I just have eye pain/strain when I read (more pain at closer distances)
But that is one of the main symptoms of CI. Since near vision is a triad of convergence ( both the eyes move inwards with the help of eye muscles), miosis ( constriction of pupils) and accomadation ( constiction of the ciliary muscles which helps to bring objects into focus), one of these has to be affected for the eye strain which you are experiencing.
I also get eye pain/strain when I read t a nine foot distance on my 100" projection display.
Ok. Is the eye pain experienced only if you read something ( irrespective of the distance) ?
Do you think I should try going to an orthpist?
Is the eye pain more pronounced around the brow area or more so behind the eye?
I mean orthopist
the pain feels like it is in the eye itself, like a tugging/aching feeling
Do you have any known history of sinusitis ( allergic ) ?
no sinusitus. it actually feels a little worse in the right eye
if I cut out reading, the pain goes away. But I have to work
Since you have been examined by four eye doctors separately, I guess there is no intraocular cause for the eye pain ( very few painful eye conditions which I am sure would have been picked up by atleast one of the eye doctors). Thus the likelihood of extraocular cause is more.
that makes sense but the pain is relieved by cold gellpacks on my eyes
It would do no harm to consult an orthoptist who can atleast confirm if all the eye muscles are fine and whether there is any weakness in the eye muscles. If there is , then eye exercises can be given a try.
ok, will do.
Thanks for your help. It is nice to have someone who actually listens to my problem.
You are most welcome. It was a pleasure to have assisted you today.