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Eye Strain
[Health Matters Column]


January 10, 2001
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Eye Strain
[Health Matters Column]

Many law enforcement agencies have strict physical requirements that candidates must meet in order to be eligible for hire, including visual stipulations. However, like weight and body shape, vision tends to change over time.

Some of the changes are inevitable, but others, such as eye strain, are preventable and treatable. Eye strain and headaches that are caused by certain visual conditions can be prevented. All adults should schedule a visit to the eye doctor at least every two years, whether or not there is an existing need for visual correction. Of course, if eye strain, pain or blurry vision occurs, an eyecare professional should be consulted immediately.

Certain visual conditions known as "refractive errors" and which include myopia (nearsightedness), hyperopia (farsightedness) and astigmatism (an irregularly shaped cornea) are correctable with prescription eyeglasses, contact lenses or surgery. Not everyone experiences these refractive errors; but "presbyopia" is one that almost no one escapes.

Presbyopia is sometimes wryly referred to as a condition in which one's arms become too short for reading. What actually occurs is that at approximately age 40, the crystalline lens inside the eye gradually begins to lose some of its flexibility, making it difficult to focus on fine print or other tiny objects. The presbyope, or person suffering from this condition, then needs to hold smaller items farther away in order to see them clearly. The individual can no longer focus on things they would like to see close up. Headaches and eye strain can result from the effort of trying to get the eye do what it can no longer comfortably accomplish on its own.

The solution for presbyopia is corrective lenses: either eyeglasses or contact lenses. Presbyopia is often confused with farsightedness, or hyperopia, because the same types of lenses are prescribed for both conditions. But the two conditions have different causes. Not everyone will be affected by hyperopia, while almost no one who enters their forties escapes presbyopia.

Just as presbyopia eludes almost no one, few LEOs are exempt from filling out forms. Many law enforcement officers need reading glasses in order to complete paperwork. But to many cops, wearing glasses is a sign of weakness to be avoided at all costs. They dread the thought of pulling out half glasses in order to write a ticket or examine documents in front of others. It galls them to think that their colleagues will see them in glasses that look like the specs their grandparents wear. For these officers the price for clear close-up vision and relief from eyestrain simply seems too high.

Yet there are few alternatives. Eyeglasses or contact lenses are the solution to eye strain caused by presbyopia. Fortunately, there are choices available to today's modern presbyope. Half-eyes, or the half glasses that are worn lower down on the nose are just one option.

Bifocals with or without a visible line in a full-size eyeglass frame are another. These glasses can be worn all the time, and the lenses can be made to disguise the presbyopia factor. If a no-line bifocal, or progressive lens, is used, the glasses can be worn all day so that no one suspects the user's true reason for wearing them.

The lenses can be darkened so that officers who work the day shift have near-vision capability built into their sunglasses. Photochromic lenses, which darken in sunlight and become almost clear indoors, are another option that allow for all-the-time progressive lens wear and provide visual comfort at the same time.

Contact lenses also can be worn for presbyopia. As with eyeglass lenses, there are choices. Contacts with a bifocal, or near-vision, segment built in are available, and so are progressive-style, or no-line, bifocal contact lenses. Another contact lens option frequently used to correct presbyopia is called "mono-vision." This technique involves using the dominant eye for distance vision tasks such as driving, while the non-dominant eye is fitted with a contact lens and used for close work. Similar to "handedness," eye dominance often, but not always, involves the right eye for right-handers and the left orb for lefties.

Someone who normally doesn't require any visual correction for distance -- in other words, someone who isn't nearsighted, farsighted or astigmatic -- may wear only one contact lens with a near correction on the non-dominant eye. Although this technique sounds strange, it is quite successful.

The important thing to remember with contact lenses is that they are medical devices. That means regular check-ups with the eye doctor are needed to make sure that the contacts are and not beginning to create difficulties that the wearer might not yet be aware of. Contact lenses need to be cleaned and disinfected properly in accordance with the eye doctor's instructions. Because they are placed on the surface of the eye they must be cared for to ensure that no bacteria or other potentially harmful organisms have a chance to irritate or infect the eye.

The other tricky thing to keep in mind about contact lens wear is that not all persons will be able to use them. Not everyone is enchanted with the thought of sticking a finger in one's eye in order to insert the contact lens. Before a user can find a type of bifocal contact lens that will work, some trial and error may be needed.

The fitting eye doctor may have to experiment with different kinds of lenses in order to find the right one. The patient will generally have the opportunity to wear the contacts for a week or so to determine whether they fulfill his or her visual needs comfortably. If not, it's back to the drawing board. After several attempts, it is possible that no contact lens will be found to meet the presbyope's needs.

In this case, the eyecare practitioner may keep any professional fees and apply what has been paid for the contact lenses toward a pair of eyeglasses. For this reason, it is always wise to discuss the doctor's non-adapt fee policy at the outset so there are no nasty surprises if contact lenses are not the solution.

If presbyopia is not causing eye strain another condition may be. Commonly, LEOs who do a lot of driving find that their vision is compromised and perceive some strain when confronted with glare, either from sunlight or from headlights and street lights. The perception of scattered light or halos around lights can indicate serious eye conditions such as the onset of glaucoma or cataracts — which are easily diagnosed. But oftentimes, combating the strain from this type of glare involves a simple solution.

A clear anti-reflective coating (a/k/a "anti-glare" or "reflection-free") can be applied to eyeglass lenses. These coatings have the additional advantage of making prescription spectacle lenses appear thinner because they remove internal reflections.

For officers whose eye strain occurs while driving in sunlight, polarized (also called "polaroid") lenses filter out the reflected light, or "bounce-back" from chrome bumpers, water, ice and so forth.

Regardless the effective treatment for eye strain, it's important to allow a qualified eyecare professional to diagnose and treat the underlying condition. Healthy vision is too precious for self-diagnosis.

— Liz Martinez DeFranco

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