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Ask HN: Do your eyes bug you even though your prescription is "correct"?
339 points by jbornhorst 12 days ago | hide | past | favorite | 326 comments
I’m digging into an idea around eyeglasses, screen-time, and vision discomfort. If you wear prescription glasses but still get headaches, eye strain, or blurry vision after long screen days, I’d love to chat briefly (20–30 min).

Pure research, zero selling.

Interested? Drop a comment below or email me directly at jbornhorst [at] gmail.com. I’ll coordinate a convenient time to talk.






The solution for me to eliminate headaches when working at computer screens was getting an extra set of intermediate distance glasses specifically for computer work. The "computer screen distance" of 3 ft is in between book-reading distance of 1 feet and driving distance 20'+ feet. I also avoid progressive lenses or high-index lenses for computer work. I commented about how arrived at this solution previously: https://news.ycombinator.com/item?id=15375221

Reading glasses work fine when the screen is very close to your face such as a laptop screen. However if it's a separate monitor that's ~30 inches away, reading glasses are slightly blurry which can lead to eyestrain and headaches.

https://www.warbyparker.com/learn/wp-content/uploads/2023/04...

Look into it if you suspect it's a contributor to headaches: https://www.google.com/search?q=computer+glasses+%22intermed...

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> I also avoid […] high-index lenses for computer work.

Yes! You're the first to mention this.

It's not refractive index itself that's the problem, it's dispersion (roughly, the degree to which refractive index varies across the visual spectrum, described by ‘Abbe number’). We've all seen pictures of a prism splitting a beam of white light into a rainbow — for visual purposes, the less split the better.

Higher-index materials tend to have poorer dispersion, but especially in the mid-range 1.6ish, there are wide variations in quality at the same index. Glass tends to be best, if your prescription is light enough that you can handle the weight. Polycarbonate and acrylic are awful. MR-8 is in the middle, and what I've settled on for recent computer glasses.

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Hear, hear!

Here's a good way to test your glass's refraction index. On your desktop find a small red icon with something white in the center. Stare directly at it. Now turn your head until the icon is at the edge of your vision. If your lenses are cheap polycarbonate, the white part of the icon will appear to move towards the edge of the icon or even out of it.

Most non-cheapo glasses today in the US use Trivex. It's a polymer, not glass, but its Abbe number is 43, which is perfectly adequate.

Crown glass, with its Abbe number of 59, is superior, but the eyeball can discern differences only up to 45-50, so most of Crown glass's improvement over Trivex is imperceptible.

This is partly why it's not offered in glasses (again, in the US, at least according to my optometrist). It is also twice as heavy, shatters (polymers like Trivex don't), and scratches more easily.

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Among non-glass options, CR-39 is a good choice for computer glasses with prescriptions weaker than -5:

  - high (58) Abbe number
  - thick (1.5 index)
  - cheapest
Thickness and weight can be mitigated with a smaller frame, e.g. vintage options.

Actually buying CR-39 lens might require solving a dark pattern maze of online or offline options, since the cost is so low.

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My indoor (non Transitions™) multifocus² glasses are CR-39¹.

I'd used the same material for my outdoor/sports/driving frames but it's higher density caused them to slide down my nose during activity so the next pair I opted for Trivex.

--

¹–CR-39 requires full frame spectacles, as drilling holes is verboten.

²–Shamir Autograph III, awesome & highly recommended.

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https://www.selectspecs.com/ if you are in Europe. I've been using them for years.

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I don't know which type of glass my glasses have, but I know I had to pay a ton for it, because the cheaper sort can't handle my prescription without being really thick and/or heavy. But as someone that actually wears my glasses all the time and not just randomly, it's worth the extra expense.

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Interesting, is the lens ultra high-index? How's refraction? As far as I'm aware, high-index, as the index becomes higher, generally will have a progressively worse Abbe number.

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A fun fact I learned recently, after years of casually skimming color science, is that our eyes cannot focus the entire visual spectrum at once.

That’s why our cone response to the spectrum looks like https://en.m.wikipedia.org/wiki/Cone_cell#/media/File%3ACone... instead of having cleanly segregated red vs. green responses. If it was segregated, we could only focus on red or green but not both. By having a heavy overlap, we can get a sharp focus on yellow. And, the visual system makes the full spectrum work by deriving the red vs. green concepts from the difference between the two cone responses. Blue focus is accepted as a necessary sacrifice.

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>instead of having cleanly segregated red vs. green responses.

I suppose that's why r/g colorblindness is so common.

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A few years ago an optician convinced me to get some fancy 1.67 index lenses, but I couldn't deal with the chromatic abrasion. The text at the peripheral parts of my monitor were clearly split into their RGB components. For frontend work it was impossible, as I couldn't tell if something was not aligned or it was just the chromatic abrasion.

Now I always go for the thickest lenses (which are also usually the cheapest) for this reason. My prescription is -3.75, and there isn't any noticeable difference with thinner lenses.

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All the high index lens materials suffer from chromatic aberration.

The lens material you've now chosen actually has the best optical properties out of all the plastic lens materials. Its only downside is that the refractive index is only 1.5 which does mean they will be a little bit thicker than the high index ones.

You could also try a material called Trivex which also has low chromatic aberration while being a little thinner than the material you are using which is called CR-39

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chromatic aberration

https://en.wiktionary.org/wiki/aberration#Noun

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It's not just about the material. It's also about how the lens is made. For me, choosing "freeform" over "aspheric" was night and day.

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Where are you ordering glasses from that you can make selections like this?

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Firmoo for example. Probably a local optician should also be able to make this choice.

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One problem I have (well, one of many these days, including some double vision, sigh) is that I'm very far sighted in one eye, and near sighted in the other, so one lens is barely anything, and the other is a coke bottle.

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You could also try Trivex instead of MR-8. Lens thickness should be similar but it has a higher ABBE value.

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I do the same. In fact I usually just wear the intermediate distance glasses all the time around the house, and only switch to my primary glasses when I leave the house. Considering I work from home that can mean that I wear my intermediate glasses almost all day long most days.

That almost seems to reduce eyestrain as well, at least for me, as they're still good enough to see everything (I can't read text across the room but I can halfway across the room), just not without some light blur on things, and I seem to have trained my brain to stop trying to focus on things, just let it stay in the blur (at least while I have my intermediate glasses on), and that seems to relax my eyes more.

But the intermediate glasses are super clear for when I'm on the computer, which is a good chunk of the day and where I really need to see nice and sharp, as I'm manipulating things with pixel precision at times (game ui, web ui, board game graphic design).

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I have a very weird situation where my right eye was fine but my left, for reasons unknown, has a thicker lens. This can be happen with cataracts but I'm just under 50 and have zero clouding. The eye doctor said it's not myopia in the "usual" sense but the end result is the same: myopia prescription lens.

Thing is, I ignored it for about 10 years and my brain simply ignored whatever signal was coming from that eye. I'd look at things and see no blurring unless I closed my right eye. However, at a certain crossover distance my brain "switches over" because my left eye has amazing close vision and my right eye doesn't. I can actually feel it when this happens, like a physical sensation. No headaches, but it is "odd".

Anyway, I decided to get glasses, and it turns out I need two different prescriptions. One is close up (not longsightedness, it is still a myopia lens). The other is for 1m-∞

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A myopic prescription can actually be good for seeing things close up but not in the distance- explains why you’re able to see close up with that eye OK

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This worked for me as well. I just asked the eye doctor for something that would work just past my out stretched finger tips which is where my monitor lives.

What kills me is going into the office where I am switching between glasses. Different rooms with different Zoom screens. At home is much nicer where I just have one big monitor to watch.

I take my glasses off to read my phone most of the time. Technically my primary glasses are progressives but it is nicer to take them off.

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> I take my glasses off to read my phone most of the time. Technically my primary glasses are progressives but it is nicer to take them off.

Same. I wear progressive lenses and I feel like they do fine as far as being able to read the text on my phone or for reading a book. But I tend to take off my glasses anyway to do these things. I'm not entirely sure why this is since I seem to be able to read the text fine with the glasses. My hypothesis is that I like being closer to the text so that it fills up more of my visual field which helps me mentally focus on the text better.

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I only need a basic 1.0 reading prescription but I have about 5 pairs of glasses. I'm hyper-sensitive to even the slightest deviation in prescription.

Currently wearing, to look at arms-length monitor screen, add +1.0. Will move out to the porch to read and switch to add +1.5. Will come back to cook and switch to my basic prescription.

I must put on and take off 300 pairs of glasses a day. But I don't care. I can't do anything else.

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I’d love to speak with you - your experience is right in my target zone to research. If interested ping me at jbornhorst [at] gmail.com

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Same - the funny thing is that right now my 3-foot prescription is zero (plus a bunch of astigmatic correction). Apparently my mortal frame has accepted its purpose.

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I'm in a similar boat.

I'm nearsighted and don't need glasses to see my computer screen clearly at all. But nevertheless I started getting headaches from eye strain.

Went to the optometrist, got a pair of glasses just to reduce eye strain at screen distance. Zero difference in sharpness, but I can work all day long with zero eye fatigue.

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I got a pair of these just before Christmas and they've really helped - I tried "occupational lenses" which are a strange bifocal with a central focus of 3ft and then outwards it changes to the reading prescription, did not work with how I use the display in that my head is usually fixed and I move my eyes.

The intermediate distance lenses are great and my headaches have vastly reduced - because they were specific for VDU, my work paid for a portion of them.

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I use a 60" TV and get farther from it. Stopped needing glasses.

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I don't wear glasses (yet) but came to this thread to ask what effect this would have. (I do a good chunk of my computing on a 65" display at 2m.)

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I also regularly look farther away out the window and back inside. That kept me going back and forth on needing glasses for years, but when I set up the monitor, no more need for glasses. (I'm 65)

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Same here: my reading glasses are great for reading, but when I work with computers, my screen is halfway between wrist and knuckles on an extended arm. That's too far for reading glasses. So I got a set of intermediates and things are great. I use them for working with a screen or a laptop, while I use the reading glasses for reading, soldering and other work where the objects I'm looking at are within 40cm of my eyes.

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I use different corrections for laptop at about 18-28" and reading in an armchair at 15-23" -ish. It's really not a big difference in distance!! - and still very noticeable.

It's not for avoiding outright headaches (I don't get vision headaches) but it's clearly more comfortable. It's quite possible that what's pleasant is in part the change of pace - but it is also better adapted for sharpness.

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>The solution for me to eliminate headaches when working at computer screens was getting an extra set of intermediate distance glasses specifically for computer work.

My wife is getting bifocals for basically this same reason.

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That makes a lot of sense. I've heard of people using computer-specific prescriptions, but I never really thought about how much difference that intermediate distance can make. I wonder how many cases of "mystery" eye strain are just from using the wrong focal range all day

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I can second this, after getting PRK I ended up slightly farsighted after being majorly nearsighted, I did a intermediate pupillary distance between my distance PD and near PD and its great for how I use a computer which is 99% of reading I do.

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How do you do with driving and seeing smaller things on your automobile dashboard? I'm up around 7 diopters nearsighted so maybe it depends on the range of needed focusing.

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What sort of prescription is right for Oculus?

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You can get specific insets for the headsets from places like VR Optician. I’ve had some made with my normal prescription and they work perfectly. The people running VR Optician are actual opticians so you can also ask them if any correction factor would be needed for your particular situation.

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> book-reading distance of 1 feet

12 inches?

that's way too close

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Can’t find the message you’re replying to but I think you’re imagining the person sitting up.

Imagine them lying down or propped up on their elbows with the book on the floor. Then that distance seems about right.

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That's way too close for books or screens. Long term it can cause myopia.

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I thought this had been debunked as the cause of myopia?

(Or am I totally misremembering something...)

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Yes, I'm very nearsighted. I've worn progressive lenses for years but they continue to drive me crazy. I can see fine with them, but my eyes easily get fatigued and I have to take long breaks to get them to calm down.

Over the summer I added a pair of progressive occupational lenses (not reading glasses). They are focused arms length in front of me. This has been a complete game changer. I can now see my monitor crisply, clearly, and easily in a way that I haven't seen it in a decade.

When I swap back and forth between my regular lenses and my occupational lenses, the difference is stark. With my regular lenses there's a part of the screen that's about a half dollar coin in size that's clear and in focus. The rest of the screen is every so slightly blurry. I have to move my head to constantly adjust the focal point, or move my eyes and struggle to focus.

When I switch to my occupational lenses, the entire screen is clear. I don't have to move my head. I don't have to fight to focus. Where I look, it's crisp.

No wonder I was struggling! I was fighting to focus all day long. I suffer from almost no eye fatigue now. If my eyes are tired, it's usually because I'm tired and it's been a long day.

The downside is I now have to juggle two pairs of glasses instead of one, but that's oh so totally been worth it. I'm not going back.

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Unsure if this will work for your case, but I am _very_ happy with my implanted contact lenses. They sit behind my iris and optically function as normal contact lenses. No hassle, just a straight up body upgrade.

See https://en.wikipedia.org/wiki/Intraocular_lens

I was very surprised that this is not a more common thing to hear about amongst people with bad eyesight. Laser correction sucks in comparison, with more risks of complications, generally worse vision outcomes, longer recovery, etc. The lens implantation process is even undoable and as safe as cataract surgery which has been done since the 1970s.

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Honestly, I'm absolutely terrified of doing anything that might damage my eyesight. I know the common procedures (i.e. Lasik) have come a long way in the last two decades and are very low risk, but they are not zero risk. I won't even wear contact lenses, I long ago fully committed to glasses. That type of procedure doesn't fit my risk tolerance.

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I understand the hesitation, but that's the thing about this: It's even simpler than cataract surgery (where they actually _replace_ your own lenses instead of just flopping one in front of it), which is very very common, and very very safe.

See: https://en.wikipedia.org/wiki/History_of_cataract_surgery

IIRC the chance of complications for Lasik is about 10x that of the one for intraocular lens implantation. The nature of the complications for the latter is also more along the lines of "an eye infection for a month" instead of something permanent.

I definitely suggest researching it (and not mentally lumping it in with Lasik, because they are quite different). Cheesy, but my only regret is not having done it years sooner.

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>cataract surgery, which is very very common, and very very safe.

Ever since my elderly friend had cataract surgery (5 years ago) she finds bright light painful, so she spends less time outdoors.

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> so she spends less time outdoors

Instead of just wearing shades? That's silly.

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I perpetually rub/touch my eyes. My big fear around these surgeries is weakening a structure such that damage is more likely.

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you need to stop, that can cause keratokonus

try bandaids on your fingers, it takes 21 days to form a habit. buy a few big boxes, 30 bandaids a day is cheaper than a beer

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I would still never bifocals or at least reading glasses. Once you reach around 45 everyone day. Lasix probably makes you need them sooner (but we are talking at most a couple years, not very significant)

I get my glasses in ANSI rated safety glasses so wearing glasses all the time doubles as protection from all the things that could get in my eyes. This is useful if you have hobbies where that is a worry, though for most people you are fine without.

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> I would still never bifocals or at least reading glasses. Once you reach around 45 everyone day.

What are the rest of the words? Or the auto'correct'-corrections?

You would still wear* and after 45 everyone does* perhaps?

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Sigh too late to edit anymore.

never should have been need

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>I won't even wear contact lenses, I long ago fully committed to glasses. That type of procedure doesn't fit my risk tolerance.

I feel similarly, but as the thickness of my glasses increases as I age, I'm starting to consider Lasik or similar. If I already had cataracts, implanted lenses as part of the cataract removal would be a non-brainer.

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Lasik et al are elective surgery on a critical organ.

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In my case, I've had multiple ophthalmologists recommend against getting IOLs until I'm much, much older, as the risk of side affects (specifically retinal detachment) outweighs the benefit I would get from having them.

I still dream of being able to see first thing when I wake up.

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I did the same more than 10 years ago, still perfect vision. It did take around 15 minutes for each eye, with 2 weeks between and 10-15 minutes recovery time

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Same, I have occupational lenses that are also focused to arms length, and it has made a huge difference for me as well when using it for reading things on my computer screens. It makes reading small text easier and feels crisp.

Using it outside of its intended distance will cause eye strain since your eyes won't be able to focus properly.

My provider calls them "computer glasses". It does not have blue light filtering as I do work with implementing web designs and color accuracy does matter to me.

I totally recommend computer glasses for anyone who works all day looking at a computer screen.

They would be a separate prescription / lens type (as in not progressive I think) compared to daily use glasses. I do have to swap to my daily use when not using my computer glasses outside of sitting and looking at a monitor.

Using my daily use for computer monitor reading doesn't feel "right" compared to my computer glasses. There is a clear difference between them.

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>Using it outside of its intended distance will cause eye strain since your eyes won't be able to focus properly.

Mine are more useful that I anticipated when I'm not using them for work. I would advise against anybody driving with the wrong pair of glasses, but I can see significantly better with my occupational lenses than without. I would not trust them at night, but during the day I can see well enough I am not concerned about my driving. I don't intend to drive with them, but there has been the occasion here or there when I had to run somewhere quickly and forgot to swap my glasses.

It also helps that mine are progressives, so the very very top part of the lens is my "regular" prescription. I can use that to focus on something at a distance if necessary.

>They would be a separate prescription / lens type (as in not progressive I think) compared to daily use glasses. I do have to swap to my daily use when not using my computer glasses outside of sitting and looking at a monitor.

Like I mentioned above, mine are both occupational and progressive. I'd like to try non-progressive occupational lenses to see if I like them better, but I'm not convinced it would be worth the money.

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Same. I've driven short distances sometimes to pick up lunch or something 5-10 minutes away because I forgot to switch my glasses. It wasn't ideal but perfectly doable.

I've only done it a handful of times, though. And also I wouldn't do so at night.

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> Using it outside of its intended distance will cause eye strain since your eyes won't be able to focus properly.

I don't find that at all, personally. I wear my computer glasses almost all the time in the house and just let myself not try to focus on things. If anything it seems to be better than my normal distance lenses for eye strain, for me, because my eyes do try to focus with my normal lenses since it's supposed to be perfectly clear, where I know there's a good reason they're not in focus when I'm not wearing them.

My distance glasses have progressive lenses, which may be part of that, as there's different strength depending on where you're looking at in the glasses. I've been tempted to remove progressive lenses from my next pair, as I tend to take them off to read anyway, and then I'd get a flat prescription like I have on my computer lenses.

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Me too. My progressive lenses give me eye strain and it is much worse at the computer. I have non-progressive lens for work and they’re much more comfortable. (Especially with my large monitor.)

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Would love to speak with you for 20 mins to learn from your experience. If interested, ping me at jbornhorst [at] gmail [dot] com and I'll coordinate times.

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> With my regular lenses there's a part of the screen that's about a half dollar coin in size that's clear and in focus. The rest of the screen is every so slightly blurry.

I have two glasses that have lenses with a similar prescription. The older one has some basic lenses and anything outside the center gets gradually less clear towards the edges. The newer one has aspherical lenses and even the areas near the edges are quite clear. It wasn't expensive either. The best lens I have used was probably a zeiss one but I'm guessing the full featured zeiss is probably quite expensive.

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Look at the image in this article, it shows very clearly why my occupational lenses work so much better than my standard progressives:

https://www.presbyopiaphysician.com/issues/2024/march/the-un...

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> now have to juggle two pairs of glasses instead of one

This can be mitigated with custom magnetic clip lenses, e.g. Chemistrie. Tiny magnets are implanted into your current frame. Clip lens changes the focal length of your existing glasses by a fixed offset. Computer or reading clip can be changed in seconds. They also have polarized clips for instant sunglasses on your existing frame, which are better than Transitions/photochromic because they work while driving and are instant on/off.

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It's an interesting approach. I used clip on sun glasses for years, but you still have the problem of having to juggle the clips and while they are smaller and easier to carry they are also far more fragile and easier to lose. I'm not sure they would provide any benefit over what I have now but it's good to know there are options!

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oh these are super interesting - i've never seen magnets in the len's before. thanks for sharing.

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They are mostly sold via opticians who do the changes locally, but there's also an online option, 150 for clip + lens mod + 2-way shipment, additional clips for 75, https://www.buychemistrie.com/product-page/chemistrie-comput...

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this totally works. I also had a someone add in prism, which really did help fatigue. but for reasons I ended up using the occupational almost all the time, and ended up really screwing with my ability to use perspective to gauge distance. now I'm really poor at judging the sizes of things and I used to be able to tell you at half a meter if it was a 10-32 or a 5mm screw

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The brain and visual perception system are incredibly adaptable, even to incorrect prescriptions. Some unwanted adaptions can be reversed by slowly changing any problematic parameters, like (un)training wheels. This would have been inordinately expensive before the era of self-service online glasses.

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Hey, thanks for replying! I’d love to chat briefly. Can you shoot me a quick email at jbornhorst [at] gmail [dot] com so we can coordinate?

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Do you find yourself swapping glasses a lot throughout the day, or do you mostly stick with the occupational ones when working?

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I wear my occupational lenses 100% while working at my computer/laptop or doing some up close and small fiddly work (i.e. soldering a circuit board). I wear my regular glasses otherwise, but find myself frequently taking them off to focus on things close to me (i.e. if I want to read something really quick or use my phone for more than a quick glance).

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That makes sense! It sounds like the occupational lenses have made a huge difference for screen work, even if juggling two pairs is a bit of a hassle

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Before I got my first pair of progressives lenses I saw a lot of conflicting anecdotal accounts. After doing research, the conclusion I came to was simple: I got the very best progressive lens that Lens Crafters sells because the best lens has a much larger intermediate “corridor” size than less expensive progressive lenses. I have had zero issues with my progressive lenses. I forget I even “have” progressive lenses at all!

By asking to talk to only those who have problems, you could be self selecting for a population who may not help you actually solve your problem, even if they mean well.

This is just my experience of course. When I did my initial research, I asked a question on Blind about progressive lenses. Lots of people said they have progressive lenses and they have zero problems.

If I was forced to guess, I would say that some (or maybe even all) of these folks who start talking about the computer glasses……it makes me wonder if they simply under-bought their lenses. Yes glasses are expensive. Getting a better lens will cost more. Yes yes, the Luxotica this and that. I don’t care about any of that crap. All I care about is getting the best lens possible and so should you!

Do what I mean!

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I thought similarly and went with the most expensive lenses with the largest "corridor" for my first pair of progressives. They're great for up close and distance, but for me so far, the middle distance region for screens is a sham. There's almost no spot where the monitor is both clear and non-straining, and the tiniest shift of my head causes warping or blurring. I've had them redone but it didn't solve the fundamental problem.

Maybe my astigmatism correction is causing problems, though it's a small correction. Do you have any astigmatism in your prescription?

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I'm not the person you replied to but the solution, in my opinion, is computer vision lenses. I have progressive lenses and, at my current prescription, I really can't use my computer well with them. It's basically a necessity to use my computer glasses now.

What's great with this lenses for computer use is that anything from screen to close up is clear so they're great for hobby work, etc.

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> If I was forced to guess, I would say that some (or maybe even all) of these folks who start talking about the computer glasses

Not all, because I'm one of them and I think progressive lenses are dumb and won't buy them, but I will buy top of the line distance correction and get it checked to make sure it's correct and then get top of the line computer glasses and make sure that they're correct too. I will get transition lenses though. Those are pretty great (except in a car I guess).

I don't need glasses that sacrifice fov for distance and also for my computer when I can just keep the right glasses with my computer.

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I'm not sure I'm entirely on board with the idea that we've got optometry down to the point where anyone can claim to have arrived at the correct prescription without the wearer having tried a bunch and finding what works in reality. Having worn glasses for over 75% of my 40-ish year life, I've come to the conclusion that optometry is as much art as it is science. I think every time I've gone to a new optometrist, I've been told something along the lines of "wow, your old prescription is way off" and ended up with a half diopter or more change.

I don't sit at a screen much these days, but for a while when I did, I had a computer prescription pair that I swapped on every day when I sat down at my desk, and swapped off when I went to leave. The distance vision with it was good enough to walk around the office or down the road to lunch, but not good enough to drive to and from the office.

After moving and getting a new optometrist, I got a different main prescription, and was told to try wearing them at the computer instead of swapping. Lo and behold, they worked without causing headaches, which is why I ended up with a computer pair previously.

For all of the time I've been in glasses, I've read books without them.

I'm probably not interesting to talk to, because I'm no longer in front of a computer when I can avoid it and I'm in my 40's so I'm staring down (pun intended) some vision changes in the near future anyway.

Minus 2 or 3 in both eyes with a cylindrical correction as well.

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I recently made an optometrist appointment, and was surprised to discover that I could do virtual appointments. And they were a lot easier to get.

I'm skeptical that that can work. I suppose you can administer a basic eye test and get a close-enough prescription, but this is really important and I want to get it exactly right.

I kinda wish I could give it a try, just to see what they can manage to do without all of the tools that an optometrist would apply. But I've got some concerns (which is why I made the appointment) and I'd rather have somebody look closely.

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Getting your correct prescription is easy. They have had machines that do that for 30 years. The optometrist might tweak that a little, but the machine is good enough.

What you also need though is someone to look into your eye and machines still don't do everything an optometrist does there. (though there are other machines that do things your optometrist cannot)

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There is no way that some computer or smartphone app can replace optometrist equipment. I have different prescriptions for reading glasses and occupational glasses, the distance difference is about 20" and it does call for different lens.

Furthermore an assessment by an optometrist should also check for glaucoma and macular issues.

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I’d still love to chat for 20 mins if you’re up for it. Want to better understand your frustration with the typical optometry process. I’m at jbornhorst [at] gmail.com.

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About 15 years ago or so I was part of a study for Zeiss wavefront lenses. They used some sort of interferometer to map my vision and generated a set of aspherical lenses based on that. They were absolutely the best pair of glasses I ever owned hands down. No chromatic aberration. Absolutely crystal clear vision. Granted, this was before presbyopia set in. As far as I could tell, they never really rolled out the system for anything but progressive lenses. It's a shame.

Anyway, I've been fighting progressives for about 5 years now. I have 2 pairs that I got a couple years apart but could never bring myself to wear them. Like some others have said, I much prefer having a pair of medium distance computer lenses. They end up being the glasses I wear when I'm at home even when I'm not in front of the computer. I now have to lift them up to see up close, but that's a reasonable compromise to wearing progressives.

I really want to find an optometrist who uses some alternative to the old phoropter system. My prescription is currently a bit "off" and I swear it's because the phoropter system is fundamentally flawed. My eyes adjust and adapt during the test, causing me to misreport the optimal setting. There just isn't enough time in a typical appointment to detect eyestrain or other issues with a particular prescription.

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The problem as I see it is that the diopter system only has a limited number of different profiles. So if you fall in between a diopter (need more than a 2.5 but less than a 2.75, say) the lenses won't be perfect and you'll have eyestrain.

Presbyopia hit me about 10 years ago. Some people I know use all-day contacts for distance vision then wear glasses on top for computer use and reading. I'm considering it.

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Zeiss i.Scription, linked in a sibling thread, solves the coarse diopter scale as well.

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Yes. Another huge problem is that, at least for me, my mind switches into "compeitive" mode and I start squinting, etc.

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Zeiss i.Scription seems to be their single-vision wavefront lens, https://www.zeiss.com/vision-care/us/eye-care-professionals/...

$10K MSRP for the optician's profiling equipment, https://navaophthalmic.com/product/i-profiler-plus/

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I tried this recently and it’s the real-deal. Really neat to see a Rx written in .01 Diopter accuracy. Haven’t tried the Zeiss lens yet that takes advantage of the resolution info, but plan to. You can find providers with inscription on the the Zeiss website.

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I’d love to speak with you - would like to learn more about your phoropter comment, and any steps you’ve taken to mitigate. I’m at jbornhorst [at] gmail.com if you have 20 mins to spare.

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Since it hasn't been mentioned yet, I must add this: when we work and focus, especially when using digital screens, we tend to blink a lot less frequently. If tear composition is not good or there are other exacerbating factors (e.g. an AC with high flow), the break-up of the tear film can easily lead to eyestrain and even blurry vision. In such situations, preservative-free artificial tear drops 3-5x a day can lead to pretty good results. In some cases, one needs to try a few, each for a week or two, before finding the correct one. Pro tip: any eye drop can cause discomfort for a few seconds, especially if the dry eye symptoms have persisted for a long time.

Further reading: https://eyewiki.org/Dry_Eye_Syndrome

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There's an interesting new treatment, Miebo in the US, Evotears in other areas. It's basically a tear film reinforcer (pure PFAS!)

https://en.wikipedia.org/wiki/Perfluorohexyloctane

It's really eerie how moist it makes your eyes feel after even a few uses. I have definite reservations about instilling megadoses of PFAS directly into my eyes but there's no doubt that it is amazingly effective.

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Thanks for this! Haven't heard of this agent yet, but it really seems promising.

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just a +1 here. I thought I had serious eye fatigue and focus problems. screwed around with various prescriptions. changed optometrists twice. went to an opthamoloist, and she just said..wow, yours eyes are really dry, use these drops. helped immensely

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I asked by eye doctor why there was so much mucus around my eyes and after she dumped in a little dye she noted my eyes were almost like sandpaper from not blinking enough.

This seems like something that could have a technical solution beyond just putting liquid in your eyes. I am wary as liquids are sometimes contaminated with bacteria or other substances. Perhaps screens or headbands that trigger blink reactions.

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+1. Something interesting I’ve learned - there can sometimes be a .25 - 1 Diopter difference in the Rx depending on one’s tear film. (Which intuitively makes sense - it’s the surface of the focusing lens, essentially). PF free eye drops have been very helpful for me.

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Yawning helps with tear production.

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I don’t know what your intentions or hypothesis are, but this is a dangerous place to be a novice in. Eye health is misunderstood and most people are ignorant of the basics. If you don’t know what emmetropization is, if you don’t know who Bates is, and if you don’t know why Bates is a quack, then I strongly discourage you from experimenting with user surveys.

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I mean, what are the risks of the surveys? I don't think it will be dangerous to survey people without the full knowledge. Better to be curious about it than do nothing. Discouraging low risk research just for being pendantic sounds a like toxic gatekeeping.

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It really is just unnecessary and arrogant gate keeping.

OP for now just wants to talk to people, I assume to understand their issues, what they tried, what makes it better and what makes it worse for them. Talking to people volunteering for a call is not dangerous.

For all we know, OP will not see any pattern that fits their hypothesis and leaves it at that.

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Get checked for keratosis? Prescription lenses make certain assumption about the shape of your eye. Keratosis means your eye is a slightly wonky shape and doesn't fit the "spherical with cylindrical astigmatism" model, so a lens won't correct your vision properly.

Does the problem persist with contact lenses? Soft contact lenses can do a better job of correcting vision for someone with keratosis, as they conform to the wonky surface of the cornea.

Edit: Just realised you're probably doing market research rather than asking for yourself. Either way, people with keratosis, who don't fit into the box, might be something to consider.

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This, but also look into the rigid lenses. Was a game changer for me.

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I'm nearsighted with no astigmatism, so I have a simple -2/-2 prescription (if I remember correctly).

I sit at a screen 8-16 hours a day. I get strong headaches every single day, for which I keep a supply of ibuprofen at work and home. 400mg a day is generally plenty.

I do not wear my glasses while at the screen, as it's close enough that I don't have any issues.

I suspect my headaches are neck muscle related, not eyesight, but I haven't investigated further.

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Taking pain meds daily for life doesn't seem like a good plan.

Maybe try e-ink? There are e-ink monitors on the market if that works, if the problem's the light. You can also try software like Redshift[1] for regular monitors.

If it's your neck, at least put some books under your monitor stand, if you're not able to get better monitor mounts. Or lower your chair. You should be looking straight ahead for your monitor, so your neck muscles shouldn't have to do much work.

[1] https://en.wikipedia.org/wiki/Redshift_(software)

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>Taking pain meds daily for life doesn't seem like a good plan.

Definitely not a good plan, especially Ibuprofen. My mother took Ibuprofen for years to manage her arthritis and that absolutely wrecked her kidneys. Not to mention Ibuprofen can also cause internal bleeding. It's a quick short term fix but not a good long term solution.

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> especially ibuprofen [...] wrecked her kidneys

As opposed to what? It's all metabolised by something, choose what you wreck. Take paracetamol routinely instead and you'll wreck your liver instead.

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IMO neither is good for chronic pain management. Ibuprofen reduces blood flow to the kidneys which causes (chronically) cell death. Weirdly paracetamol is bad for the liver as you mention… unless you already have a bad liver, in which case it’s somehow the recommended pain medicine? (For responses I’ve unfortunately forgotten).

It’s much harder to address the root issue (speaking as someone who’s taken their fair share of pain meds themselves), but it’s infinitely better in the long term.

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Certainly didn't mean to suggest they are, especially not without professional medical advice. (Not just to check the dose or have a different one prescribed, but for a PPI to protect stomach lining from taking a lot of ibuprofen for example.) The non-prescription doses on the packaging are suitable short-term, for a one-off headache or to manage a fever, but continued use (a bad injury meaning your taking it several days even) should be with advice, that might differ.

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Paracetamol is world standard for long chronic treatment. It starts tu hurt your liver only on big dosis. Source: FORTA List https://forta.umm.uni-heidelberg.de/

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E-ink isn't possible for either my work or home solutions. I cannot replace any of the work monitors. I do use f.lux while at home, though that only triggers later at night.

My monitor is at the appropriate height (eyes are roughly even with top of the screen) and distance (about arms-length), so I'm looking straight ahead.

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If it's posture related, here's more free advise: try sitting on stools rather than on chairs with a back, and sit up straight and keep your arms actively powered while typing (not laying on a surface). Also, when you need to think for a minute get up and walk around.

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A stool without a back would be very uncomfortable, but I do have ergonomic chairs (Herman Miller Aeron) which should do a decent job from what I understand.

The rest I'll consider though, thanks.

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The point of sitting on a stool is that you have to use your core strength to sit up straight, and using that core strength reduces all sorts of pain in back and neck.

I didn't start doing that (sitting on stools) till I had been meditating for a long time, so it wasn't that different than sitting on the floor in half lotus position, which I had extensive practice doing.

I've been doing it for >10 years now; I will confess that when I have a meeting in a meeting room with proper chairs, I do really enjoy the chair back. It's all about using your body in a variety of ways.

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"I do not wear my glasses while at the screen, as it's close enough that I don't have any issues."

This could be the problem, especially if you are close to 40 years old. You may be starting to develop presbyopia, which is typical. In the early stages you can still read and focus on closeup things fine, so you may not realize it is starting, but in the background your eyes are, in fact, straining a lot and causing headaches.

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I'm not in my 40's, but I'll keep that in mind, thanks.

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If you haven't already, you should look into some stretches for tension headaches. For me at least, they don't make the headache go away completely (because often dehydration is a factor as well), but they sure take the edge off.

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Get your blood pressure checked just to be on the safe side. Those headaches could be caused by other health issues. Taking that much headache medication all the time is not good.

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Does BP vary significantly throughout the day? Do I need to be measuring it while at work, or will a simple visit to a doctor be sufficient?

My last appointment was a couple of years ago, and I don't believe they raised any issues about it then.

I'll see about an appointment.

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If you're getting headaches every day and it's related to computer use, it might be worthwhile to talk to a professional about your workstation ergonomics, screen/font size etc. That is not normal. At all. I don't know anyone else complaining about having headaches daily. I put my monitor on an adjustable arm and it made a tremendous difference, just being able to move the monitor up/down half an inch throughout the day. Also as I've gotten older I've gone from 20 to 22 to 27" displays which helps.

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You're probably suffering rebound headaches at least most of the time.

https://en.wikipedia.org/wiki/Medication_overuse_headache

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How much water do you drink? How much are you sleeping? Is your room dark when you sleep?

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I get 7-8 hours of sleep, in a very dark and quiet room. No loud neighbors, no room-mates.

I think my water intake is fine, but I don't have a specific measurement.

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A good indication that you may be dehydrated is if your eyes are burning after a few hours of work or partway through a long drive.

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Hey, thanks for replying! I’d love to chat briefly. Can you shoot me a quick email at jbornhorst [at] gmail [dot] com so we can coordinate?

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I'll send a message once I'm home from work, which could be a couple hours.

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Are you using a laptop (looking downwards) or are you using a proper screen setup?

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This is a very important point. Staring down on a laptop screen strains neck muscles but it feels like you are getting headaches from your eyes.

Make sure your posture is correct when sitting in front of a screen before attempting anything else.

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Proper screen setup, most of the time a 27-inch screen at about arms length.

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I was born with congenital bilateral cataracts and had the lenses in both eyes removed as an infant (a condition called Aphakia). I have been set up with monovision since I was very young -- that basically means I'm intentionally far-sighted in one eye and near-sighted in the other so that I use one eye for reading and the other eye for distance.

I wear hard contact lenses most of the time, but I do have glasses. My glasses prescription is around +21/+23 (I would fit right in hanging out with Milhouse Van Houten or Professor Hubert J. Farnsworth), but I only wear them in emergencies because I get headaches and dizziness after 10/15 minutes of wearing them. I mostly keep 'em for the novelty of showing people just how thick my glasses are. 8)

My eyes do get tired after long screen days, resulting in blurry vision and watery eyes. I also get headaches on a somewhat frequent basis.

If that's useful at all, I'd be happy to chat more.

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The cold bottle glasses. You get those because they're cheaper these days. You can get the same prescription on a much thinner lens. I did that for my kid. He has a pretty strong prescription in one eye, but his lens is no thicker than mine.

It adds a lot to the cost of the glasses, though. Easily $75 to just get half of the thickness.

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someone else reminded me it's called index, and you can get like 1.74 index glasses that are wafer thin.

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Where? Even thick ones are super expensive here. Over $250 a lens. I'd gladly pay $75 more for a significantly thinner lens. Point me in the right direction please.

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I haven't met too many people who share this condition. Nice to meet you.

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Same! Excluding members of my family, over the years I've only met a few people online who share it.

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If you're over 40 and have been wearing glasses for years, you might now need a pair with a weaker prescription just for computer use.

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What's the reasoning behind being over 40? I recently complained to my optometrist that I was having a harder time seeing things up close and he prescribed me weaker lenses for work/reading. My regular prescription is right around -7 in both eyes. I'm not over 40.

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Presbyopia - the lens in our eyes begin to harden at age 40, making it harder for our eye muscles to "squeeze" the lens to focus. Presents itself as blurriness and eye strain. We usually encounter a change in our Rx during this time too, sometimes needing a weaker Rx (counterintuitively).

Would love to chat about your experience in any case. I'm at jbornhorst [at] gmail.com if interested.

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Most people get this after 40. Some people get it earlier.

Presbyopia: https://www.mayoclinic.org/diseases-conditions/presbyopia/sy...

  Presbyopia usually becomes noticeable in your early to mid-40s and continues to worsen until around age 65.
If you're much younger than 40, maybe google "early onset presbyopia".

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I have a prescription for "office glasses" which have been great.

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Not OP, but would like to try it. How much weaker? And should I weaken the cylinder strength as well?

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Don't trust random strangers on the internet!

You should ask a qualified or licensed optometrist or optician or whatever it's called wherever you live.

AIUI:

- you don't adjust CYL

- The amount you add is roughly 0.75, plus an extra 0.05 for each year above 40yo.

For example, at age 50:

Add = 0.75 + 0.05 × (50 − 40) = 0.75 + 0.5 = 1.25

So let's say that this person's regular glasses are -3.25 in each eye. Their computer glasses would be -2.00 in each eye.

Don't trust random strangers on the internet!

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My optometrist set the adjustable lenses to what he thought was in the right ballpark and then had me read the chart at my requested distance for the computers lenses. A few adjustments, and done. They're perfect! Bonus: text is a bit bigger now, and I can read smaller fonts than I could before getting computer glasses.

The downside of this is that I now find it very difficult to read computer screens and my phone while wearing my distance lenses. The practice of holding things further away to be able to read them always was, I suppose, inevitable.

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Or progressives (aka bifocals.)

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I have progressives and computer glasses.

If I accidentally wear the progressives at my desk, I usually notice within half an hour that I'm not comfortable.

With the computer glasses, everything is clear (including my laptop screen, which is below my monitor).

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+1 - computer glasses especially as presbyopia sets in (around age 40) are surprisingly not well known. this has been a huge help for me.

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What about computer glasses?

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Some people, including me, have what's commonly called ‘astigmatic halation’ — although it's often not due to simple astigmatism, but rather ‘higher order abberrations’‡ which aren't correctable by glasses.

For this case, dark text on a light background is much better than light on dark. Dark on light, the light halation blends more or less evenly over the dark letter stems, resulting is slightly lower overall contrast but sharp lines. Light on dark, it's Las Vegas in the rain.

‡ https://www.allaboutvision.com/conditions/aberrations/

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oh ive never heard of aberrations? it sounds like i might have it as i get weird shadows and stuff that i cannot put into exact words whenever i try to read black background white text! i will have to talk to my optician thank you

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You can find some images on line that try to describe it. For me it seems a lot like this: https://www.threads.net/@mrmedina/post/CuciL0Uvam9 (But I have to remember that when I look at these, I'm stacking my own vision on top.)

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Tons of responses so I don't know if you'll read this but a few things:

Post-concussion syndrome (and screens)

After getting a concussion, I had to change my screens in a big way. Many people have heard of sensitivity to PWM and low frequency PWM in particular. The alternative is DC dimming, and it helps tremendously. Additionally, higher refresh rates seem to help. At least 120 Hz but preferably 144, 165 or higher. My phone has some complicated PWM / DC dimming settings[0] - possibly 120 / 360 Hz[1]. My laptop is 165 Hz and does not appear to use PWM[2]. My desktop screens are 144 Hz and have DC dimming.

I'm going through the hassle of getting a physician to sign off on an ADA request to get my current employer to allow me to use better screens at work, as they provided a laptop with a horrible 60 Hz screen, and two crappy 60 Hz monitors. Fortunately I'm only in the office twice a week.

Glasses

Last year, I got brand new glasses with the prescription determined by the optometrist. However, it took three tries of adjusting things like pupil measurements and the "base curve" or index of the glasses before I started to get used to them. Up until then, I felt very tired and brain foggy while wearing them. With the third revision and a week of adjustment, I finally started to settle in. It takes a really good eye doctor to figure out these kinds of issues, and be willing to swap out lenses for you.

[0] https://www.eyephonereview.com/post/oneplus-12-its-complicat...

[1] https://www.notebookcheck.net/OnePlus-12-5G-Smartphone-Revie... (120 Hz PWM)

[2] https://www.notebookcheck.net/Acer-Nitro-16-AN16-41-review-A...

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PWM is a real concern that impacts, say, 10% of the population, and probably only 0.1% are aware of it. It's been a growing, silent epidemic due to a very clear culprit: OLED screens, particularly on cell phones.

Phone manufacturers know that OLED screens cause eye strain, and they've tried to mitigate it, but it's still sort of an unsolved problem that phone manufacturers haven't prioritized. For the most part, they tend to prioritize making the problem worse over time.

A quick intro to the topic: https://flickeralliance.org/pages/about-flicker

Personally, I am grateful to have an LCD laptop (the MacBook M2 Air's screen is a godsend), and I hope more people would recognize OLED PWM as the source of their eyes strain and complain about it, so that manufacturers change their priorities.

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I don't really know if anybody will read this, but if somebody does and knows what it is, please give me some advice. I see double text, not anything else, only sources of light, like anything on a computer screen. It is like what I am seeing from both of my eyes does not line up correctly. On a completely white background, I see spotches of grey. I have visited two or three doctors and each gave a different prescription, currently I have -1/1 approx, (I don't remember correctly). Man I am only 19, don't want to live like this T.T

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That sounds like an astigmatism to me, which basically just means your lens is a little misshapen. I have a pretty bad astigmatism in one eye and have double vision in that eye without glasses, especially so from lit things like screens.

Go to an eye doctor, they can diagnose. It's likely just something as simple as an astigmatism and some glasses should help you with that.

https://www.conshohockeneye.com/why-am-i-seeing-double-visio...

> Astigmatism is one of the most common causes of monocular double vision, and can be easily corrected by glasses or contact lenses.

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early stage keratokonus, if this is true you need to get the corneal crosslinking procedure done asap while you are young as the condition progresses rapidly in your 20s. The double (triple, N-ary) vision can be corrected by special contact lenses. You may need a specialist ophthalmologist for this diagnosis. https://en.m.wikipedia.org/wiki/Keratoconus see “signs and Symptoms” image, and note that is advanced, as a 19yo I recall a single, sharp double image when looking at the moon at night. You can also try lowering an index card in front of your eye and looking across the edge at the moon and seeing if the double image goes away when your eye is partially occluded, this is because the doubling is caused by a physical distortion of your cornea and if you manage to cover the distortion you will see clearly

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Shit, It did match, looking at the text through the edge of a card does make it clear for me. Although the blurriness is not as extreme as given in the wiki page.

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https://www.reddit.com/r/Keratoconus/ -- but do not freak out, most cases are completely treatable with scleral contact lenses, social media bubbles up the outliers. Next step is ophthalmologist, ask for a corneal topography (photograph and measure the surface shape of your eye w/ a computer) to establish a baseline and monitor for progression. Not all ophthalmologist offices have the corneal topography machine so ask for that on the phone. https://en.wikipedia.org/wiki/Corneal_topography To get a KC diagnosis they will likely want to see progression over time in these topography readings. You want to get this sorted while you are young, the corneal cross-linking procedure will halt the progression of the disease and "lock in" your current vision. I did not get the CXL procedure when I was young (it was still experimental back then) and regret it, my vision is fine with correction but the scleral lenses are a pain and it's unclear if i'll be able to read in bed without lenses in my old age.

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I was recently diagnosed with keratoconus, I'm 28.

I'm unable to get CXL for at least a year due to demand.

What sucks the most about the diagnosis is that the opthalmologist explained that there's essentially no treatment, it's progression can only be slowed, and I'll never be able to get LASIK or SMILE.

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I have keratoconus and stigmatism. 8 years ago I stopped wearing glasses since my vision was good enough for laptop, phone and watch but distance was always a problem. I've been doing eye exercises daily for 8 years and my 3D vision returned last year and on more and more days I can read the street signs across the street, as street signs in the US. My prescriptions used to vary between -3.25 and -4.25 with 90% distortion. My laptop vision is better also. Lately, the glare that emanates from the source of light is less and reflections off of glassy surfaces are also less. My first diagnosis was 35 years ago and over the years various surgeries and fixes were offered. Over the years, technology improves, so I feel I wait. Prognosis so far is manageable. Best of luck to you.

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Have you visited ophthalmologist? I’d start there. Your situation sounds too specific for good advice on HN…

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I have visited two or three of them, but each one just gave a different prescription though turns out I have a little blood clot in one eye due to an accident I had a few years ago and a cataract in the other one, though it is to the side and not directly in the front, so no operation is required for that as of now.

Also, currently a broke college student, so don't really have the money to visit a good ophthalmologist :)

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Hope you find some relief soon...

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Thanks man!!

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Apologies if not helpful: have you tried consulting an AI?

(This is not medical advice)

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Dry eye is a major issue for people who stare at screens. You most likely aren't blinking enough, which causes your eyes to dry out.

Quoting a previous comment of mine (https://news.ycombinator.com/item?id=42796950#42797424)

> A big thing not often spoken about with eye strain is dry eye caused by the lack of blinking due to focusing on screens too close to our face. This is an evolutionary phenomenon--close dangers cause extreme focus without blinking. Extreme focus on close items reduces our blinks. Our eye lids have glands in them that release oils on your eye with each blink. These oils help prevent the watery part of your tears from evaporating. When it evaporates your eyes dry out causing discomfort and potentially pain.

> If you don't blink enough, the oil doesnt get on your eyes and eventually, in extreme cases, the glands can even die. A lack of oil in tears can cause extreme eye fatigue and even pain.

> This is why dry eyes is on the rise. Remember to blink!

> I actually built a little web app to count my blinks. See https://dryeyestuff.com/. Not perfect, just a prototype. 100% free.

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Also https://www.nhs.uk/conditions/blepharitis/

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I will say this: if you're not happy with your current prescription, there are ways to get a more intense workup and better outcomes by going to an academic optometry center. In my case, I went to the New England College of Optometry and got prescribed a special type of contact lenses ("scleral" lenses) which have been a major quality of life enhancement.

They're expensive, there was a learning curve for getting them on correctly, and it took several followup appointments to get the correct fit from the manufacturer, but I can wear the lenses almost all day and they give me clear, sharp, 20/20 vision.

Also, when I'm wearing them I need reading glasses to read up close--my uncorrected vision actually compensates for my slight age related nearsightedness. But my vision is so much better I don't mind at all!

The back story is that I had lifelong astigmatism and 2 eyes with different powers (one more farsighted than the other one) which led to some mild amblyopia (lazy eye) that I've had since childhood. My vision wasn't "that bad" so I got by without using my glasses for a long time. But when I tried using my several year old prescription glasses I found that presbyopia (that age related inability to focus on anything up close) made the glasses almost useless for reading.

Even though I'm a dev who looks at screens all day, I didn't think I minded, but I noticed in recent years that my appetite for reading books had disappeared was partly due to noticeable eye strain, but also due to generalized eye fatigue that I wasn't really acknowledging. I also had to sit up front in meeting rooms to follow along with anything projected on the screen, which was annoying.

A colleague mentioned the book Fixing My Gaze (https://www.google.com/books/edition/Fixing_My_Gaze/Ul16tPVk...) and I bought it. It's partly a personal narrative by a neuroscientist who was stereoblind and taught herself to develop stereo vision in middle age (she was profiled by Oliver Sacks at one point). But it's also a history of research optometry, which focuses on refractive vision correction and visual processing (as distinct from eye diseases) and which I barely even knew was a thing. Which led me to NECO and my big quality of life improvement!

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I just recently got sclerals for dry eyes and I'm still going through the adjustment process. Usually they are prescribed for keratoconus (misshaped cornea) and not something most people need. The doctor actually said it's more challenging putting it on someone without keratoconus (like me) because I am used to having fairly good vision with my glasses and sclerals aren't as easy to get right as glasses/normal contacts. They have been amazing for dry eyes so far though.

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Not sure if 20-30 mins of discussion is necessary for my case, but my case was simple. When the new prescription glasses arrived, the nose pads are not properly adjusted, resulting in the glasses sitting too high on my face. This means I'm looking through the bottom portion of the lens. This makes things blurry and causes headaches. Fortunately once the problem is noticed, it takes one minute to fix.

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I'm amazed at how often I see people with poorly adjusted nosepads. In some cases I can see one or both pads not sitting flush on the nose, but digging in at an angle.

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Or people with the temple bridges too short, so the ends don't go over the ears.

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My eyes have always bugged me, but I've also had allergies. It's also become clear over time that I have pretty bad astigmatism. I've always been farsighted.

I first got "dimestore readers" specifically for computer use, to reduce eyestrain. When I put them on at the beginning of the day I'd notice some weirdness (phantom artifacts and double vision) but my brain would cancel it out and all was good. After about a decade though, I wasn't noticing those artifacts at the beginning of the day, but while driving home I'd see double. That led to getting prescription glasses, and learning lot about astigmatism.

Until recently, I always tested better than normal at infinity without glasses. At infinity, most of my correction is astigmatism. Corrected, I'm still 20/10. But here's the "weird trick": I've learned that it's something that my eyes / brain are doing combined with the astigmatism. I can still conjure "hot spots" with near perfect clarity even without glasses, but it strains my eyes (I don't get full FOV clarity without glasses anymore).

I can't stand progressive lenses, although I have a pair for super close-in work. All my task glasses are "single pane of glass", my "infinity" glasses are bifocals. These days my eyes are more comfortable wearing the infinity glasses than not. The truly noticeable difference with glasses was night driving: no more stars! Huge reduction in eyestrain and improved basic ability to see when challenged by oncoming headlights; I've combined that with some aggressive rose tint in a pair specifically for night driving (very 70's mod frames. woot!).

I'll never get Lasik because I've been told repeatedly that if I did so they wouldn't be able to correct me to 20/10 any longer.

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They won't officially try and correct to that level. I did maintain 20/15 both before and after, but still have a mild astigmatism, so I still wear glasses

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Would love to chat. Drop me a line at jbornhorst [at] gmail [dot] com and I'll coordinate times.

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I am having so many issues with my vision. I don't have a very high prescription(+1.5 on left and +1.25 on my right) but I consulted 3 eye doctors and optometrists last year. I still don't think my prescription is correct as I get headaches and my eyes get tired after few hours. I don't know if there is any better solution around.

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Have you adjusted the lighting around your monitor/office? This seems to have a big impact on my eye strain.

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a brighter room with light screen (not dark mode) causes smaller pupils and thus better focus.

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You need to specify your working distance. I use reading glasses with my laptop and occupational glasses with desktop LCDs. If I accidentally pick up the wrong glasses I notice the less-clear vision.

High display brightness tends to hurt more with glasses than without.

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Would love to chat to learn more. I’m at jbornhorst [at] gmail.com if you have 20 mins to spare.

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My optometrist told me that I have a tendency to 'overcompensate' the last time I had my rx checked; I now tell the optometrists that I have a tendency to overcompensate and ask that they dilate my eyes before anything starts and it's really helped me reduce eye strain.

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Same here: it's called "accommodative excess". And in particular, it won't show up on a vision test.

I always got 20/20 on my vision tests, but kept complaining to different optometrists, and finally found one smart enough to recognize my situation, and now I wear -0.5 lenses. It brought my life out of a very dark place.

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That hits a nerve for me. Sure I get 20/20 but if the astigmatism doesn't line up I'm going to have a bad time.

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I'm nearsighted with a slight bit of astigmatism. (-6 or so). I got progressive lenses the last time around at the optician. I hated the whole process; it was desperate and high-pressure sales. I hate the progressive lenses because using them requires tilting your head at awkward angles. I hate that the near-sighted prescriptions are regulated as much as they are.

I ended up self-serving at eyebuydirect.com. For the price of the highway robbery at the local optician I got 6 pairs of reasonable quality frames with regular lenses stepping along a range I guessed I need for computer work. And I couldn't be happier, even though I ignored the astigmatism bit. It's possible there is a bit of that engineer DIY itch that got scratched in the process as well :-)

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I also recommend eyebuydirect.com. Although it's part of the eyeglass monopoly (Essilor Luxottica), they have frames that are good looking and affordable, and all the single vision lenses are cheap except for the 1.74 high index ones.

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> they have frames that are good looking and affordable

Some of their frames are clones of expensive, popular frames from boutique designers. Perhaps that's why they are retired after a while.

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Well done. EBD lenses are made by the same company that sells to local opticians.

Progressive lenses also influence visual perception after years of use, unlike old-school bifocals with a clear shift in focus.

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I would LOVE to speak with you. 20-30 mins? Drop me a line at jbornhorst [at] gmail [dot] com?

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Anecdotally related, but, during Covid and remote work I went to an optometrist around age 35 after I noticed my distance vision was blurry, especially at night after working inside all day.

They told me "you have 20/20 vision, your vision is completely fine, you don't need glasses!" But, I responded, my vision is definitely blurry. They politely told me to stop wasting their time.

Dissatisfied, I went to another optometrist, and paid closer attention to the whole process. After some discussion with the doctor, we arrived at the conclusion - I've had essentially 20/7 vision my entire life, and now in certain circumstances my vision has degraded to 20/20!

They gave me a prescription and now I am perfectly happy having laser-sharp vision again when I want it.

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How the hell did you convince your optometrist to correct your vision to 20/7?

The past two docs I've been two have ignored me when I've said "I can make out the letters, but they're blurry and fuzzy. Can we go stronger?" with "Well, that's corrected to 20/20 vision.".

I'm very, very strongly considering finding a used eye-testing-headgear thingie like they have in their offices, learning how to use it, and doing the testing for myself.

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Search "trial lens set" and "trial lens frame", the portable versions which were used for decades in the past.

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Wow...thank you for this phrase. I always thought it was impossible to find prescription lenses online, and there's a box with literally all of them...

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As recommended elsewhere in this thread, EyeBuyDirect is quite good if you have enough knowledge to specify your own glasses and fitting. They are owned by upstream BigLens™, so lens quality is comparable to many opticians, with low pricing since they make their margin on frames. If you need custom fitting height for one of their frames, you can measure and return after receiving the glasses, then they will remake a new pair for free within 14 days of receiving the first pair.

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I've used GlassesUSA.com before as well. I kind of switch between them depending on who has a better sale for my kids' glasses.

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Oh, sweet. Thanks very much for this new and useful vocabulary.

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That's odd. Most optometrists I've seen over my life (and specifically here in Canada, BC) will keep trying to adjust and ask you if it's sharper or not before they settle on the numbers. They'll go higher or lower power and/or astigmatism in different increments. They're also generally pretty cool with things like testing with a laptop monitor and getting the sharpest computer prescription.

Maybe this is your sweet spot?

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> Maybe this is your sweet spot?

I doubt it. I played around a bit with the hand-lenses and was able to get a much more clear picture by increasing the lens strength more than the doctor was willing to.

If the doctor was making any sort of tradeoff, they were not informing me of it. They kept asserting that I was "corrected to 20/20" when I protested that the letters on the chart were still quite fuzzy. If they'd have informed me of a "close range vs. long range" lens tradeoff, I would have happily informed them of my willingness to have multiple pairs of glasses.

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Would love to chat if you’re up for it. I’m at jbornhorst [at] gmail [dot] com

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Two factors worth looking at:

1. Base curve. Some people are bothered by lenses with a high base curve. Talk to an optician.

2. Flicker. Lights that flicker can cause headaches and other issues. This includes many LEDs, especially ones from more than a couple years ago, as well as old CRT monitors. “Driverless” LEDs are a major offender. Some modern “low persistence” displays could also be problematic. (I have no idea why anyone wants a low persistence monitor. I understand why low persistence is useful for VR, but monitors aren’t VR.) There’s a standard called IEEE 1789 that the industry mostly ignores.

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I avoided glasses for years because no matter what, wearing them would give me horrible headaches. Then one day I went to a higher end optician, spent $1000, and have been comfortably using glasses since.

So maybe more selling, less research?

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Sounds like you've solved it, but I'd love to learn from your experience. 20 min chat? Can you shoot me a quick email at jbornhorst [at] gmail [dot] com so we can coordinate?

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What is a higher end optician and how do you find one?

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Can't speak for GP, but in my case it was an academic optometry center. Life changing. See my longer toplevel reply.

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My guess is an ophthalmologist as opposed to an optician.

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It's an optician that takes you to the cleaners in such a way that you feel good about it afterwards.

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I'm in my 50s and about 3 diopters farsighted. I had trouble getting a good prescription for screen glasses. My optometrist insisted that +1.25 was the right correction for desktop screens, but it gave me eye strain. I like my screen a little closer, or else my corneas are extra-stiff. Anyway, I tried a few versions and found that +1.75 was better for my desk setup.

Tip: Zenni.com lets you order pairs with custom corrections in 0.25 diopter increments for under $100 each, so you can try a few and find what feels best for several hours of screen time.

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You can also just get an optical trial lens set like they have at the optometrists for less than 200$.

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I'd love to speak with you, especially given that you've already tried multiple test Rx's. Email me at jbornhorst [at] gmail.com if interested?

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Up to +3 can easily be tried on and bought at a drugstore.

I’m severely myopic (-11), though that is corrected completely by contacts. Presbyopia, alas, hits us all.

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Well, I need a substantial astigmatism correction too. I've tried combining both -- my prescription distance glasses with drug-store reading glasses over top -- but it's wobbly and limits my field of view to less than a whole big monitor.

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I went decades thinking that all prescriptions were imperfect until I started getting age-related presbyopia (reduced close focus abilities) and sought perfect correction or a clear reason that it couldn't happen.

The diagnosis: keratoconus (thinning and ultimately misshapen cornea). The prescription: highly-corrected rigid scleral contact lenses. The result: radical. I would describe my uncorrected vision as 480p, glasses as 1080p, and scleral contacts as 4k.

The scleral prescription makes my medium and far vision great while further limiting my ability to focus closely. I experimented with "monovision" to have one near-focused eye and one far-focused eye with my brain sorting out the difference, but I could tell that it resulted in lower resolution. I optimize by sticking with the medium-far prescription and wearing 1.5x reading glasses for anything within a few feet. It works great.

If you're in a similar boat, I can't recommend it enough to get checked for keratoconus. To get that you'll want to find a place that can do a corneal tomographic scan with a device like a Pentacam. Oh, and try to not rub your eyes and tell your kids the same because it's believed to be a major cause. I used to do it for fun as a kid to make colors while I was bored.

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I have a strange vision problem these days. I dont feel that my eye power is constant, rather, it feels like a range

Some days i can see clearly through my prescription lenses while on others i dont. I also have gone for eye power checkups on different days and indeed my prescription is different.

On my last visit i also got my axial length checked. Will do the same on my next visit and see wtf is going on in there

Ive got all sort of test btw Fundus examination Corneal thickness Corneal shape Topography

So far no one knows whats happening

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I have the same problem. My eye doctor suggested moisturizing eye drops. I was skeptical, my eyes didn't feel dry, but it has made a big difference.

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I was CTO for an online eye exam for 5 years and have a couple of patents in this area. Happy to chat! Not an ophthalmologist but I know some things and some people. Email is in my profile.

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Tell the doctor/optician what you are going to use it for (distance, long hours, environment) and the least they can do is to test the comfort level to match it correctly.

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One solution I haven't seen mentioned is trifocals. Progressive lenses used to be sold against bifocals and trifocals by saying "no lines" but there are some advantages to the old school designs. In particular, progressive designs tend to end up with an hourglass-shaped field of view[^1] in which the horizontal field of view at mid-distance can be so narrow you can't see your whole monitor screen without pivoting your head. The mid-view area on trifocals is significantly wider than on progressives and I found it much more useful for medium distance work of computer monitor or car instrument panel. In addition, the area of distance vision is much wider on the traditional trifocal, which means you don't have to move your head as much or not at all to see out car side mirrors.

[1] It's been maybe a decade since I researched this - at the time I concluded that the hourglass FOV shape was a result of progressive lens designers not having enough surfaces to play with and was unavoidable if they wanted decent near and far areas, which tends to work well when your presbyopia isn't too bad yet. Maybe since then someone has introduced a different compromise in that space (maybe narrower close window trading for wider middle distance region?) but I'm not aware of it.

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I've recently started wearing progressives, previously I was constantly putting on and taking off reading glasses (I'm far sighted). My usable field of view is more funnel shaped than hourglass shaped. At the bottom I can barely get both eyes to focus on something up close at the same time, it's only really wide at the top (wear I don't need much correction, just for slight astigmatism). It's better all around than no glasses or keeping my readers on all the time, but it's not as nice as I had hoped.

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My ophthalmologist said that the two things to do to prevent glasses headaches are to back off from the "correct" prescription slightly and to use computer glasses designed for focusing 2-3 feet away when at the computer rather than the distant target typical for corrective lenses.

Your optometry office can also test your glasses to make sure that they're actually the right prescription. Lensemakers sometimes (often?) do the fabrication slightly wrong.

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Yes, but the solution is simple — get up and look at something further away than my screen. I rely on my eyes bothering me to tell me that I need to get up and move.

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This is called the 20/20/20 rule: every 20 minutes, look at someone 20ft away (or just close your eyes) for 20 seconds.

I wouldn't call it "the" solution: it's part of a complete breakfast.

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Hey, would love to chat. Can you shoot me a quick email at jbornhorst [at] gmail [dot] com so we can coordinate?

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The longer i stay up the blurrier my vision gets, and no pair of glasses completely corrects my vision. i was 25/20 or better in each eye until a couple of years ago, i scratched my left lens somehow and i got wicked poked in the eye by my kid in the right eye, into the socket. I can drive without glasses, but i can't read the sideroad signs on the 8' poles very well.

I originally got my prescription with an Eye-Q device, and had a professional "correct" it.

I cannot read pill bottles and the like without a magnifying glass, and haven't been able to for a little over 2 years, right before the poking and scratching - which is why i originally thought i needed glasses.

my biggest issue with the way prescriptions are decided is the "this one, or this one" and they both look equally crappy, and they say "which looks less crappy" and i just pick randomly, because they're both awful. and then it continues, where it's just blurry from there on out. I don't understand the mechanism to give me glasses that will correct my vision when the device they use to test makes everything look blurry! At least i understand how the Eye-Q device works...

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> my biggest issue with the way prescriptions are decided is the "this one, or this one" and they both look equally crappy, and they say "which looks less crappy" and i just pick randomly, because they're both awful. and then it continues, where it's just blurry from there on out.

I had an eye opening (ha) experience once I got pretty deep into 200/300/600 yard high power rifle. I was trying to debug an issue with my 600 yard shots clustering in three places - one cluster right in the middle, another cluster directly left, and a third cluster somewhere else

You set up these camera thingies (https://scattusa.com/) and it shows you an exact trace of what's going on with your aiming, while not using any ammo (recoil hides a lot so you do most practice without ammo).

The left cluster ended up being super obvious: trigger control and problems relaxing, making me physically jump shots over there - you could see lines from the Scatt go right after shot breaks.

The other cluster though was strange as hell. It was just not in the right spot. But it was a singular spot, I had two remaining clusters. There was no movement between middle and other cluster like there was with the left. It just looked like some percentage of the time I aimed at the wrong spot (not that far off, but enough to drop points).

Then one day when lying on the ground for an hour with the Scatt, I started seeing double. I'd blink and it would go away, but by relaxing a lot I could make it go back. The double vision was right where the cluster was.

Then I looked up more info on astigmatism (had >2 diopter astigmatism?), and it turns out it's literally just light refracting into 2+ places instead of 1. And of course the real bullseye people know about this (since in high power honestly we're kinda pretending at it), and they have specialized sights for correcting the axis and magnitude of astigmatism:

https://gehmann.com/en/579-Cylindrical-lens-system-0-2-Spher...

And sure enough, that's like the same thing the optometrist is doing. Except in the context of bullseye you can physically see the 2 bullseyes floating around an axis and then coming together.

I get why they do it the way they do it, because your brain corrects the astigmatism and doesn't let you see double normally, but if you can train your eye/brain to kinda dissociate and see double, you can get a pretty exact correction for astigmatism.

Then I got LASIK and my 600 yard scores went from high 170s/ low 180s to like 195+. Lol.

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the damage to both my eyes was such that my left eye i had a giant ryuken swish around any point source of light (leds on devices, car headlamps, etc). The right eye was like 3 dim blurry copies around a point light source.

Eventually, i was able to count 8 distinct "copies" in my left eye. It made trying to determine what was in front of me at night nearly impossible, and i stopped driving until after the medication they gave me worked.

The Eye-Q device has a red and a green "bar" and those rotate with each "test", you push buttons on the device until you see a yellow bar appear distinct from the red and green bars, then you hit "ok", it rotates, spreads the bars apart, and you start again.

What's interesting is i never failed to get that yellow bar with the eye-q - i'd have expected that to be synonymous with getting a clear image from the optometrist tool - which copilot tells me is called a phoropter. To be silly, i will pronounce that "fuh-rope-ter" and see if anyone notices.

edit; i just checked, right eye i can see 4 lights on my NAS blinking, left eye i see at least 8 without glasses, only 4 with. These aren't very bright, so i'll have to remember to test outside at night with a planet or a distant street light. a single copy of a light source isn't as bad as 4 or 8 or a giant swish!

2: I know the doubling you're talking about when looking through sights. There's something about the way parallax works that i don't think it's "tricked" me in the past. I wonder now if i could group, at all?!

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I'll give you my summary, yes.

1. My perscription was out of date by two years and I let it go too long. My eyes struggled to compensate. Got it fixed.

2. For a while I had two different computer setups at different lengths, that contributed to it, they were different by almost two feet. Made changes to make them about the same distance.

3. My night computer I used in a dark room with no backlight. Added a single directed light facing the wall behind the monitor which gives it a soft but focused glow around the computer.

4. I'm PWM sensitive (see associated subreddit). I reduced brightness drastically on my phone and it helped alot with eye exhaustion since my brand is a well known bad source of PWM eye exhaustion and headaches.

After all these changes and a healing time of about a month, I'm back to being able to see individual pixels in text on my screens. My eyes feel like they have de-aged about 10-15 years and eye exhaustion almost never happens now, maybe once in a month and a half, after a few bad nights.

Other stuff that helped, improving sleep and restfulness and getting out and doing exercise more often. Also not using glasses when not needed.

Hope this helps!

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When I went to check my sight after repeatedly getting blurry vision/eye strain after working (mostly reading on laptop) they said they couldn't find any issue with my sight. One of the eye were a bit worse than the other, with trouble with distant object, but not to the level of needing glasses.

But I insisted and made (very weak) glasses with blue-light filter included, and these days I use it when I need to read stuff on the screen (I get zero strain or blurry vision when I play games, in same setup, oddly enough). It helps a lot but they're not perfect, sometimes I still get blurry vision after a while.

Later on I experimented with lightning condition, and realized that my eyestrain often correlated with bad lightning (cafe, when remote work) and stress/bad sleep. Better lightning also help, but not perfectly. It's also odd because since childhood I've been sensitive to light. Walking outdoors in the summer, I can't keep my eyes fully open.

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About four years ago I went to the Costco optometrist for a contact lens prescription. The O.D. said I was at the age where people start needing reading glasses, but I passed on those. It was the strongest prescription I'd ever had. After the appointment I put the contacts in the case and wore my weak glasses for the rest of the week. The day before the check appointment I put them back on my eyes - everything was crystal clear, but I couldn't read my phone.

The check appointment was with the practice's other O.D. I said the prescription would've been great for sniper shooting, but I just needed something to read the computer monitor. "You want an intermediate-range prescription." It was better, but still too strong. I used the curvature measurement to order my own prescription from one of the online contact stores. Three years later I upped my prescription by a quarter diopter.

Contact pro-tip: I use my contacts for 1.5 to 2x the rated time. Daily contacts can't be used for more than a day. 2 week contacts are good for at least 3 weeks. I've found my monthly contacts are good for at least 6 weeks. I've started using the hydrogen peroxide contact solutions: https://clearcaresolution.myalcon.com/

> even though your prescription is "correct"?

Most people have a range of prescriptions that they find acceptable. Some people's visual mechanism only 'likes' a specific prescription that might not correct them to 20/20. Developmental Optometry is a sub-specialty of optometry that considers more than acuity. This is a overview: https://www.theottoolbox.com/behavioral-optometrist-developm...

My contacts correct to 20/40 or 20/50, which are good enough for most tasks.

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I had what you described. This correlated significantly with reduced sleep / increased stress at work / increased blood pressure. Eye strain and headache would come within a couple of hours.

Some time ago I prioritised sleep, inner calm, strict 9-5 work etc. Both blood pressure got better and eyestrain / headaches went away soon after.

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General question for anyone with this visual discomfort/headache problem: do you ever get dizzy or have feelings of vertigo after prolonged computer usage? I've had the usual eye strain and discomfort problems for years, but have recently started feeling dizzy to the point of nausea after a 6-8 hour shift at my computer. I also get these strange, extremely brief bouts of vertigo when I lean forward in certain directions (e.g. brushing my teeth).

I've seen my doctor about it and given my existing tinnitus/pulsatile tinnitus, she diagnosed me with BPPV which sounded reasonable to me. But the epley maneuvers don't do much of anything to help, and given these bouts of dizziness/vertigo are brought on/made worse by screen usage, I'm wondering if it's related to my eyes instead of my ears.

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I do, but I find something surprisingly simple practically alleviates it for me: Take a break from the monitor every ~30 minutes, get up and go over to a window, and stare at something far away for at least ~30 seconds -- I count in my head because sometimes I get so into things at work I'll get distracted if I don't. I use a pomodoro timer to remind me, and I rarely have issues anymore.

As I get older and nearing 40 now, I'm realizing the wisdom in all these things I've been told throughout the years but never had to heed before: Take _frequent_ breaks from monitors. Strive to take daily brisk walks (keeps my bp in check). Drink enough plain water (keeps some of my frequent headaches at bay). And so forth.

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Thanks for the advice, I'm honestly just relieved to hear that someone else experiences something similar. I'm terrible with taking breaks, I need to get better at it. I've certainly noticed the days when I'm not working at my computer are also days I'm not feeling terrible by 5pm.

> As I get older and nearing 40 now, I'm realizing the wisdom in all these things I've been told throughout the years but never had to heed before: Take _frequent_ breaks from monitors. Strive to take daily brisk walks (keeps my bp in check). Drink enough plain water (keeps some of my frequent headaches at bay). And so forth.

I'm almost 37 myself, and it might be time to accept that I'm not as young as I think I am anymore. I've convinced myself for years that I have plenty of time to worry about sleeping better, eating better, and exercising more when I'm older. But now I am older!

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I have had very high myopia (-9D) for most of my life. Used contacts for nearly a decade starting 30 years ago. Went back to glasses after that. Would have eye strain issues due to 12+ hours on the computer every day.

When I turned 40 and started have issues with presbyopia, I asked my opthalmologist (who also writes my eyeglass prescription) during my biennial checkup why he has been prescribing powers based on how well I can read the tiniest letters on the board when I spend most of my life reading stuff that is two feet away.

He reluctantly suggested that I could use glasses with 1D shaved off the powers in the prescription. I had already done this before I asked him about it. And it has been a big help as the strain disappeared.

Things get blurry at a distance with the new glasses, but it is not as if I am driving at night on the roads or anything.

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yep. 1d is a rule of thumb. My optometrist is cool with me bringing my laptop and measuring at the distance I feel is best for me.

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I have very slight astigmatism. I don't wear glasses when I ride my motorbike because they're a pain with the helmet. I don't have issues, but when I drive a car, I usually wear them. The difference is that I can see traffic signs much further away, especially at night. I do wear them when working at the computer, since I find they help with eye strain, but I do like using high-definition displays and prefer my text an widgets on the smaller side.

I only ever get blurry vision after very long days in front of the computer without doing anything else (think 12-14 hours). I doubt this is glasses related, since I remember having this issue while studying late as a child, and at the time I had perfect vision (which lasted until my late twenties when my ophthalmologist suggested glasses would be a good idea).

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OP here - wow, didn’t expect this to resonate so strongly! Thanks to everyone who’s commented or reached out directly.

I’m currently lining up interviews to learn more about your experiences. If you’ve commented here but haven’t connected yet, feel free to email me at: jbornhorst [at] gmail [dot] com.

I’m especially interested if you’ve experienced persistent discomfort even after updating your prescription professionally (headaches, eye strain, subtle blur, etc.). Pure research, no selling. Your insights will help shape a better solution.

I’ll do my best to reply promptly to everyone. Thanks again, and please keep the stories coming!

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My monitor (a Samsung ultrawide thing) has an option to reduce contrast (I think it’s called ‘eye saver mode’) that makes a massive difference. I don’t use for gaming but for work it’s made a massive difference to my comfort.

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Lassik surgery got rid of all those issues for me. Completely.

20 minutes of (intense) discomfort. 30 minutes later I was seeing the world in high definition (with sand-in-my eyes, yes. But high definition). I took eyedrops 3 times per day for months. Totally worth it. 20 years later I remain glasses-free.

Granted, I was a mild case: Some myopia (3 and 4 if my memory serves) and .5 astigmatism on each eye. And not everyone is eligible; some people's corneas are too thin to be "sculpted".

Only drawback is that when driving at night the lights from incoming cars and traffic lights have "extra halos" around them. Very minor inconvenience for me and definetly worth it.

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The long screen time is the main cause. The perfect glasses, light, or monitors might make you feel better in the short term, but the same environment and low activity might still lead to eye strain. I have been struggling with eye strain for a long time. The best practice I’ve found is to leave the desk and go out for a walk. I have even built an app[1] to help with that.

[1]: https://blog.damnever.com/en/2024/reminding-myself-to-take-a...

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For me absolutely not so maybe try to discuss more with your optometrist .

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Wearing glasses for over 20 years, I am super bugged by chromatic aberrations when looking anywhere except straight ahead. I chose lenses with the highest Abbe number that I could find but there are still chromatic aberrations. I might finally go get surgery just to get rid of this horrible aspect of glasses.

Also most eye correction technology like glasses don't fix the higher order aberrations, that can cause halos and other artifacts. Only wavefront scleral contact lenses do that, but they seem scary so I haven't tried them.

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Yes. For the past few years I've been feeling like something isn't quite right with my glasses. It feels like the focus never quite aligns, there is an oh so subtle yellow tint, and I generally feel somewhat restrained looking through a frame. Recently, assuming that it might just have to do with low quality lenses, I purchased a larger frame and the highest quality lenses my local optician offers. No improvement. I'm wondering if it might just be a mental thing that I get too caught up in.

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Would love to chat to learn more if you’re up for it. Jbornhorst [at] gmail.com

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I'm nearsighted, and I use reading glasses at my age, but when I was younger and used the same glasses everywhere, occasionally my left eye would just give up focusing and I'd have blurry vision for an hour or two. It'd be pretty disruptive to my work and I'd have to take a break. It'd occur a few times a year.

These days I still use screens a lot but I don't recall the last instance of this happening, and I think my reading glasses have largely solved this problem for me.

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I don't have eye strain but have great difficulty getting glasses that work for me. I have a -6 prescription and two out of my last three glasses have had horrible distortion around the edges.

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I used to have that problem too, I was -5.25 or so. The problem was I kept getting upsold on high index lenses. Yes, they are thinner, but the distortion at such a high correction was horrible. Small frames help, but then you have no peripheral vision. I switched to CR-39 and it was so much better. It's also the cheapest possible option which is nice. If you ask for the edges to be polished clear the thickness is less noticeable to others.

I eventually got sick of the coke bottles and got Lasik. I can see better than I ever thought possible, but the recovery was brutal. It was more than two years before I could go a day without Systane Ultra.

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It can be a result of bad fitting, where the optician doesn't measure your pupillary distance correctly, and doesn't line up the focal point properly with your pupil. Similarly, if you wear your glasses in a manner where it doesn't line up correctly (either because you like the way they look at a different spot on your face, incorrect frame adjustments, etc) you can get the same results.

(Not a subject matter expert, but my wife was an optician for 15+ years, so I've picked up a lot via osmosis)

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I have a strange problem with my left eye. I wake up every day with either burning or itching sensation only in left eye. Feels better after washing my face and pain either goes away after couple of hours or resurfaces back at the end of the day. I spend around 10-12 hours either staring at my laptop, phone or monitor on a weekday.

Went to ophthalmologists and doctors and they keep claiming that everything is alright. Still not able to figure out what is wrong.

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Not specific to this, but if you can solve issue with progressive lenses, you have a big market. Progressive lens sucks. They simply do not work and causes too much strain and practically unusable for daily operations. What would be great if there's a digital way where the lens changes depending on your activity. Driving, then go to long vision. In front of laptop - change to reading glass etc. I will be your customer if you solve this

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As someone who's been wearing glasses for all my life:

1. Your eyesight is not exactly "fixed". It can vary during the day depending on stress, tiredness, dryness, etc..

2. A prescription glass can help and does help but it doesn't magically fix your eye sight. If your eyes are strained from lengthy screen usage, the glasses are not going to do anything about that.

3. There is a possibility that your doctor prescribed you un-correct glasses. It took me a while to find my "correct" range.

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I was told I have astigmatism by multiple optometrist, but I'm convinced they aren't right. I have clear double image (not blurring) in one eye shifted by ~1% or so down and to the left, no prescription has ever corrected it in the slightest (some have made it worse). These days I just live with it and don't wear glasses. I've contemplated getting eye surgery if I was confident that the issue would be corrected.

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So I've just got a pretty major astigmatism in one eye, very minor in the other, without any other distortions. I went thirty years without corrective lenses and I think this kind of caused and reinforced my lazy eye.

With simple prescription lenses for the astigmatism my eyes are much better at looking at the same place, but at the end a long day I have a ton of trouble getting them to agree on where to look and often end up just closing my right eye.

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I’ve found the best solution to eye strain is just turning down my screen brightness. It’s solved all my problems, and I can stare at a screen as long as I need to now

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Yes, this is a huge issue. The screen brightness should be close to the ambient brightness.

I test by looking around randomly a bit, keeping my screen in my peripheral vision. If it “pops” brightly in my peripheral vision, I know it’s too bright.

Or I adjust the other way; if I’m planning use a screen for a while in a dark room, I’ll turn on some lights to bring up the ambient level a bit.

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Or using dark mode. There are chrome extensions that force dark mode on every page.

I personally can't last 1 minute on a white screen, and bringing brightness too low isn't without its issues.

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Also look at a doctor specializing in small prisms. Sometimes your eyes don't perfectly align at their resting state so one eye is constantly constantly using muscles to pull it centered. For me, that means when I get tired and those small muscles can't keep up, I get headaches and it gets worse. Neurovisual places can give very tiny prism additions so your eyes don't have to move but the light is "shifted" over.

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Also there are very cheap prescriptions sites online which ship. You can try different prescriptions, with varying power (magnification) and see which works for you for computer, reading. I found that the computer glasses prescribed were way to strong (all they do is subtract .25 from the first number on both eyes, often). But if I only subtract .1 it was perfect, helpful for computer sessions but if I look up everything isn't blurry

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would love to chat to learn more from your experience. i'm at jbornhorst [at] gmail [dot] com if you have 20-30 mins to spare.

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Mine used to and I went back to the optometrist a few times about it last year but… turned out I was getting tension headaches and blurry vision working from home not because of screens or my glasses, but because the radon in my home was regularly about 6x the EPA limit. What’s solved my headaches has been moving away, not changing my prescription. OP, consider if something else in your environment is bugging you.

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I got new prescription glasses recently and they cause some eye strain.

The prescription is about the same as my old glasses, 12 years apart, perhaps they are dialed in just a little bit too much.

The other thing is that these glasses have blueguard filter, which I have been attributing the eye strain to. I've been looking for a way to remove the blue guard, but I can't and I don't want to spend A$400 on a new pair. :(

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When I was young, every time I got a 20-20 prescription, my eyes got worse. When I stopped going to the optometrist, my eyes stopped getting worse. Now I wear glasses that only correct to around 20-40. I take them off for reading, and I have weaker glasses for the computer screen. Supposedly I have astigmatism but I use no astigmatism correction and can see fine.

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I am very nearsighted (-7.5 in both eyes), I've worn daily contact lenses almost exclusively for 20 years. I also have non glaucoma ocular hypertension which puts me at a higher risk for retinal detachment. I have no headaches or eye strain after long screen days, but I do get blurry vision and lots of floaters after long screen days. If you want to know anything else I'd be happy to chat.

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would love to chat - i'm at jbornhorst [at] gmail [dot] com if you have 20-30 mins to spare.

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I got a new pair of glasses last week after seven years with the previous pair. The first thirty minutes felt strange until my brain adjusted and made it “normal.” When I haven’t been wearing them and put them on (including my old prescription), I look out a window at distant objects before looking at the computer screen. This improves my focus close to me.

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This sounds like an interesting area of research! I built LookAway[1], a break reminder app for Mac that helps reduce screen fatigue by nudging users to take short breaks. A lot of users report feeling less eye strain and headaches after using it regularly. Might be useful data for your research!

[1] https://lookaway.app

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I use this app! It’s amazing. Would love to connect. I’m at jbornhorst [at] gmail [dot] com

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I have the oddest type of “poor vision”. Some of it is out of focus, yes, but no matter how precise the prescription, I have a “too many sharp+clear edges” problem.

Look at the number 0, like the zero on a speed sign that says “60 km/h”, what do you see? Likely two sharp ovals, with a pigment between them, making the shape of a zero. If you have trouble seeing it, it’s likely because your eyesight is poor and it’s blurry.

Well, I see sharp ovals. I just don’t see only two sharp ovals. I see dozens of fragments of those two ovals, both on the interior as well as the exterior. Those fragments are razor-clear and razor-sharp with a good prescription, but the smaller the zero is, the closer these fragments intrude on each other, and the harder it is to make out that zero as a zero.

Plus, when something like a speed sign gets small enough (enough distance, in terms of speed signs), I even get a distortion of the overall number - a zero starts looking like an egg balanced on its pointy end. It is fatter at the top than it is at the bottom.

This gets immeasurably worse with more complicated glyphs, like a 6 or an R. All those extra sharp-clear edges make them look like other things, like an 8 or a B.

Now, these “fragments” are kind of like looking through an insect eye at the same time as looking through a human eye. I see a part of the glyph that is clear and sharp, which then fades out around a roughly-circular distance from the place of maximum sharpness like it’s a mirage. And these cluster together such that they overlap, and also hover over the “master image” that my eye sees. So I am seeing the same part of that edge multiple times.

For example, if I look at the letter T, I can see the top corner of the left arm multiple times, both as a part of the full image of the T as well as multiple fragment overlays. If I choose a T that has the right contrast, the right thickness, great clarity and the right sizing, I can easily count how many replications of any one point are visible. Even for a precise point like the top left corner of a sans-serif uppercase T, it can be anywhere from 3-5 replicated corners. Teeny-tiny replicated fragments, and clustered tightly around that area, but multiple copies that can dramatically confuse the image and make the letter look like something else.

And this problem is in both eyes, pretty much equally. I take the glasses off, and so long as the text is close enough (I’m nearsighted), it happens without glasses equally severely.

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Slightly related: does anyone do eye “exercises”? As in, for 5 minutes, move the eyes all around in a 360 degrees fashion, alternating with left to right (and right to left) movements. I use the computer many hours per day and that means my eyes are usually fixed at a 27 inch monitor for hours. I think the exercises are “strengthening” my eyes muscles… not sure if true though.

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This might be vestibular or neurological in nature. I had a vestibular condition that affected my eyesight and did rehab and they gave me eye exercises that helped somewhat. Fast forward a few years of struggling and I found that it was caused by migraines (not the painful kind, just brain disruption). And those migraines are caused by temporal lobe epilepsy. But that part isn’t important, it’s that all sorts of migraines caused by all sorts of issues can disrupt eyesight. And I think it is more common than people realize because there is no pain. It can cause eyesight issues, brain fog, and potentially dizziness. You need that brain to see so if it is disrupted often your sight will be as well. I am surprised people are talking about neurological angles.

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The term to Google for this is "vision therapy": there are several tried and true exercises.

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Yes, they bug me.

I am nearsighted (-7.5 with astigmatism in left, -6.0 in right).

Recently been experiencing slight spasms and fatigue in the left eye. Always been very sensitive to light changes. Dry eye isn't frequent (yet), but I assume will get more so with age.

Night-time driving is awful even with full correction, it seems like I get afterflashes for a fraction of a second after seeing every single oncoming vehicle.

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I would love to speak with you. This is the exact case I'm interested in. I'm at jbornhorst [at] gmail [dot] com if you have 20-30 mins to spare.

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I had a problem with my previous pair of glasses. I think they were defective. I won't say where I got them, but it's a popular chain. My new pair is from a different optometrist. On paper, the exact same prescription, but my vision feels clearer. The new optometrist looked at my old pair and said it looked like the lens were somehow bent. So it can happen.

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My first pair of glasses were glass and even though I suspect the prescription was not correct I never had eye strain and headaches but they shattered in less than a month and then I moved to polycarbonate...it took me a year to find out that the polycarbonate glasses were the ones causing me discomfort and strain. Since then I only get actual glass.

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My elderly father-in-law had this issue even with new glasses until I switched him to my own optometrist who identified some eye muscle issue (need to find out exactly what.) They had him consult with an ophthalmologist which said it was not serious. Then the optometrist made additional correction to his prescription and the new glasses were perfect.

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A blue light filter on my lenses helped reduce eye strain. Certainly worth considering and works better/less noticeably than the screen adjusting it's blue and red balance.

I also have caterscts that have made screen time progressively less fun for long periods of time. It's time that I took care of them.

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Yeah. They bug me. Especially as my prescription got stronger over the years. I have computer glasses and I just got a new prescription. I often find myself taking them off and getting closer to the monitor.

I'm gonna look into the lens material as suggested by some of the comments. That sounds promising.

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I was experiencing discomfort while staring at the computer in my glasses. In the end the solution was quite simple: there was a bend in the frame of my glasses. The second optician straightened the frame manually, so the lenses now line up without much of a curve. After this, my symptoms went away.

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Your prescription might not be correct.

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I just don't wear my glasses when using backlit screens, and use eink whenever possible. It's waaay better than wearing glasses, and doesn't really reduce my ability to read as the screen isn't on the other side of the room, it's right in front of me.

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Turns out I'm extremely sensitive to small changes in astigmatism. I got LASIK done at one of the best places in the country, still have better than 20/20 vision (corrected) but enough of a difference in astigmatism that I still wear glasses.

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https://refraction-explorer.lovable.app/

Take a look at the test @globnomulous I hope that this helps people.

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If the first thing I do in the morning is play on my phone for 20 minutes, my eyes are fucked literally the entire day. First thing I do is look out the window for a while or go outside. Even looking across the room is better.

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I partially solved this problem by getting bigger (4k) monitors and sitting farther from them. My eyes are now over five feet from my screens. I also also try to follow the 20-20-20-20 rule but need a better timer.

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If you want to solve a serious generational problem you should look into dry eye syndrome.

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I used an app iOS “eye movement training” for free post concussion.

The slide rule looking eye training is also kind of rough. A string with two or three beads on it. All fun things that could make me puke from doing too much.

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This is part of what's referred to as "vision therapy". Optometrists would tell you to go to a paid expert---because purportedly some people do it wrong---but IMO you can just YouTube it.

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I don’t think YouTube is the solution. It took me 1 year plus to recover and the iPad part was take home work. Much more intensive in person.

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If your eyes are straining then you may also have posture issues that can contribute to headaches. I asked a colleague to take a few candid pictures of me at my desk as recommended by the physiotherapist.

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I had this issue until I got a 2nd prescription by a different provider and new lenses. Sometimes lense material etc also matters. Bigger PITA than I thought getting glasses was going to be.

Nearsighted, left eye worse.

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Lens material absolutely matters. Glasses suffer from chromatic aberration, and this causes visible rainbows away from the center of the lens. A material with a higher Abbe number will perform better.

For common lens materials, polycarbonate has a low Abbe number, and Trivex is a widely available alternative with a higher Abbe number. You can find tables online for common lens materials.

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Has anyone used the app http://www.glassesoff.com/ ?

I'd be interested and negative and positive experiences!

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Yes if I don't ask them to do these two things I have issues;

- Don't make my stigmatism stronger, keep it the same

- Don't change my eye center/focal point, keep it the center of the lens

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A lot of things can affect your vision. Definitely your sleep patterns, your diet, if you get proper exercise. Your eyes are truly a window into your soul (and your body).

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My ophthalmologist made the point that blurry eyes after lots of computer time is commonly from dry eyes, not blinking enough, and recommended TheraTears.

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I found eye drops using trehalose to be significantly nicer, feel a lot better for my eyes. I know ivizia and thea thealoz use it. TheraTears were decent, but not as nice

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I did…then I went to another eye doctor who found that my prescription was off because they were plastic. She recommended glass. Then it was much better

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Yes, sometimes I get a blurry vision in one eye the day after and hurts, cannot focus and cries a lot

It has always never lasted more than one day but it fucks up my day

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Would love to chat to learn more. I’m at jbornhorst [at] gmail.com

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Add incandescent light to your setup. The lack of near infrared is destroying our health and it's most evident with eyes.

Go outside, have incandescent lights.

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I was thinking about this too - my eyes find the white LED light quite harsh. I've found warm / yellow LED lighting to be more soothing to the eyes.

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Look up esophoria and exophoria and convergence insufficiency. Optician online and review of optometry are credible sources.

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This is me! I got another set of prescription glasses just for screen time (and reading) which helped. strathausen[at] gmail.com

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It happened few days before. I'm wearing specs on my forehead. It's more comforting than wearing for eyes.

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Yeah please hit me up. Available whenever. Been dealing with eye strain and headache issues for absolute ages now.

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Yes. Would love to follow this

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Yes, one London doctor’s unethical self-dealing in ReLEX SMILE left higher order aberrations (HOAs) in my eyes.

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here is what works for me - dedicated non progressive glasses, antiglare coating - no high contrast colors, solarized light, wheat background - avoid dark background - redshift for the late work - constant monitor light, no pwm - flicker free environment (some leds are horrible)

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Yes, two things helped. Less powerful glasses for closer work and high index lenses.

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I've had the bad luck that my first prescription was quite wrong: incorrect axis for astigmatism, and incorrect spherical (I basically have only astigmatism, no spherical). So for years I was suffering through the days. Optometrists flat out refuse to correct such mistakes (I've been to many!), preferring only minor changes. I finally started ordering a bunch of glasses cheaply online, and eventually found a prescription that works for me. Cannot trust optometrists anymore.

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I found an ophthalmologist that gets my prescription right, with optometrists it's a roll of the dice.

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I would love to speak with you. This is the exact case I'm interested in. I'm at jbornhorst [at] gmail [dot] com if you have 20-30 mins to spare.

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Sometimes when I'm wearing glasses, never when I'm wearing contacts.

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would love to chat. Mind dropping me a line at jbornhorst [at] gmail [dot] com and I'll coordinate a time?

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In the hope that someone else has the same issue as I do and knows a solution - for me, my eyes, I have a double image. It moves. I have 12 pairs of glasses I've gotten from 3 "doctors" and several visits to places like Warby Parker, Jins, ZOff.

In all cases, all the doctor did was stick me in the machine, read off the numbers, give me some glasses. They work 10% of the time. I don't mean one in 10 doctors gave me good glasses. I mean on Tuesday pair #3 works. On Wednesday pair #7 worked at 10am but then stopped working pair #11 worked at 5pm. More often than not, no pairs work.

I feel like I need some kind of adjustable lenses (I'm imagining something steampunk with multiple lenses or a dial so I can dial in what works AT THIS MOMENT) but AFAICT no such thing exists

Does any one else have this issue?

Note: I have no pain

Anecdotes

(1) A doctor in SF put me in the machines, measured my eyes, made me some glasses. I come back a week later and using them is worse than not using them. I tell them they don't work. They get upset and reprimand me. Finally they give in. Make a new appointment. A week later doctor sees me, makes a new prescription, orders glasses, a week later the same, using them is worse then not.

Again they get angry an berate me. They give my some BS about I should take them home and let your eyes get used to them. I respond, if that's the case then the doctor could not make a prescription with his machine because I'd need to take the machine home to "let my eyes get used them" before he'd know if it was working.

Anyway, they finally let me make another appointment. the doctor measures and claims he knows what must have happened (didn't tell me) and orders another pair. A week later I check. These ones are marginally better than than not wearing anything AT THAT MOMENT. It take them home, every time I try to use them they're worse than not using them. (oh, and they apparently charged the eye insurance $999)

(2) My previous SF doctor I had a similar experience in that their glasses didn't work. They didn't berate me. They re-ordered once. I was shy and didn't complain the second time even though they were no good and I never used them.

(3) I've bought lots of glasses at Jins (Japan) - They have fully automated machines for measurement. I've got 2 pairs from them that help the most often, though not always.

(4) Last time I bought glasses I was at ZOff in Japan (because the wait for Jins was too long). The "doctor" their claimed my eyes were fairly good - meaning the images are clear, it's only the double vision that's the issue (letters look like there's a ghost 15% as bright/dark) about 4cm down from the actual letters)

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Would love to chat. I’m at jbornhorst [at] gmail.com

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I've coloured lenses that sort this out, I have meares irken syndrome.

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Are VR headsets better for the eyes than a screen?

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look up convergence insufficiency, esp phoria and exophoria. Opticianonline and review of optometry are credible sources

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Castor oil drops on the eyes, and beard packs.. I guess they call them neck wraps for everyone else.

Also xylitol and salt sinus flushes help, even with those floaters.

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I (nearsighted) wear glasses that are quite old at this point, I think ~7 years? My prescription has certainly changed since then, and I have had new glasses made a couple times, but the new glasses always make my eyes feel uncomfortable, despite improving my vision. I try them for a couple days and then give up and return to my 7-year-old glasses. It's been a while, so I don't remember my true prescription, nor the prescription associated with my 7-year-old glasses.

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I think you'd be a great candidate for a 20 min interview. Ping me at jbornhorst [AT] gmail [DOT] com if you'd like to chat.

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Could also be something as simple as lacking proper hydration.

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Yes. I think I need to get checked for BVD

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I had headaches for 6 months before I heard about BVD. I got checked, and ended up getting glasses with +-0.25 diopter vertical prisms in them. A very small correction, but life changing. I felt like I was walking on solid ground immediately after putting them on. Definitely recommend getting checked for BVD because the fix is so easy, and the impact is huge.

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have you talked with an opthalmologist?

what's your eye pressure?

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It’s called “getting old”. Seriously: your eye lenses lose the ability to adjust so there is no longer a “correct prescription” just frustration. I’m in my late 50s and it started almost exactly at 50.

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