Eye Strain (Asthenopia): What It Feels Like and 6 best Treatment ways

Asthenopia is a functional visual disorder that is accompanied by increased fatigue when performing visual work. Clinically, this one remains demonstrated via a sensation of scorching, hurtful, aching, hyperemia, the attendance of fog before the eyes, a feeling of sand. As well as a decrease in visual acuity that develops after intense & prolonged visual work. Diagnostics is based on determining visual acuity, conducting refractometry, biomicroscopy, and studying accommodation. Treatment measures include correction of ametropia, conservative therapy, as well as hardware treatment methods.

General information

Asthenopia is a pathological condition manifested by a complex of subjective symptoms of visual fatigue. In practical ophthalmology, this pathology is considered as a borderline condition between functional visual impairment and the initial stage of the formation of an organic eye disease. Visual fatigue is equally common among males and females. There are no racial or age differences. More than 75% of the world’s population report asthenopic complaints during or after working with electronic devices. The risk group for developing asthenopia includes people whose professional activities involve prolonged fixation of vision at a short distance.

Causes of asthenopia

Asthenopia is a multifactorial pathology, in which certain etiological factors are triggers in the development of individual pathogenesis mechanisms. Long-term work with electronic devices, reading in low light, working with small objects, driving in bad weather conditions and failure to observe the rules of visual hygiene are predisposing factors to the development of accommodation spasm .

Asthenopic complaints also develop with a decrease in accommodative ability caused by hyperopia, cataracls , astigmatism , hypotrophy,Anophthalmos or disruption of the innervation of the ciliary muscle. A spastic state of the muscular apparatus of the eyeball over a long period of time is clinically manifested by rapid visual fatigue.

Pathogenesis The provoking factor of asthenopia development is the violation of coordination between accommodation and convergence, as well as the increase of load on the internal rectus muscles of the eye, which in turn acts as a predictor of myopia . The appearance of a number of asthenopic complaints is associated with the development of dry eye syndrome, since with prolonged concentration of attention the number of blinks per unit of time decreases. This indications to a decrease in the emission of the meibomian glands.

The disruption of the processing of visual signals into nerve impulses occurs with neuroreceptor exhaustion of the visual analyzer, which is manifested by the symptoms of asthenopia. A certain role in the development of visual fatigue is played by a low level of psychological adaptation to visual work. Thus, based on the etiology and pathogenesis, such forms of asthenopia as accommodative, muscular, neuroreceptive and psychoemotional are distinguished.

Symptoms of asthenopia

The clinical course is characterized by the stage-by-stage nature of the process. The stages of compensation, subcompensation and decompensation are distinguished. With asthenopia, at each stage, the development of such non-specific symptoms as headache, irritability, general weakness is possible.

At the compensation stage, short-term visual impairments are possible, not exceeding physiological limits. Therefore, compensated asthenopia is considered to be visual discomfort that develops after visual stress and is leveled after a planned rest, without reducing working capacity. Clinically, this one is revealed by a burning sensation, increased lacrimation,glaucoma, hyperemia and the appearance of fog before the eyes.

At the subcompensation stage, a long-term visual impairment develops, which is potentially leads to color blindness. The symptoms of this stage are characterized by the addition of a feeling of burning, sand in the eyes, distortion or double vision. Functional visual impairments can be observed 1-2 days after rest or occur after minor exertion with short periods of remission.

The decompensation stage is manifested by classic symptoms of visual fatigue. Patients have a history of frequent development of blepharitis and conjunctivitis . The key modification stays the irreversibility of changes in diversion and housing. Therefore, at this stage, the appearance of early clinical signs of presbyopia , the development and progression of myopia are possible .

Diagnostics

Patients with asthenopia are recommended to undergo an annual examination by an ophthalmologist with an additional examination of the fundus and measurement of intraocular pressure . The complex of diagnostic measures includes:

Visometry . The visometry method allows determining the degree of change in visual acuity. Patients with asthenopia are prone to myopia. It is very important to conduct the study dynamically. Before choosing a treatment tactic, visual acuity should be measured after a long rest from visual loads, which will make it possible to obtain true values, and not those caused by accommodation spasm.

Accommodation study . It is one of the key methods of asthenopia diagnostics and includes proximetry, width measurement, volume and tension of accommodation ability. In patients with increased visual fatigue, a shift in the point of clear vision towards myopia is observed. During proximetry, patients note the early appearance of symptoms such as double vision, blurry text, low ability to fix the gaze, development of burning and pain. The desired width, volume and tension of accommodation often allow us to establish the progression of myopia.

Refractometry . The purpose of refractometry in patients with asthenopia is to detect myopia or astigmatism, as well as early changes in refraction. The advantage of using this method in people with increased visual fatigue is that the device produces the result of average values ​​after several measurements in a row.

Biomicroscopy . The method allows for a detailed examination of the anterior parts of the eyeball. It is important in patients with decompensated asthenopia.  As it allows for the diagnosis of conjunctivitis the assessment of the nature of changes and the effectiveness of the treatment.

Treatment of asthenopia

Management of asthenopia is created on a wide-ranging approach. Patients at the stage of compensated visual fatigue in the absence of organic changes are recommended to alternate between rest and visual loads. At the stage of compensation and subcompensation, it is advisable to prescribe hardware vision treatment methods . These contain:

• Accomodation trainer. The range of application of the accommodation trainer is quite wide. With the help of this device it is possible to eliminate residual effects of accommodation spasm in patients with compensated asthenopia, as well as to carry out optical correction of myopia and the initial stages of hyperopia development.
• Laser stimulation . Stabilizes the retina receptor gear and reduces the manner of the ciliary power. Indications for this type of hardware treatment are neuroreceptive asthenopia, as well as astigmatism, myopia, hypermetropia, computer vision syndrome , accompanied by asthenopic complaints.
• Sidorenko glasses. The effectiveness of asthenopia treatment with Sidorenko glasses is achieved through vacuum massage of the eyes and surrounding structures. Massaging schedules inspire regional microcirculation and advance trophism.

In patients with visual fatigue at the stage of decompensation or ametropia in the anamnesis, it is necessary to correct it with glasses or contact lenses . Conservative therapy consists of prescribing a course of short-acting mydriatics. The length of the development of drops rest on on the period and sternness of asthenopia.

Prognosis and prevention

The prediction for asthenopia hinge on the period of the disease. With the normalization of the visual load at the compensation stage, full restoration of vision function is possible. Adequate treatment at the subcompensation stage can ensure the reverse development of the process, so the prognosis is favorable. With decompensation, as a rule, full recovery cannot be achieved.

Prevention of asthenopia consists of alternating visual loads with periods of rest, as well as proper organization of the workplace. Patients with asthenopia are recommended to take vitamins for the eyes. Before the expected visual work, it is recommended to instill moisturizing drops into the eyes. At home, to reduce accommodation spasm, you should use special glasses with small perforations and do eye exercises.