Asthenopia is a visual discomfort, which is caused by overexertion of the eyes due to internal and external influences. This so-called eye fatigue is not yet a disease, but if it persists, it can lead to eye disease in the long term. Preventive measures are important to prevent asthenopia.
What is asthenopia?
Asthenopia often occurs in younger individuals and is characterized by an entire symptom complex of discomfort around the eye during stressful visual situations. The term “asthenopia” comes from the Greek and means eye fatigue. Especially in today’s age of computers, asthenopia plays an increasingly important role. It can be assumed that almost everyone suffers from eye fatigue at least from time to time. Already with a longer concentration on a certain fixed point it comes to an overstrain of the eyes. In addition to slight visual disturbances, eye pain or even headaches can then occur. The causes are manifold. They can be both organic and functional in nature. Often it is an overuse of eye muscles. For example, six small eye muscles are responsible for the activity of the eye lens. When one of these muscles is overworked, the coordination of the entire eye muscles is no longer guaranteed. The images produced by the lenses can no longer be perceived as a whole image. Thus, blurring of the images or the occurrence of double vision occurs.
Causes
Causes of asthenopia include inadequately corrected or uncorrected refractive errors, preexisting eye muscle coordination disorders, accommodative disorders, general fatigue or overtiredness, psychological stress, neuralgia, or conjunctivitis. Inadequately corrected defective vision (farsightedness or nearsightedness) due to an incorrect choice of glasses or contact lenses puts a lot of strain on the eye muscles, so that they quickly become overloaded. Coordination disorders of the eye muscles are expressed by uncoordinated movements of certain muscle groups of both eyes. Thus, both eyes should move together in the same direction. However, there are coordination disorders in which there is a convergence movement of the eyes. Latent strabismus or motor dysfunction of both eyes seeing together also belong to coordination disorders. Accommodative disorders are characterized by the insufficient ability to combine the individually produced images of each eye into a whole image. Overexertion of the eye muscles is also caused by long fixation on a specific point during concentrated activities. Especially concentrated work on the computer can quickly tire the eyes. The same applies to reading under poor lighting conditions. The eyes need a certain brightness for this, because otherwise the incidence of light would have to be regulated by changing the pupil size. This results in rapid muscle fatigue. Finally, psychological influences also have an effect on the eye muscles. Of course, inflammatory processes in the eye, conjunctiva, or ocular nerves also affect ocular resilience.
Symptoms, complaints and signs
Asthenopia is characterized by rapid fatigability, heavy eyelids, fatigue, and headaches, among other symptoms. In many cases, double vision or blurred vision occurs. The eyes are red and often watery. Eye pain is very common. Dizziness is also observed. This is only a reaction to overuse of the eyes and not already a disease. However, chronic eye strain can damage the eyes in the long term.
Diagnosis and course
When symptoms of eye fatigue occur, overuse is initially assumed. However, differential diagnosis should exclude true ocular diseases. It is important for therapeutic measures to determine any refractive errors, coordination disorders, or accommodative disorders of the eyes. In the context of an anamnesis, it can also be determined whether strenuous computer activities, reading in unfavorable light conditions or other activities that strain the eyes lead to eye fatigue.
Complications
Asthenopia manifests itself through a number of symptoms, which can lead directly and indirectly to further complications. First, the visual disturbance causes a feeling of heaviness in the eyelids, accompanied by rapid fatigability and a general feeling of malaise. This is followed by headaches, dizziness and blurred vision, and rarely double vision and severe eye pain. If these symptoms persist, eye redness and eye rims develop, and sometimes vision decreases. The severe fatigue quickly develops into full-blown lassitude and may contribute to the development of burn-out syndrome or depression later in life. The general malaise contributes to this negative spiral and severely limits the possibilities of those affected. The asthenopic symptoms usually significantly impair the quality of life of those affected. If the symptoms are not treated, the discomfort increases rapidly and makes everyday and professional tasks considerably more difficult. The chronic symptoms may subsequently develop into psychological disorders associated with further complications, while the physical stress can lead to a variety of secondary diseases and exacerbate existing conditions. However, with early treatment of asthenopic symptoms, long-term sequelae are unlikely.
When should you see a doctor?
With asthenopic symptoms, it is essential to see an ophthalmologist. For example, if there is dizziness, blurred vision and a feeling of heaviness in the eyelids, there is most likely an eye disease. Medical diagnosis and treatment is necessary to prevent further deterioration of vision. A visit to the doctor is particularly urgent if the symptoms are associated with rapid fatigability and general malaise. Accompanying headaches, eye redness and double vision are also clear warning signs that should be clarified at the earliest opportunity. Typically, symptoms occur during the day or with increasing visual stress. Asthenopia manifests itself, for example, after intensive computer work or after reading long texts. If the above-mentioned complaints occur in conjunction with exhaustion, severe overtiredness or psychological complaints, it is advisable to talk to your family doctor. Depending on the type and severity of the asthenopia, further contacts are the ophthalmologist or optician. Under medical supervision, the usually causative ametropia of the eye can be reliably diagnosed and treated.
Treatment and therapy
The treatment of asthenopia also depends largely on the willingness of the affected person. If defective vision is detected, the correct glasses or contact lenses should be determined with the help of an optometrist or ophthalmologist. Eye drops can be given for a certain period of time to relax the eye muscles. It is also important to treat inflammatory processes in the conjunctiva and ocular nerves. Of course, sleep and relaxation exercises also help. This is especially true in the case of functional disorders caused by psychological influences. Convergence disorders are often corrected by prism glasses or eye exercises. Correction by prismatic glasses is an intervention in the eye muscle balance. Since improper use here can cause serious side effects, this procedure should only be performed by an ophthalmologist. In certain cases, strabismus surgery may be necessary. For some anomalies, such as fixation disparity, appropriate approaches to therapy are still being sought.
Outlook and prognosis
The prognosis of asthenopia is good if the patient cooperates and is willing to improve. Without medical assistance, various self-help measures can be undertaken that can also provide relief from the symptoms. For some patients, these methods are already sufficient to achieve a cure. The severity of the asthenopia is decisive for this. If the asthenopia is mild, stress reduction, relaxation techniques, and adequate sleep can already provide significant relief or cure. With medical care, the possibilities are altogether more varied and comprehensive. However, the best prognosis is found in the combination of medical treatment and independent options.With visual aids, targeted training of the eye, and self-directed exercises to relieve eye strain, the patient can achieve freedom from symptoms that is permanent. The wearing of visual aids should be done according to the optician’s or ophthalmologist’s instructions for an optimal result. Once these are no longer used, there is a risk of asthenopia relapse and worsening of vision. In some cases, surgery is performed to correct the condition. This is done routinely and is associated with a rapid prospect of improvement. Following this, however, self-care support to maintain health should still take place.
Prevention
Preventive measures to prevent asthenopia are particularly important. Anyone who has to work a lot with a monitor should take regular screen breaks. A few minutes per hour during which the eyes are not focused on the computer is recommended. The best way to do this would be to look out the window without fixating on a particular spot. Eye exercises between strenuous work on the computer can also relax the eye muscles. Adequate lighting of the computer workstation is also important. Information should be absorbed not only via the computer or television, but also by reading newspapers, magazines or books. To ensure good blood circulation to the head and eyes, it is recommended to keep the head and neck upright. This can be aided by regular massage in the collar area.
Aftercare
With asthenopia, there are few aftercare options available to the sufferer. The condition also usually does not need to be treated until the becomes permanent and if the symptoms do not go away on their own. However, the patient’s life expectancy is not negatively affected by asthenopia. In most cases, the symptoms can be alleviated with the help of glasses or contact lenses. However, the patient should always wear the visual aid in order not to strain the eyes unnecessarily. If asthenopia is not treated, in the worst case it can also lead to complete blindness of the affected person. In some cases, eye drops can also be used to alleviate the symptoms. These should also be taken regularly. Furthermore, relaxation exercises are possible to alleviate the discomfort. These can also be done at any time when the symptoms of asthenopia occur or make life difficult. In severe cases, however, the patient is dependent on surgical intervention. After such an operation, the body must be rested and the affected person should rest. Therefore, strenuous activities should be refrained from.
What you can do yourself
What those affected can do themselves about asthenopia depends primarily on the specific trigger of the disorder. If asthenopia is triggered by eyestrain caused by excessive computer screen work, preventive measures are of particular importance. Anyone who works a lot with a computer or sits in front of other monitors should regularly take a break from using the screen. This should be at least four to five minutes per working hour. During this time, the eyes should not be directed at the computer or another monitor. The most effective way is to stand at the window and let your eyes wander over the landscape. Alternatively, targeted eye exercises can be performed. To do this, the eyes should be rolled clockwise for about half a minute and then in the opposite direction. Repeated vigorous blinking for about ten seconds at a time protects the eyes from drying out. A short telephone conversation can also relax the eyes. Texting, on the other hand, is counterproductive. The workplace should be ergonomically designed and allow for upright sitting to prevent tension in the neck and ensure good blood circulation to the eyes. If asthenopia is due to defective vision, the ophthalmologically prescribed visual aid should be used all the time. Those who find glasses annoying can switch to contact lenses.