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I and a 45 year old male. I have had chronic eye strain/pain

for about 1.5 years (since...
I and a 45 year old male. I have had chronic eye strain/pain for about 1.5 years (since around December of 2011).
I have gotten my prescription checked four times since then and have been to four different eye doctors.
I have purchased six pairs of glasses since the eye pain began and I am currently using Zeiss personalized progressive glasses. The last eye doctor I went to @ 2 months ago said my prescription was correct and gives me 20/20 vision with my Zeiss glasses, and he said my problem may be dry eyes so he recommended lubricated eye drops and steaming wash cloths. Neither of these recommendations has helped at all. (eye drops actually seem to make the pain worse)
The eye pain is most severe when I try and read. Although the words are sharp, I can feel pain around my eye sockets within a minute of reading and I haven't read any books for over a year.
I work out of my home at a computer for @ 4-5 hours a day.
For the last 6 months I have been using a 100" 1080P DLP projector at @ 9 ft. viewing distance for my computer monitor since using a typical computer LCD display at 3-4 ft. is too painful. I zoom in for larger font reading whenever possible.
The 100" screen at 9' distance helps but I still get bad eyestrain & pain.
I have been using a frozen gellpack on my eyesockets throughout the day to alleviate the pain. The eye pain is worst at the end of the workday which mostly goes away by the end of the weekend. Aspirin helps a little.
Hoping someone can help me out with diagnosis/treatment as the correct prescription or dry eye treatments does not seem to be the problem.
Thanks,
Paul
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Answered in 8 minutes by:
6/4/2013
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2,450
Experience: MS Ophthalmology with 13 years of surgical expereince
Verified
Dr. A.S. Desai :

Hello, Thank you for the question.I am Dr.A.S.Desai and I look forward to assisting you .

Dr. A.S. Desai :

Are you available for chat now?

Customer:

yes

Customer:

thanks for taking your time

Dr. A.S. Desai :

Your symptoms may not be due to dry eyes since you have not got the desired relief with lubricating eye drops.

Customer:

yes, the last doctor said my eyes appear in good condition but appear slightly dry. I am in very good health.

Dr. A.S. Desai :

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.

Customer:

yes, all eye doctors I have been to have said I have no signs of glaucoma

Dr. A.S. Desai :

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.

Customer:

what is the recommended treatment for convergence insufficiency?

Customer:

would it be unusual to have no eye pain until 44 years old?

Dr. A.S. Desai :

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.

Customer:

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).

Customer:

I can see everything perfectly sharp with my progressive glasses. I just have eye pain/strain when I read (more pain at closer distances)

Dr. A.S. Desai :

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.

Customer:

I also get eye pain/strain when I read t a nine foot distance on my 100" projection display.

Dr. A.S. Desai :

Ok. Is the eye pain experienced only if you read something ( irrespective of the distance) ?

Customer:

yes

Customer:

Do you think I should try going to an orthpist?

Dr. A.S. Desai :

Is the eye pain more pronounced around the brow area or more so behind the eye?

Customer:

I mean orthopist

Customer:

the pain feels like it is in the eye itself, like a tugging/aching feeling

Dr. A.S. Desai :

Do you have any known history of sinusitis ( allergic ) ?

Customer:

no sinusitus. it actually feels a little worse in the right eye

Customer:

if I cut out reading, the pain goes away. But I have to work

Dr. A.S. Desai :

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.

Customer:

that makes sense but the pain is relieved by cold gellpacks on my eyes

Dr. A.S. Desai :

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.

Customer:

ok, will do.

Customer:

Thanks for your help. It is nice to have someone who actually listens to my problem.

Dr. A.S. Desai :

You are most welcome. It was a pleasure to have assisted you today.

Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2,450
Experience: MS Ophthalmology with 13 years of surgical expereince
Verified
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Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2,450
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Experience: MS Ophthalmology with 13 years of surgical expereince

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