Eyes Driving You Crazy?

"Doctor Reed, my eyes are driving me crazy! It’s even worse now that I’m working from home in a COVID world. What can you do to help?"

We've had a significant increase of eye and visual comfort complaints lately and are chalking it up to poor computer ergonomics and trigeminal nerve over-stimulation, also called trigeminal dysphoria. The good news is that we can help with new lens technology called Neurolens. First, let’s start with symptoms of trigeminal nerve over-stimulation and computer vision syndrome:

• Headaches (including a consistent dull ache, or those that are worse at work than on the weekends)
• Discomfort with computer use (including burning or redness)
• Tired eyes
• Light sensitivity (especially sensitivity to fluorescent lights)
• Neck/Shoulder tension
• Dry eye sensation
• Dizziness

Where do these symptoms come from? Well, the trigeminal nerve is a relatively large nerve with three branches. The superior ophthalmic branch provides innervation to the area around the upper eyelid and forehead. This branch is implicated in controlling the muscles that move the eye, as well as those that provide stimulation to the lacrimal gland, one of the glands responsible for tear film development. The middle maxillary branch provides innervation to the area around the lower lid and cheeks, and the lower mandibular branch provides innervation to the jaw area. Those branches all meet together right in front of the ear and then connect to the spinal cord. When we move our eyes, the trigeminal nerve is stimulated, and if we have a slight mis-match between the focusing accuracy of the right and left eye (don’t worry, most of us do!), our neck muscles engage to help realign our vision in order to prevent double vision. The trigeminal nerve is large and involved in so many of our facial functions and sensations, so when it is unhappy, it tends to produce a wide array of symptoms.

Test Yourself

Try it: take your hands and place the pads of your fingers right at the base of your skull going down the neck. Line your head to be straight ahead and move your eyes side to side. If you can feel movement, your body is using more muscles to line up the eyes than we’d like it to, resulting in a stiff neck and shoulders, along with many of the above symptoms.

Neurolenses to the Rescue!

What makes these lenses so special? These lenses offer what is called contoured prism to bring the eyes back into alignment. Prism bends light (yes, prism is also what splits white light into a rainbow), and we sometimes use that in optometry to help align the light that enters our eyes. However, most people need a different amount of prism to align their eyes when looking farther away compared to up close. Traditional glasses lenses can only have one amount of prism, so the majority of people would require two separate pairs of glasses with a potentially different prescription and likely different prism amounts depending on if they are looking far away or up close. Talk about annoying. Neurolenses provide different amounts of prism in the lens when looking far away versus up close. When prescribing Neurolenses, we will use their device that takes a series of measurements to determine the amount of misalignment a person has between their two eyes, both at distance and up close. It takes about 2-3 minutes to complete. Then, we will sometimes use trial lenses to ensure the person will tolerate the recommended amount of prism.

What’s the risk? Neurolens and ModernEyes have partnered together to ensure that when we recommend Neurolenses to our patients they will love their lenses. If you decide to purchase Neurolenses and do not like them, we will restyle you into lenses without the contoured prism technology Neurolens provides. The other thing to be aware of is that because Neurolenses are proprietary technology, we are unable to bill these to your vision plan. However, we will happily try to help you submit for out of network reimbursement on them. We cannot guarantee those results, but we will do our best to help on that front. Neurolens uses MSRPs for their lenses, so our team will have them priced at those MSRPs without additional markup. These lenses have all of the latest coatings and technology in them. The only real decision you’d need to make is if you want them to get dark when you go outside (Transitions) and what material they’re made from. Our staff will help you make the best decision on which material is best for your prescription.

I think I have some of these problems. Am I a good candidate?

Check out their LifeStyle Index below. If you score a 4 or 5 in the first three categories, or if you have 3 or more 3’s, 4’s, or 5’s on the entire sheet, you would likely benefit from Neurolens technology. If you want to discuss your options with our team, please contact our office for an appointment, whether is it is for an updated comprehensive exam or just the Neurolens consultation, depending on the date of your last exam.

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Lifestyle Index

This questionnaire is meant to help your doctor understand what you’re experiencing on a regular basis—whether it’s caused by your eyes, posture, stress, etc. Your responses will help make sure you receive the best care possible.

How often do you experience any of these symptoms?

Headaches	You get headaches of any severity each week (even just a dull headache counts). Your headaches tend to get worse later in the day.
	1 Never	2 Rarely	3 Sometimes	4 Very Often	5 Always
Stiffness/Pain in Neck or Shoulders	You experience stiffness/tension in your neck/shoulders when you work at a computer or read (this might even be from your posture).
	1 Never	2 Rarely	3 Sometimes	4 Very Often	5 Always
Discomfort with Computer Use	Your eyes get tired, burn, or get red easily when you work at a computer for long hours.
	1 Never	2 Rarely	3 Sometimes	4 Very Often	5 Always
Tired Eyes	Your eyes feel increasingly fatigued/tired as the day goes on.
	1 Never	2 Rarely	3 Sometimes	4 Very Often	5 Always
Dry Eye Sensation	Your eyes progressively feel more dry/sandy/gritty while working at the computer or reading.
	1 Never	2 Rarely	3 Sometimes	4 Very Often	5 Always
Light Sensitivity	Bright/Strong lights (vehicle headlights, florescent lights, etc.) bother you.
	1 Never	2 Rarely	3 Sometimes	4 Very Often	5 Always
Dizziness	You experience dizziness, motion sickness, or vertigo.
	1 Never	2 Rarely	3 Sometimes	4 Very Often	5 Always