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Thread: Computer Vision Syndrome

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    OptiBoard Apprentice macularry's Avatar
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    Computer Vision Syndrome

    Why does it seem like the optometric community is slow to react to Computer Vision Syndrome (CVS)? I opened my new computer mouse to find a Microsoft insert page dedicated to correct computer ergonomics and optical correction. That’s more literature than the average optometrist gives to his patient regarding CVS.

    Only 15% of optometrists ask every patient how often they use the computer. However, there are 130 million people with CVS in the US alone. CVS is now 4 times more common than carpel tunnel. Eighty percent of computer users have CVS. How many of those get proper optical correction dedicated for their computer environment? I’ll bet it’s nowhere close to what it should be.

    Does anyone agree with my observation out there?

  2. #2
    Optical Clairvoyant OptiBoard Bronze Supporter Andrew Weiss's Avatar
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    I'm not sure whether your observation is correct because I can only speak from my experience. At the last place I worked for, in Massachusetts, both the ODs and the opticians were careful to ask the patients about computer use. I was also pleasantly surprised at how many patients knew they needed a different Rx for their computer use and asked for it.

    A different Rx did not always translate into a separate pair of glasses, however. I was amazed at how many people who worked on computers 8 hours a day would want a traditional progressive and balked at spending the $$ for a pair of occupational progressives or even an Intermediate/NV FT.

    I heard Mike DeSanto comment once that we need to talk in terms of a vision solution rather than a pair of glasses. Sometimes (frequently) a vision solution means more than one pair of specs.
    Andrew

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    Quote Originally Posted by Andrew Weiss View Post
    Sometimes (frequently) a vision solution means more than one pair of specs.
    AMEN!
    To the origional poster, I guess I wonder what treatments you're referring to. Almost all of our patients have AR, and the discussion about computer use occurs with every patient. Beyond the proper power and the AR, what more should they be getting? I guess that personally, I don't consider it to be such a burning issue simply b/c most of our patients already own the proper computer use lenses.

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    I often tell people that if you want to pound a nail, you should use a hammer, and if you want to drive a screw, use a screwdriver. If you want to use a screwdriver to do both jobs, it will do one job well, and one poorly, although it will do both. If you want to use a computer 6 or 8 hours a day, buy the tool designed to do the job.

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    OptiBoard Apprentice macularry's Avatar
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    Proper Computer Glasses

    Using general use correction for continual computer use is like running a marathon in dress shoes! Perhaps that’s why CVS is 4 times more prevalent than Carpel Tunnel. Imagine giving someone 600% more computer viewing area than in there general use correction.

    Even the “Office Lenses” that are out there use a one size fits all approach. A person who his 6’1” will have different computer ergonomic demands than someone who is 5’1”

    I use a computer program that will calculate the computer Rx using factors such as height, age and monitor distance. The program will make the determination as to whether an add will be required in the computer Rx. It can be used for computer or reading glasses over monovision contacts. I invite anyone interested to try it. The program is accessible at CrystalEyesRX.com.

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    macularry,
    Why use the program? Are you starting with a full distance/near prescription? I'll have to tinker around with it and see whether or not it gives the same answers I'd get manually.

    Any benefits to the program besides doing the math for you?

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    OptiBoard Apprentice macularry's Avatar
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    Why Try CrystalEyesRX?

    Yes, it does eliminate the math and errors involved in modifying a prescription. It calculates the exact demand at the patient’s monitor distance. It further modifies the prescription to adjust for age related loss of accommodation.

    It is especially useful with monovision contact lens patients. As long as the person using the program can enter the contact lens prescription and general prescription, it will give solid results every time.

    Once the calculation is made, the order can be placed with a click. I invite you to try it. I will comp you the first pair of lenses. Go to CrystalEyesRX.com

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    *Light Goes Off In My Head*
    I just realized you're an OD. I was thinking you were an optician, and I was wondering why you would need to calculate loss of accomodation at any age since LDO's can't legally decide the power anyway. LDO's can and do, however, modify a Distance with Add Rx for any work distance, which is a very simple equation (easier than any program that isn't in my calculator at the dispensing table).
    Now I get it!

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    ATO Member HarryChiling's Avatar
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    I don't like the fact that their is alot of hype about this calculator when the goal is to sell his lenses. First off you should be ashamed of yourself for selling lenses online. And the fact that you are asking someone to punch in data and you will determine the Rx is snake oil my friend. You should not be able to modify prescriptions from over the internet and then ship someone lenses.
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    Master OptiBoarder Cindy K's Avatar
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    Funny thing, the first time I read the original post I had this gut feeling this poster was abouts to try to sell us something!

    My personal interest if this product could be significantly higher if they weren't being marketed via the internet to the consumer directly. I have no respect for any internet based direct -to -consumer optical supply. I'm sure many of us here have the same opinion.

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    Paper Shuffler GOS_Queen's Avatar
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    Quote Originally Posted by Andrew Weiss View Post
    I heard Mike DeSanto comment once that we need to talk in terms of a vision solution rather than a pair of glasses. Sometimes (frequently) a vision solution means more than one pair of specs.
    :hammer: What a great idea! :hammer: (I should have had a V8) :p

    (Michael DiSanto is da BOMB ....)

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    Paper Shuffler GOS_Queen's Avatar
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    Quote Originally Posted by Dave Nelson View Post
    I often tell people that if you want to pound a nail, you should use a hammer, and if you want to drive a screw, use a screwdriver. If you want to use a screwdriver to do both jobs, it will do one job well, and one poorly, although it will do both. If you want to use a computer 6 or 8 hours a day, buy the tool designed to do the job.
    This is an excellent illustration ... :cheers:

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    OptiBoard Apprentice macularry's Avatar
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    Dr. Harry

    Harry,

    I have read your statements regarding CrystalEyes Computer LensesTM. Consider this: When a patient walks into my office with an outside prescription and requests Shamir Office Lenses by name, I would honor the request. The glasses they would then receive would not be the exact prescription on the written prescription. How would this be any different had this been a patient who comes in and asks for CystalEyes Computer LensesTM?

    If you try my lenses and disagree with the optics behind the lens design, understandable. However, to call a system that I have personally invested a great deal of resources in and worked on for eight years “Snake Oil” is offensive to me. I would go so far as to say slanderous. I would like to think that you would be more professional.

    If you disagree with selling lenses online, understandable. However, CrystalEyesRX.Com is aimed at helping consumers and doctors. We do not undercut any doctor. We don’t charge to use the program or to be listed in the search database. I don’t discriminate against opticians. I offer my lens to ophthalmologists, opticians and optometrists who are personally in control of buying their own materials. If more than 4% of computer users were originally prescribed computer specific glasses, the market wouldn’t be wide open.

    Larry Tarrant, O.D.

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    OptiBoard Apprentice macularry's Avatar
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    I don't like the fact that their is alot of hype about this calculator when the goal is to sell his lenses.

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    OptiBoard Professional Ory's Avatar
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    Larry,

    I appreciate that you are a businessman selling a product. I certainly hope you verify a prescription better than those other online lens merchants. I see no step in the ordering procedure that mentions faxing the Rx or contacting the prescriber.

    Also, I find the following statement misleading:
    Whereas typical glasses use a "one size fits all" process, our patent-pending program factors essential variables such as your age, height, monitor distance to insure that your lenses will have the appropriate focal length for your needs.
    To state that the average practitioner doesn't take such factors into account means either you underestimate or I greatly overestimate the current standard of care.

  16. #16
    OptiBoard Apprentice macularry's Avatar
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    Good Point Ory

    Good Point Ory- It would be bad business to make a set of aspheric progressive lenses over the internet, or face to face without verifying a prescription in writing or orally. That is why a patient phone number is required to place an order. We then call the patient to get the providers phone number to verify the prescription, if we don’t have the provider registered already. If a fax number was listed, we would all kinds of junk faxed to us. Imagine the number of remakes alone relying on a patient’s ability to complete that form!

    There really is no industry standard set up. Tell me what the industry standard is for a 55 year old who is 5’1”, has a monitor distance of 22” and has an Rx of +1.00 with a +2.25 Add? What if that person was 6’1” and the monitor distance was 28” instead? How many providers would treat these two situations the same? My algorithm will consistently give the same results for whether the Rx is from a doctor in China or New York and independent of provider training. If you want my answer to what I would prescribe, use the computer algorithm on CrystalEyesRX.Com, it’s free. If a provider or consumer orders lenses from me, I guarantee the Rx.

    Larry Tarrant, O.D.

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    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by macularry
    If you try my lenses and disagree with the optics behind the lens design, understandable. However, to call a system that I have personally invested a great deal of resources in and worked on for eight years “Snake Oil” is offensive to me. I would go so far as to say slanderous. I would like to think that you would be more professional.
    It is offensive to me and my profession for you to sell lenses online, and for you to market such a simple thing as computer lenses under the guise of 8 years worth of research and a great deal of resources. Your calculator is justa marketing ploy for a lens that I can make for my clients in less than an hour in my shop with accuracy. I can take all the factors into consideration as well as your calculator.

    Maybe I should start a site selling reading glasses (you know the ones that I have invested a great deal of years and resources in). I take into consideration your age, your height and all other factors, mine will also ask what color car you drive and I will match the light tint to your cars color (hows that for professional). Also my calculator will take the Rx from a distace Rx with an add power and after being computed through my algorithms which I have taken 8 years to perfect will produce a reading only Rx. (please hold the applause).

    I called it snake oil, because you are takeing a simple thing and obfuscateing the facts to make it seem like this miracle you perform. By the way if the Dr. Harry thing is a pot shot at me I would tread carefully as you just started surfaceing lenses in your lab around (10/2005) so although your ability with prescriptions would have more education behind them your lab experience is in it's infancy compared to what I know and since we are talking about lenses and prescriptions it's a slippery slope.

    I will also take a crack at your algorithm:

    1) the average person seated is most comfortable at or around 75-80% of their height (if anyone finds this to be different just plug in whatever percentage you see fit to refine the algorithm)

    2) an average desk is about 30 inches off the ground

    3) the height of a monitor can be computed from the diagonal display size

    For screen height the aspect ratio of a computer screen is 4:3 (for mine anyway you can use what ever aspect ratio you would like) so the screen height is

    a^2 = Height
    b^2 = Width
    c^2 = Diagonal (the measure used in monitor size)

    with a 4:3 aspect ratio

    a^2 = (4x)^2
    b^2 = (3x)^2
    c^2 = diagonal

    so:

    (4x)^2 + (3x)^2 = c^2
    16x^2 + 9x^2 = c^2
    25x^2 = c^2

    let's say you have a 21 inch monitor:

    25x^2 = (21)^2
    25x^2 = 441
    x^2 = 441/25
    x^2 = 17.64
    x = 4.2

    since we are interested in the height of the monitor:

    b^2 = (3x)^2
    b = 3x
    b = 3(4.2)
    b = 12.6

    Then I figure that the base of the monitor adds about 2-3 inches to the height of the monitor so:

    H = height of desk
    M = monitor height
    B = base

    Top of monitor = H + B + M
    Top of monitor = 30in + 2.5in + 12.6in
    Top of monitor = 45.1in

    Bottom of monitor = H + B
    Bottom of monitor = 30in + 2.5in
    Bottom of monitor = 32.5 in

    Lets say the person stands 6'1 (from your example):

    P = persons height in inches

    Seated = 0.75P
    Seated = 0.75(73in)
    Seated = 54.75in

    Now lets compensate the working distance lets say it's 2 feet (24in):

    ang = angle to bottom of monitor
    WD = working distance
    D = drop to bottom of monitor
    S = Seated height
    BM = bottom of monitor height

    tan(ang) = [S - BM]/WD
    tan(ang) = [54.75in - 32.5in]/24in
    tan(ang) = 22.25in/24in
    tan(ang) = 0.93
    ang = tan^-1(0.93)
    ang = 42.8

    Compensated WD = [WD^2 + (S - BM)^2]^-1
    Compensated WD = [(24in)^2 + (54.75in - 32.5in)^2]^-1
    Compensated WD = [576in + 495in]^-1
    Compensated WD = [1071in]^-1
    Compensated WD = 33in

    this compensated working distance can be used to adjust the power, the importance of the angle is to compensate the fitting height. if you were to subtact the panto this would be the additional amount of tilt to adjust your height for. For example a fitting height of 21mm at a VD of 12mm.

    VD = vertex distance
    panto = patoscopic tilt angle
    FC = Fitting Height (measured at eye level with client)

    Comp Fitting Height = {FC - [tan(ang-panto)*VD]}
    Comp Fitting Height = {21mm - [tan(42.8-15) *12mm]}
    Comp Fitting Height = {21mm - [tan(27.8) * 12mm]}
    Comp Fitting Height = {21mm - [0.53 * 12mm]}
    Comp Fitting Height = (21mm - 6.3mm)
    Comp Fitting Height = 14.7mm

    This is just a rough example, you may want to factor in the corridor length of the lens and adjust the angle to the middle of the screen instead of the bottom, I would be curious to hear anyone elses input on the compensations you all would allow for CVS. I left out any age or physiological optics, because I consider that outsde of my scope, that would be left for the doctor to compensate for.
    Last edited by HarryChiling; 01-19-2007 at 08:34 AM.
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    Master OptiBoarder Cindy K's Avatar
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    (Applause!!!!)

    Thanx Harry, well illustrated!!!!!


    Ok, I have another question, Larry. As any optician (and optometrist) knows, a good set of glasses, made for whatever purpose, is also a WELL FITTING PAIR OF GLASSES. Pray tell, who is going to assume the responsibility for providing this small service to your clients? Also, correct bridge size, temple length, frame width, etc. etc. is rather difficult to determine over the internet. How is this accomplished?

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    OptiBoard Apprentice macularry's Avatar
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    Cindy,

    The person that sells the frame is responsible for the fit of that frame. I don’t sell frames online. However, I would gladly refund a consumer’s money for any reason.

    Yes, it would be difficult to get the frame dimensions online. That would be confirmed when the frame arrives for processing.

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    Anger

    Harry,
    I don’t understand why you are so mad. Have you done a search on line for computer glasses and see what comes up.?There are a lot of worse things out there than this. You seem to be going over the top over nothing. Why can’t he sell what ever he likes over the internet? Why does this hurt you? Oakley , Rayban a lot of companys that I buy from also sell there things over the internet, I still buy from them. They are far larger and could do more damage to your business than he can.
    I am not trying to start a fight with you. I am only asking a question.
    Dean

  21. #21
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by dncaldw
    Harry,
    I don’t understand why you are so mad. Have you done a search on line for computer glasses and see what comes up.?There are a lot of worse things out there than this. You seem to be going over the top over nothing. Why can’t he sell what ever he likes over the internet? Why does this hurt you? Oakley , Rayban a lot of companys that I buy from also sell there things over the internet, I still buy from them. They are far larger and could do more damage to your business than he can.
    I am not trying to start a fight with you. I am only asking a question.
    I am not necessarly upset, but it does bother me that this board is supposed to be "The Premier Online Community for Eyecare Professionals" and all he can give is the marketing hype. I am a curious person when it comes to these things, I like to know whats under the hood before I drive the car so to say. A while ago, this same individual lead me to believe that he had an algortihm he was shareing and it was at his site all I had to do was sign up. So I did, it was then that I found out that he had a online calculator and was selling the lenses. Fool me once shame on me. Now, he is trying to fool others. For example:

    Quote Originally Posted by macularry
    If you try my lenses and disagree with the optics behind the lens design, understandable. However, to call a system that I have personally invested a great deal of resources in and worked on for eight years “Snake Oil” is offensive to me. I would go so far as to say slanderous. I would like to think that you would be more professional.
    I thought he was the doctor, I was not aware that he was a lens designer. Maybe I am wrong, maybe he has designed a new lens what's the patent number?

    Let me give you another example of a top secret formula derived by a special doctor we all know and love:

    http://www.framesdirect.com/lens_drh.asp

    The bottom line is he is an internet dealer, there are no good ones. I have a right to my opinion and I voiced it, I also took the time to lay out a formula so that competant opticians can look and see that it is not some proprietary thing that only this guy can do and maybe see a little through the marketing hype. I love my prefession and do get a litlle upset when people cheapen it.

    How beneficial is this calculator, I don't have access to it because he asks that people register and I asked him to remove me when I found out he was an internet dealer.

    Is the compensation available to you the user or is it only available for him to make you lenses?
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    I have to agree with Harry that I don't like people buying eyeglasses online, then coming to me for free adjustments/repairs/PD'S. I don't think glasses can be fitted properly when purchased online, and I frown upon companies which tell consumers there's no down side.

    As for the algorythm, I guess my feeling is,
    Pt comes to me with vaild Rx. (If there is no valid Rx, I won't sell lenses).
    Valid Rx shows full distance and full reading powers.
    From that prescription, I can make your glasses any way you'd like, set for any focal distance. I cannot, however, use any computer program of any sort to "pick" the add power for the patient. I can move the add power around in the lens, but online calculations based on age, etc, really seem to be stretching what I'm legally allowed to do as an Optician.
    Besides, it sounds like all you're acomplishing with this complicated program is coming up with the appropriate powers for their work distances, something any optician should be able to do with any calculater which divides.

    What are your thoughts, Macularry? How is this not illegal and considered me prescribing for my patients? Are you putting your OD license on the line for the lenses you sell?

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    Opinion

    Ok that is your opinion on his formula. Here is mine, We live in a free country and he and others can sell what ever they like on the internet or in stores. It is just like people that don't like Wal-Mart, if you don't like them then don't shop there. But they have the right to be in business just like you do.
    I think you got upset because he came into your sandbox to play.
    Again just MY opinion.

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    What in the world is this "Top Secret Progressive Fitting Formula?" (Harry's frames direct link) Could it be B/2+3?? There's no possible way that's working. Sure, maybe it comes close enough for him, but I'm sure that they are on average a few mm off.

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    OptiBoard Apprentice macularry's Avatar
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    Good Point Eyefitwell

    The original prescribing doctor would be contacted. If he has a computer prescription from the original exam, we would go with that. If he doesn’t and refuses to give a computer prescription, I think that is a disservice to the patient. Why would a patient with CVS leave a doctor’s office without it being addressed? That would force the consumer to return for another visit and spend more money. Yes, the doctor would have the option to sell the lenses himself. Our price is very competitive for the small independent provider.

    This is about giving consumers options for CVS. That’s all I’m doing. If you don’t like it, move on.

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