I got a little pushback (not a lot) from my optometrist when I first requested an FD set at laptop distance. However it has made a huge quality of life difference for me.
I also gave up on progressives and now have two pairs: readers and drivers. My current correction is insanely good for reading and for driving. In fact, my opto said it was quite a bit better than 20/20 with no eye strain. Well, there was some eye strain when I adapted to the new prescription. That lasted about a month.
So I strongly recommend that you educate yourself (nerd out) about your choices before going to you optometrist or optician. They can’t educate you and they need to make a buck.
At this point I just go in and say I want single vision Trivex on Marchon 623s. I'm up in the air on coatings, tints, polarized and photochromic. I don't need free form given how good my correction is but if you have a difficult prescription that might be a quality of life thing for you.
You cannot depend on optometrists+opticians to make the right choice for you. You need to educate yourself on the available choices.
BTW, I think the same can be said for contacts. Know your choices.
Single vision lenses are always going to be better at that one thing than anything else which tries to cater for all (or multiple) distances, at the expense of everything else.
I also agree with educating yourself to protect yourself. However, there will be many holes in your research which a good optometrist should be able to fill in. Together you can make the best choice.
One area I never see discussed, especially from the "I can find my own prescription" crowd, is binocular vision. How your eyes work together at certain distances and with certain tasks will determine not only which prescription you need but also how the spectacles are set. I'm not only talking about setting the PD and lens height (which may need to be different for your right lens compared to your left, at different at all distances). There are many more considerations such as vertex distance, pantoscopic tilt, frame choice, lens material, wrap angle etc.
Sometimes the optical centration is intentionally different from the PD to induce prism to decrease eye strain. This is not uncommon with complex prescriptions and in the older population.
And sometimes there are other solutions such as vision training. Not the woo woo Bates method, but real vision training used to fix real problems.
Good optometrists provide a lot of value. There just way too much information and most patients will be happy to just let them do what is needed.
And sometimes you just need to get off the PC for a bit.
Yes, I have a great optometrist who provides a ton of value but I only get a certain window with them which at Berkeley is about an hour which is a lot. And I got an awesome prescription from them.
But optician (!= optometrist) generally want to talk to you about frames and not about lenses. This is understandable since they have to make a buck.
So the gap filler here is educating myself. I still let them do what they are in fact very good at but I educate myself on the choices.
This has worked out very well for me. My sister in law has terrible vision and I wonder whether my approach (self-education) would work for her. Maybe, maybe not. But I do think she should get personalized free-form lenses and her optician hasn't suggested that. Dunno why.
I've talked to a ton of people about their phones and apps. I've never talked to someone about lenses. That's strange.
>I also gave up on progressives and now have two pairs: readers and drivers.
Yes, both progressives and high-index lenses suffer from the same problems: smaller field-of-vision and higher distortion of peripheral vision
If I sit with my eyes 36 inches away from a 30-inch screen...
With a single-vision lens, without my head moving at all, my eyes can move within their sockets to see the bottom corner of screen showing the date & time, and to the top corner showing the [x] button to close windows. Single-vision lenses have edge-to-edge clarity.
With progressives or high-index lenses, it requires rotating & tilting my head to put those corner locations directly in my central field of vision. Imagine a horse with blinkers[1]. The edges of those lenses are blurrier so you have to move your head to move the lens' center spot toward the item of interest for maximum sharpness.
Maximum field-of-vision is the optimal ergonomics of looking at multiple windows of text on a 30" monitor. Yes, high-index lenses are thinner and more fashionable but I don't need that when concentrating on programming code and reading web pages.
>You cannot depend on optometrists+opticians to make the right choice for you. You need to educate yourself on the available choices.
That's why I bought my own set of trial lenses[2]. I can methodically optimize my computer distance vision without exhausting the patience of my optometrist repeatedly asking, "which is better? 1? or 2? (again) 1? or 2?". I then go to Zenni and order the exact diopters I need. (I'm not going to buy a glaucoma tester so I'll still go to the eye doctor for that.)
I end up with 3 separate pairs of single-purpose glasses: 1 for reading books ~12 inches, 1 for computer distance ~36 inches, and 1 for driving 20+ feet. Swapping out glasses for each purpose is inconvenient but the larger field-of-vision makes it worth the hassle.
That's a really good description. My TL;DR would have been that everything was bad with progressive lenses. I can drive with my readers and if I slide them down my nose, I can read with my drivers.
I'm lucky I guess. I'm myopic with an FD of about 12 inches. So it was really dumb to have progressives with the near FD set to 12 inches.
Thanks, the same happened to me but had no idea what I was doing. Tried the bifocal progressives and the top half was fine but bottom was like looking though coke bottles. Had to move my head constantly to get text centered. Constant movement and fishbowl effect drove me nuts. Thought they were defective.
Returned them for one computer set and one driving (closeup fine) and they work well, but up until now thought they or I did something wrong.
Yes, exactly! Many others have the same issues and describe it in similar ways: "tunnel vision", or "looking through a pinhole"
It's very strange that optometrists & opticians don't explicitly explain this trade-off upfront: the "convenience" of progressive bifocals and the "fashion" of hi-index lenses will always be blurrier away from the center point than single vision lenses. If customers were properly educated ahead of time by the opticians, they wouldn't think progressives and hi-index were "defective". The lenses are not defective -- it's actually an unavoidable optical tradeoff! Your eyes just happen to be sensitive to it.
Some people adjust to progressives or high-index lenses just fine. Others don't. I tried them for 3 weeks as they recommended and never got used to them.
There’s some good advice on this thread, and I’m definitely going to do some reading before I go to the optician next. I’ve been wearing glasses for 15 years and I don’t think I’ve ever had a pair that are really comfortable for computer work. The best I had was contact lenses, but now I have a weak astigmatism which they can’t correct properly.
Anyway I wanted to ask about your test lens set. Do you just go to the optician with the glasses? I get the impression they’d give a reaction as if you are self diagnosing from something you’ve read online...
>and I don’t think I’ve ever had a pair that are really comfortable for computer work.
Yes, if your using desktop monitor is 2 or 3 feet away, that's an intermediate distance and neither reading glasses nor driving glasses will provide the optimal sharpness. If your "computer work" is a laptop monitor, a prescription for reading glasses (~12 inches) may also work for that shorter distance.
Those websites let you type in the numerical values for sphere, cylinder, etc. You don't need a prescription. (It's the online contact lens websites that require a faxed prescription or a confirmation phone call with the optometrist.)
If you need a tutorial for how to use a trial lens set, there are lots of youtube videos and text websites explaining SPHERE, CYLINDER, AXIS, ADD, PD, etc. It's really easy.
I used www.zennioptical.com but the others websites have good reviews as well.
If you absolutely must use a local optician such as LensCrafters, EyeMasters, Pearle Vision, Costco, Walmart, etc because you need to try out the frames on your face, a trial lens set isn't going to be as helpful to you.
The dash is a little blurry which is acceptable since there's no information that requires sharp vision. If I bought a Tesla where lots of important text is shown on the giant LCD monitor in small fonts, I might have to use progressives.
I think you may just need a new optometrist, they should be able to ask the right questions and provide options that make sense for you. I've also never met of an eye doctor that would push back when someone asked for computer glasses, that is extremely common...
You can easily drill Trivex so you can have rimless if you want. Polycarbonate cracks more easily.
So know your prescription and frame type. Learn about lens materials, lens types (single vision, progressives, free form, ...), tints, coatings, .... This seems like a lot to know but imagine your optometrist trying to figure out everything in 20 minutes. It's better if you do some homework.
All that said, I went to Berkeley and I use their School of Optometry. They don't mind at all if I ask questions and if I'm pretty direct.
> All that said, I went to Berkeley and I use their School of Optometry
wait, can you expand on that? i went to ucsd, is there some uc program where alumni get some kind of benefits from the medical programs? or is it just cal?
I get 20% off exams and frames+lenses as a member (life member actually) of the Cal Alumni Association. I usually schedule my visit in the summer when things are slow. It's always nice to be on campus again.
I don't think there's a reciprocation agreement. There is for library privileges. You can actually join as a UCSD alum. Life is about $750 (it was less when I joined) which has paid for itself for me. I believe there are alumni advantages at UCSF Dental as well.
Have you purchased from eyeglasslensdirect? Seems to be a one-person operation, which could be good or bad. They are the only online retailer of well known lens brands.
On their single vision lens order page, there is no input field for fitting height. Do they calculate a fixed percentage of frame height, or can you email them with your fitting height?
No, I haven't. I educate myself about lens materials and choices online but then I get my prescriptions and glasses at the Berkeley School of Optometry brick and mortar. You're asking about fitting and I think opticians are really good at that. Berkeley is. I'm talking about educating yourself on choices.
This is another online site with a lot of information:
UC Berkeley Optometry is a wonderful resource for the community. I've used them for years for both exams and glasses. Their website has info on their services and prices: http://www.caleyecare.org/general-info/
I first got into this when I was taking Physics 7C which has a chapter on lenses. There's an approximation they use and I thought couldn't they use ray tracing and do a better job? So I started reading and yeah, they could and they do. What I was wondering about is what free form lenses actually are. And with modern CNC capabilities, you can do a much better job.
There's a more subtle issue with high-index plastic lenses and the new RGB LED monitors: the high dispersion of the plastic interacts badly with the red and green wavelengths of the RGB LED backlight, to produce a much more severe color separation effect when you're looking through a part of the lens not near the optical center. I wrote a blog post about this [0]. For the last couple of years I have been using lenses made of CR-39, the older, lower-index plastic (with a correction appropriate for computer work; that's about -5.75 diopters for my eyes), and they work much better.
If your absolute correction is larger than maybe 3 or 4 diopters, and you use an RGB LED monitor, I recommend looking into this.
CR-39 is great. They're scratch resistant, light, have high Abbe number (basically a measurement of the rainbow effect; higher is better), and UV opaque. I've had a pair of CR-39s in a lightweight titanium frame for over 15 years and still going strong.
The maximum thickness is about 4mm -- very reasonable, given the strength of the correction. This is with a fairly small round frame (lens width 41mm).
The first RGB LED monitor I ran into was an Apple Cinema Display, several years ago. I initially didn't understand why I found it so uncomfortable to use. I think all the iMacs built in the last 7 years or so are RGB, as are all the Retina MacBook Pros. -- Well, as the article you linked to explains, they might be GB-r instead (green and blue LEDs with a red phosphor). From a dispersion perspective, GB-r is just as bad as RGB; so are quantum dots and the now-obsolete wide-gamut CCFL. All of these wide-gamut technologies will have much more red-green dispersion than either the old standard CCFLs or WLED.
I wasn't aware of Freeform; I guess that's because I don't use progressives -- I just switch glasses, or slide them down my nose to adjust focus. But it seems to be a lens shaping technology, not a lens material.
Hmm, does it apply to iPhone and iPad screens, especially with Apple’s “True Tone” display? Given the size of the iPhone user base, your blog post should be better known.
edit: web search did not locate definitive statements about RGB LED in either iPhone or Macbook retina screens.
Well, I'm not certain about past models, but the current MacBook Pro advertises "Wide color (P3)", referring to the DCI P3 gamut. This obviously requires a wide-gamut backlight of some kind. I found this [0] blog post talking about DCI P3 vs. Adobe RGB.
Looks like the iPhone 7 was the first iPhone with a wide gamut [1]. No idea about the iPad.
Freeform lenses, from what I can see, are an attempt to compensate for higher-order aberration than the standard sphere, cylinder/axis, prism/base prescription
There is a fascinating data, robotics, manufacturing, supply chain and retail story to be written about the optical industry.
The largest lens maker (Essilor) has merged with the largest frame maker (Luxxotica) and they also own online retailer FramesDirect. A former executive of Essilor runs a Canadian company that is acquring independent opticians. Japanese lens makers (Hoya and Seiko) have merged in response.
Essilor, Zeiss and others are asking opticians to spend thousands of dollars on equipment [1] that measures patient’s eyes for lens personalization. This data (including auto-refraction [2]) then gets aggregated with optometerist prescription data (subjective refraction = which is better, 1 or 2), providing Google captcha-style human input to improve the software algorithms used in measurement. Opticians are funding their robot replacements.
Today, online retailers like FramesDirect use average values for some fitting measurements (e.g. pupil/fitting height in frame for optical center of single vision lens). There are mobile eye measurement apps that take a photo of your face with a credit-card sized object to adjust for scale, but they are not too accurate. At some point, self-service [3] optical measurement devices and lens customization algorithms will enable optical telemedicine globally.
At my -10 diopter in both eyes there's no winning with multi-monitor setups. It's a trade-off between chromatic abberation, internal reflection, and edge distortion.
All the high refractive index lens materials I have tried have terrible abbe number and so their chromatic abberation is so bad I can't even LCD text out of the corner of my eye; or read a license plate on a car to the front left of me. I don't even bother with high index anymore.
But moderate refractive index (and decent abbe number) means my lenses are more than a centimeter thick at the edges. In addition to being heavy they are so thick that the nose pad arms don't fit. So the edges of the lenses have to be carved off. This leads to very bad internal reflections.
I've tried exaggerated spherical curvature in order to minimize thickness while keeping a good lens material (high abbe) but that tends to distort (compressing) the image out of the sides the lenses and that leads to nausea.
I wish there were companies out there that would make custom achromatic lens for eye glasses. Their internal reflections can't be worse than what I have now.
I was testing point and shoot cameras the other day and one of the things that impressed me is just how quickly and smoothly they can auto-focus. I found myself looking around at the world through the viewfinder screen and it occurred to me that with 400+ ppi LCD displays why have we not yet created a 'visor' which is simply a reproduction of the scene outside but in constant focus for our eyes (I wear progressive lenses which, with a prism, have issues). Curve an iphone X screen to make a wrap around screen I think there is certainly something there.
You don't need to include a pixel display for autofocus. DSLRs show the real world projected directly onto a screen at a comfortable focus distance for example.
I was -9.50 in both eyes and in the same boat as you. I started to get astigmatism which made contacts very expensive (toric lenses).
I went to get LASIK and even though it got me to just 20/30, it was a huge improvement. A few years later I got PRK to fix one of my eyes and I've been fine since, but in another 10 years I'll have to get a light prescription as you can't fight the aging process.
Wow, im really sorry to hear what you have to go through. Im sure you have thought of all kinds of scenarios to work around this, but I am curious about what conclusions you came to:
Combining contacts and glasses?
Surgery, even to just reduce the correction?
I've tried contacts a few times but they're such an incredible hassle compared to glasses. And with my astigmatism the contacts have to be rotated correctly. When they get nudged off-axis (by blinking) the vision noticibly changes.
I did go in for an assessment for laser eye surgery. Unfortunately there's just not enough cornea for them to fully fix my eyes. Since I do optical astronomy I didn't want to risk night vision rays just so I could wear a slightly smaller pair of glasses.
Check out hybrid contacts. I had similar issues with my astigmatism. The contacts have hard centers and soft outer rims. As a result they can provide decent astigmatism correction/stability while being __much__ more comfortable than hard lenses.
The things drastically improved my quality of life.
I too have an issue with soft contact lenses not providing great vision due to astigmatism. I tried getting sclerals fitted but had to return them due to the optometrist having trouble fitting them. The vision was crystal clear though -- shame it didn't work out. The downside was that they felt incredibly fragile and were quite expensive at around 1000$ for a pair. I pay about 300$ a year for daily soft lenses so that's quite an increase in price.
I've heard RGPs are painful. Are the hybrids unnoticeable (like sclerals/soft lenses) or is there still an adjustment period?
RGPs are unwearable for me because of comfort levels. Even after a two week adjustment period.
Hybrids have been really comfortable for me. The lens change may take a day or two to adjust, but I tend to forget about them until ~14hrs when they start to feel a bit dry.
*Disclaimer there is variance among both eyes and lens manufactures (I've had some manufactures that felt dry really soon, others are much better).
Grew up pretty poor. One of those people that just got lucky and was never seriously injured since I didn't have health insurance until I went to university.
Again, I was one of those people that always struggled to read for extended periods of time. It never occurred to me that I might need glasses and I didn't have a single eye exam as a kid.
Fast forward to one of my last semesters. I finally go in for an eye exam and sure enough, I needed glasses.
After I got the glasses, studying for long periods was effortless (at least by comparison) and needless to say, my grades improved drastically. For at least a short period, I felt what it was like to do well in at a really competitive school.
I really wish that period had been longer, so please, if you're reading this and you've been putting off an eye exam, go do it today.
Depends on exactly what you need. There are any number of places which will make prescription goggles for you, either waterproof for swimming or aerated (for playing sports). They don't need nose contact to stay in place.
www.nearsights.com specializes in monocles; technically you could wear one in each eye, but I suspect it would cause your face to ache.
I picked up two pairs, one in Taipei and one in Tokyo. The filtered one has been great so far; I have not experienced any eye strain. What a relief since I stare at the computer screen for at least 14 hours daily.
Caution: the filtered lens does affect color accuracy a little and makes the surrounding seems a bit darker.
Fwiw, I got readers a few years ago, when I was working 12 hour days in front of a screen. They're weak lenses. When other eyeglass wearers put them on, they think they're fake. But they make a huge difference for me, just by diminishing the effort of focusing on a screen to near zero. I don't feel anywhere near the same eye fatigue.
I have tried programming with contacts in (usually when my glasses were damaged beyond repair or lost). I can barely work for 6 hours before the contacts dry out, even when using contact lens drops. Does anyone know of tips for finding contacts that are good for computer use?
I sort of had this problem, my tear ducts work for 20% so I have prescription eye drops. That sort of forces me to wet my eyes. The month lenses are not that good for me, the dirt build up is big, and they don't even last a month most of the time.
Best for me is day lenses.
What I did to test out many lenses, is get a real good optician to measure my eyes. Ordered a set of lenses with them, then used the labels to order different brands online.
It was more expensive to measure my eyes there than at some random optician store who do it for free, but it was so much better.
Have you tried different brands? I started out with Bosch and Lomb contacts, which I thought were excellent. Then one year my doctor suggested that I try Biofinity Toric instead, and it was a revelation. Most of the time I can't feel that they're even there. If I forget whether I have them in, I literally have to see if my distance vision is clear to check.
That is not to say that Biofinity is the better choice, but it's worth trying out some different kinds to see if there's one that works better for you.
Same here! I swapped optometrists and my new optometrist recommended me this brand that had EXTREMELY thin lenses. She said that even though they were more fragile, they were better for people who looked at computer screens all day, since we're much less likely to blink, which causes them to dry out. Thinner lenses require much less moisture from your eye to feel comfortable.
You should look at daily disposables and see if those work better. They may be expensive, but since they're good for a day, you wouldn't have to worry about any degradation over days or weeks (like with others). If you're looking for cheaper options on a daily disposable, Daysoft is something you could try. Caveats - comes in a single (physical) size and is not available for astigmatism or presbyopia.
I'd advise strongly against using contacts. Not only for work but like ever. Eye drying seems a simple problem until the unfortunate event of corneal erosion. The risk is higher since you are putting some plastic on top of your eye. If it is dry, it is as bad as any plastic.
With time, you'll damage the surface of your eye to no repair. Read the Internet for some real experiences.
This is overly sensationalistic and seems to be based on a single bad personal experience.
Most people can wear contacts just fine with zero side effects. I've been wearing contacts for more than 20 years. I started with yearly lenses, then monthlies, then dailies, then multi-focal dailies. They've all been superb, and I've never had any issues with dryness. I use contacts from morning to night, only switching to glasses when going to bed.
People are different. I know several people who wear glasses and who say they tried contacts but that it was very uncomfortable due to drying. But I also know many more people who do wear contacts without issues. I know a person who uses "night and day" lenses that you sleep with. I tried this type myself, and every day I woke up with my eyes clogged with mucus. Again, people are different.
A good opthamologist will monitor your vision and look for corneal issues. As one gets older, the risk of corneal detachment increases, but again, it's highly individual.
Maybe, but you can check the Internet about eye dryness. I think there is a lack of stats in this area. The problem is that people react differently. And for some people the damage from dryness is quasi-permanent. So unless there are very established measures/stats, I'd not take risks.
Don't go to the Internet for medical advice. Your opthamologist will determine, based on your experiences, whether contacts are right for you.
The opthamologist will also fit you with the contacts that are right for you. There are tons of different brands and contact lens products. For example, I use Alcon Focus Dailies, and Alcon also launched Focus Dailies Total 1, a more expensive "water gradient" lens that increases breathability and lubrication [1], and for some people who have dryness issues they are much more comfortable. For me, there was zero difference, so I went back to the cheaper kind.
Your comment is a bit like saying that no one should ride bicycles because people with Ménière's fall of their bikes. It's not a proportional response. Plus, you can get training wheels.
Due to some reasons I couldn't use contact lenses in one eye for a couple of months. I switched to using contacts in single eye for that period, as I can't stand glasses for more than one hour due to very high myopia. It turns out, single contact has enough benefits that I didn't switch back to wearing two contact lenses after the issues with the eye went away. Instead I use single contact lens alternating between eyes for the last four years. Some observations:
- The issues with contact lenses became almost nonexistent. I almost never feel dryness in the eyes.
- Perhaps surprisingly, whenever I feel dryness in the eyes, it's always the eye without contact lens.
- It seems that the eyes have much much higher stamina now. They never feel tired regardless of how much I abuse them. I could look into screen all day without breaks and I wouldn't feel any issues as far as eyes are concerned.
- Since I have high myopia, using single contact gives my vision very high dynamic range. The eye without a contact is almost like a microscope.
- The potential wear of the cornea is reduced twice.
I can also attest that the brand of the contacts matters a lot. I remember several brands of contacts being really uncomfortable to use. Currently I wear 'Biofinity XR' if anyone cares. There were several other brands that I liked, but I don't remember them.
Being able to wear contacts is extremely convenient for athletic activity and times when you want to wear standard sunglasses. I personally like a hybrid approach - glasses most of the time but contacts once in awhile. I would guess that wearing contacts occasionally is fine, but feel free to disagree if you do!
Is this just FUD? I've been using contacts and doing coding for over a decade now. I get my annual checkup from the eye doctor. They would know if my eyes were getting damaged, wouldn't they?
Like any intervention to the human body, there are risks. Properly maintained and adjusted, contacts carry very few risks.
Anecdotally, I've yet to find a pair of glasses that lets me function in the world as well as contacts. (My eyesight is poor enough that I cannot see the screen on my phone with both eyes open, as it has to be so close to one eye that it is too far from the other.) Wearing contacts lets me see the entirety of my world, not just the portion within the frame of my glasses.
Do you blink regularly when staring at a screen for long hours? This helps in all situations (no glasses, glasses and especially with contacts where moisture is critical).
The natural blink reflex can be supplemented with an external reminder, similar to alarms that remind you to stand for a few minutes, or focus your eyes at infinity to balance out the close monitor.
I switched from Acuvue 2 to Oasys and it was a huge improvement. I only get dryness when I’ve got a consistent breeze on my face. (NB: I never wear them during sleep. That just seems to me like a fantastic way to get an eye infection.)
I'm in dailies, so I'm kind of a weird case. Makes sense though because I use them predominately for social events and athletics.
The ones that get itchy for me are Acuvue Moist.
A step better is Dailies AquaComfort Plus by Alcon/Novartis.
The really nice ones (comfortable for 12+ hours) are Dailies Total 1 by Alcon/Novartis. My optometrist described them as "the Cadillac of contacts," so I'm guessing they're expensive (I'm still working through my stock of Acuvue contacts).
Is anyone familiar with eye minus? I once went to two different optometrists, and ended up with completely different prescriptions, and only the one that realized I had a "minus" eye was the one that gave me the best prescription.
I find life to be MUCH better when I have a 144Hz screen running.
But then I bought a laptop with no capable video card. I'll be going back to a PC with appropriate 144Hz capable graphics very shortly for my main machine. It's like night and day on my eyes.
I've been wearing Felix computer glasses for the past ~2 weeks. I was really surprised to see the difference. My eyes were so strained all the time previously and that feeling has almost completely gone away.
This is fascinating. I have had eye floaters and tinnitus for many years. Both problems have been frustratingly intermittent for me. But over time, I have gotten them under control. The answer for me was food. If I had a burst of eye floaters or tinnitus I would ask myself “what have I eaten recently” and make note of it. Soon patterns emerged, for example, beer caused really bad eye floaters and candy would set off my tinnitus. So I ate less of anything correlated with my symptoms. Not a sexy solution(especially if you like beer), but has worked wonders for me in the long run. Good luck.
I've seen papers where floaters and tinnitus are associated to lyme disease. It can also be linked to thyroid issues that have led to autoimmunity. Autoimmunity can be connected to food.
The weeks prior to my floater onset, I had really bad migraines and pain "behind" my eyes, close to the nose.
My floaters are permanent. Most seem to be. I also get occasional mild flashes, which are probably caused by little changes in pressure within vitreous regions close to my retina.
My floaters, which admittedly weren't at all that bad, have subsided a touch since going on the ketogenic diet for a few months. No clue why or what, just letting you know.
Another anecdote for you: do a mental check you shoulder and back muscles. I’ve personally found (as have others) that my tinnitus intensity is closely tied to how tense my shoulders and upper back muscles are.
By focusing on the muscle tenseness. Meditation, massage, hot water. And sometimes just some ibuprofen to break the "it hurts, so tense up, which causes it to hurt" cycle.
They're not perfect, but I'm mindful of the state of those muscles now, and can typically head off (or deal with) the tenseness.
I highly recommend the system I've used for the last 20 years: two pairs of prescription glasses, one for computer use and the other for general use.
The computer glasses are single vision lenses (not progressive or bi/trifocal) corrected for the distance to my laptop screen, about 20". This is not a "reading" prescription, which would be more like 16" and not suitable for computer use. I bring my ThinkPad to the optometrist to check the prescription while I'm there. They have test lenses they can combine to show you what the final prescription will look like.
At my home office I use an external 24" 4K monitor in portrait mode in addition to the ThinkPad's high-DPI display. The monitor is mounted on an Amazon Basics adjustable arm (made by Ergotron), so I can easily position it at the same 20" distance from my eyes. This is a great combination with documentation on the portrait monitor and code on the ThinkPad display.
The general use glasses are progressive lenses with magnetic clip-on sunglasses. I don't like the clip-on sunglasses that have actual clips, even though you can get them for any kind of glasses. The magnetics are much nicer, although there aren't too many choices available. Flexon still makes one set.
Since I always wear shirts with pockets, this is really handy. I can use the clip-ons when outside or driving, and then when I walk indoors I simply snap them off and put them in my pocket. They don't need to go in a case when I do this; the clip-ons go in my pocket with the front facing out so I hardly notice they are there, and a cotton shirt provides ample protection.
I like progressives much better than bi/trifocals, because there are not just two or three discrete focus distances, but an entire range from infinity down to much closer than the 20" computer glasses. They are fine for reading on a phone screen or a Kindle too, since you don't need such a large area in focus. They are also great for photography; you can have both the camera's display and the subject in focus at the same time.
There is really no need for a separate pair of "reading" glasses, since the computer lenses and progressives cover all the bases.
I do not recommend progressives (nor bi/trifocals) for computer use. They are a recipe for eye and neck strain as you tilt your head back and look down through the bottom part of the lens. When I see people do this I cringe. It's OK for a few minutes but not for any longer term use.
I do occasionally use the progressives when I'm looking over someone's shoulder at their screen. It's probably going to be a lot farther away than my 20" laptop distance, so I can't really use the computer glasses.
I don't recommend the trendy-looking lenses that have very little height. They don't work well for computer use, since they may not cover the entire screen at the time, and they are terrible as progressives since the compress the focus area so much. How you see is more important than how you look.
I definitely recommend getting your eyes checked even if you are much younger than me. You may think you are doing OK, just like I thought for years. But when I finally realized I wasn't seeing my computer screen as clearly as I should, and I visited a good optometrist with my laptop and tried their temporary lenses, I was amazed by the difference.
Most people's eyes change fairly rapidly during their 40's. You may need a new prescription every year or two. After that the changes slow down and you can probably use the same prescription a bit longer. But there still are changes over time, and it's a good idea to get regular eye exams to check for other problems.
This combination of prescription computer lenses and progressives with magnetic clip-ons continues to serve me well at the age of 65. With the computer prescription, I can see every pixel on a medium-DPI display, so it has spoiled me and I only like high-DPI displays now.
I’d recommend anyone with eye strain problems consider Lasik. I used to have eyestrain multiple times a week before lasik, and now I get eyestrain maybe once or twice a year.
I have a fairly large power difference between my eyes; my right eye is nearly perfect (maybe -0.5 or so) but my left eye is -2.75. This has been the case since 7th grade or so.
At the time, I was prescribed glasses and advised to wear them all the time. But, of course, since I didn't need them in order to function (because I had a good right eye), I didn't. Moreover, I grew up programming and spent much of my adolescence in front of a screen with uncorrected vision. I was warned that there might be problems due to this later, and ignored them, since everything seemed fine. What's more, my glasses' focal point was unquestionably long-distance and simply added fatigue to computer use that was not present without them.
I first started experiencing occasional bizarre headaches in 2010, one of which landed me in the ER because it was so bad. At the time it was treated as an atypical migraine. But things really came to a crisis point in spring and summer 2012. I started getting brief episodes of vertigo after more than ten minutes at a screen. The problem was particularly bad when going from near to far focus or vice versa; I'd get this "need for speed" effect where it felt like the world was topsy-turvy, rushing past me. It was very disturbing for a person who is deeply uncomfortable with not feeling in control. Anyway, I couldn't work, and spent the entire summer doing the one thing that seemed tolerable -- watching TV shows and movies at close range. I did a little bit of travelling and had an absolutely miserable time, compounded by the dryness of the places I visited. The economic and quality of life impact could not be overstated. I was miserable, anxious, and unproductive. I was lucky to be self-employed and somewhat flexible in how I went about working, but getting through even ten minutes of e-mail was a struggle some days.
Lots of misdiagnoses and rabbit holes along the way; migraines (of which I had no history), sinus problems, allergies, etc. I took nasal steroids, did this, did that.
An optometrist prescribed me near-distance computer glasses alongside my long-distance ones, and this did not immediately solve the problem. I struggled with such symptoms for another year or so before the problem was anything like resolved. Even so, I depend on having two pairs of glasses and switching among them scrupulously depending on what I am doing. I can get by with long-distance glasses for a little while when doing computer work, but it's ultimately too straining. The most dangerous of all is no glasses: my problems come back quite quickly if I do that.
That's what happens when you ignore computer vision issues.
Edit: I've also found that I do better with a single large monitor than two medium to large ones.
I had a similar experience. I got severe migraines all throughout my childhood. When I was studying my masters I couldn't handle all the reading so I went to the optometrist, who sent me to a binocular vision specialist who prescribed a vertical prism on my right eye, which points slightly down at rest. I had been correcting for this manually for 20 years which is what had caused the migraines, since independent vertical movement is super strenuous on the eyes. Haven't had a migraine since!
I have anisometropia even more extreme than yours. I wonder, have you ever tried contacts? For anisometropia, the closer the prescription is to the eyes, the better. I choose to wear glasses now, but I still have to go out of my way to find small enough frames (unfortunately out of fashion) that the lenses sit close enough to my eyes that the images converge.
I didn't know that, but I have considered contacts for cosmetic reasons. However, they seem like an awful lot of hassle compared to glasses.
Another question: wouldn't the contacts have to be complex/progressive lenses of some kind? Clearly, I need two different prescriptions—one for computer work, one for everything else. Does staring out a bottom or top portion of a contact lens pose any difficulty beyond what one finds with progressive lenses in normal glasses?
I'm not an optometrist, and I haven't worn contacts in years. All I can tell you is that they weren't nearly as much of a hassle as people make them out to be. I just have strong, but not vision related, reasons to prefer glasses.
I too have a moderate power difference (-1 on the right and -3 on the left) along with high degree of astigmatism. Two monitors are a lot harder than a single screen. With full correction, eye strain after even an hour of looking at a desktop monitor makes me uncomfortable. So I use lenses that undercorrect while working on the computer.
How long was it between 7th grade and when your headaches started occurring? My optomitrist was surprised I did not have headaches, as I have similar eyes to yours. However, he didn't feel there was any need for intervention unless there was a problem. It's been a decade without issue at this point.
I also gave up on progressives and now have two pairs: readers and drivers. My current correction is insanely good for reading and for driving. In fact, my opto said it was quite a bit better than 20/20 with no eye strain. Well, there was some eye strain when I adapted to the new prescription. That lasted about a month.
So I strongly recommend that you educate yourself (nerd out) about your choices before going to you optometrist or optician. They can’t educate you and they need to make a buck.
At this point I just go in and say I want single vision Trivex on Marchon 623s. I'm up in the air on coatings, tints, polarized and photochromic. I don't need free form given how good my correction is but if you have a difficult prescription that might be a quality of life thing for you.
You cannot depend on optometrists+opticians to make the right choice for you. You need to educate yourself on the available choices.
BTW, I think the same can be said for contacts. Know your choices.