21st Century Lifestyle Demands


Our visual system was not made for prolonged
periods of near point work like working on a computer.

  Our visual system was designed for distance work

It was made to hunt, fish, farm and locate danger.

 Many of us experience:

  • eyestrain
  • eye fatigue
  • headaches
  • blurred vision after using a computer for a short period of time




  Computers                                               and                                          hand held devices 

   have made their way

 into our everyday  lives.

Be it at work and/or at home, adults as well as children inadvisably push their eyes past the point of eyestrain. Excessive computer use and/or uninterrupted close work can induce eyestrain, headaches, and/or other visual difficulties, which can be effectively treated with Vision Therapy.

 Do you experience eyestrain, headaches or blurred vision after working at your computer?  You may have Computer Vision Syndrome (CVS).


The National Institute for Occupational Safety and Health (NIOSH)  defines computer vision syndrome (CVS) as “eyestrain associated with prolonged computer use.”

 The American Optometric Association (AOA)  expands on this definition, calling CVS “eye and vision-related problems related to near work which are experienced during or related to computer use.”

 Symptoms of CVS fall into three categories:

  1. vision problems
  2. eye problems,
  3. general discomfort

Vision problems can include:

  • blurred vision (both near and far)
  • difficulty changing focus
  • double vision
  • glare
  •  flickering sensations
  • temporary changes in color perception.

Eye problems can include:

  • redness
  •  burning sensation
  • soreness
  •  stinging
  •  itchiness
  • dryness
  • excessive tearing
  • eye fatigue
  •  eyestrain
  • light sensitivity
  •  contact lens discomfort

General discomfort symptoms can include:

  • headaches
  • neck tension or pain
  • shoulder tension or pain
  •  back pain
  • pain in arms or wrists
  •  excessive fatigue
  • irritability
  • drowsiness 


The American Optometric Association estimates that 70% to 75% of all computer users experience CVS symptoms.

 Approximately 95 percent of the population keeps both eyes aligned on the object of regard, as shown in the Figure below.

Even though most people work hard at keeping their eyes aligned when viewing an object, many individuals have difficulty maintaining this ocular alignment. The symptoms associated with phorias can be:

  • eyestrain,
  • double vision,
  • headaches,
  • eye irritation, and
  • general fatigue.

If the eyes do not naturally line up, as is the case for most people, then a constant neuromuscular effort is required to avoid the above mentioned symptoms.

Vision is our most precious sense. Our    are in constant use every waking minute of every day.

The way we use our    can determine how well we work throughout our lifetime.

Over 80% of our learning is mediated through our 

indicating the important role our vision plays in our daily activities. Vision disturbance is a silent enemy that only appears after a long period of continued stress.

Today, millions of children are using computers every day, at school and at home, for education and recreation. Visual demands in school require the integration of a number of different vision skills:

  • visual acuity (sharpness of vision);
  •  visual fixation (eye aiming);
  • accommodation (focusing);
  •  binocular fusion (forming a single image);
  • convergence (turning of the eyes);
  • field of vision (side vision); and
  • form perception (recognizing shapes).

These systems can be stressed and overworked if not used efficiently. Computer viewing is complicating how children use their 

in school because these visual skills are not yet fully developed in children—making any near-point activities that much more difficult.


Many adults have vision problems, eye problems, headaches, visual difficulty using computers or doing close work, both on the job and on their own time.  The cause may also be a vision problem that can be addressed by vision therapy why put up with computer eyestrain when you don’t have to?


Vision is not static



Of all our senses-Smell, Hearing, Sight, Taste and Touch,

sight-vision  is our most developed.  It is our dominant sense and the means by which the average person receives the vast majority of their information and education. 

It has been shown that nearly 85% of all of the information that we gather in a lifetime is taken into our minds through our eyes.

The quality of our vision, how well and truly we are seeing, to a great extent determines the quality of our personal reality which shapes how we live our lives.


The information that we take in our eyes is the raw material from which we create our own sense of reality.  The context that is based upon past experiences determines our behavior in present circumstances.  Perhaps even more importantly, our eyes are the only organs of our bodies that are actually outgrowths of our brain.

 The eye’s retina is in reality, a specialized form of brain tissue.  This makes the interconnection and interrelationship between our eyes and our brain the most profound organic relationship on our body in our being. 

 The information taken in by the eyes is processed by the brain more deeply and completely, than the information that we receive through all our other senses.

 Eyes & Brain are a team

As we exchange our perceptions of what we can and cannot see, we can become more open to viewing the world as a whole new adventure.

We ride our bike down a country road watching for pot holes, frogs or sticks.  We end up maneuvering around these objects and adjust our speed, while visually monitoring our position.


Moments later we might get into our car, drive to the grocery store past fields with turkeys, ducks and geese always judging where we are relative to other vehicles and the flow of traffic. We arrive at our destination having made numerous conscious and subconscious judgments with varying degrees.  Whether it is shopping for groceries, watching a ball game or reading the news paper our vision plays an essential role in each of these activities through the collaboration of eyes and brain.

Vision occurs neither in the eyes nor in the brain, but emerges from the collaboration of the eyes, the visual pathway and the brain. Vision is a pervasive aspect of our existence which permeates all of our activities. Vision develops and, due to neural plasticity, can be enhanced. Optometry is the discipline dedicated to the care of all aspects of the visual process.

                                         Eyes are ruled by the brain

Seeing takes place in the our brain, not in our eyes.

Being able to understand esophoric and exophoric behavior opens up a window into how we experience our world. What one sees, how we perceive, interpret and react is all a result of our individual inner world.

Esophoria (Eso) (clinical condition) a tendency of the eyes to want to turn more inward than necessary when an individual is viewing an object at near or at distance, which may cause the individual to experience eyestrain and other symptoms.

The esophoric child uses many references to him/herself with I’s and me’s.  He/she asks of every test, “How did I do? Did I do it well?  Did I do it right?”

Esophores tend to:

  • Be introverted.
  • Look closer and judge space incorrectly.
  • Receives information better from the printed (seeing) word than from the spoken (auditory) word.



  •  Dislike being corrected.
  • Make careless mistakes.
  • Read word for word.


  • Headaches.
  • Blurred vision.
  • Eyestrain.
  • Intermittent double vision.

 Exophoria (Exo) (clinical condition) a tendency of the eyes to want to turn more outward than necessary when an individual is viewing an object at near or at distance, which may cause the individual to experience eyestrain and other symptoms. 

  The Exophoric Child tends to relate his/her space world as a complete totality with him/herself as part of it in his alignment which is an outwardizing movement. His/her performance should be complimented rather than him/her as an individual.


 Exophores tend to:

  • Not center in.
  • Not sustain near point attention, but tend to look away.
  • Daydream.



  • Have lower identification skills.
  • See where something is and not what it is. 
  • Miss detail.
  • Jump from field to field to take in information.


  • Eyestrain.
  • Headaches.
  • Blurred vision distance and near.
  • Double vision at far and near.
  • Sleepiness.
  • Difficulty concentration on reading material.
  • Decreasing comprehension over time
  • Pulling sensation around the eyes.
  • Print appears to move.

Brian Pothier Gets Traded

Brian Pothier was just traded to the Carolina Hurricanes.  In a news story that appeared in the News Observer he talks about the vision therapy he got that was a key to him getting back to continuing his career.

In March of this year ESPN did a story on the collaborative work that Susan Duram, OD and I did with a member of the Washington Capitals, Brian Pothier.  Brian had not played hockey for nearly 14 months secondary to his fourth concussion.  Sue had examined Brian and gotten him started with some glasses and asked me to see what else could be done.  After only a few vision therapy sessions he was working out again, went to the Hershey Bears to play a few games and ultimately contributed to the Washington Captials besting the NY Rangers in 7 games and losing to last years’ NHL Stanley Cup Champions, the Pittsburgh Penguins.  Brian is playing at as high or at even a higher level of play than before he left the game and he credits vision therapy with many of these gains.  His story has led to other players and members of the public finding out about what behavioral vision care can offer head injury sufferers.  Brian is to be commended for sharing his story with the public. Here is a link to the Washington Times story just prior to Brian’s return.