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Клиника офтальмологии доктора Шиловой
Лазерная коррекция ReLEx SMILE и не только…

IT specialist's vision: what you personally need to know

Клиника офтальмологии доктора Шиловой corporate blog Biotechnologies Health
Original author: Tatiana Shilova

— Which is better: glasses, lenses or laser vision correction?
It is best to see without any means of correction. If you are completely satisfied with the glasses — keep calm, no other correction is needed. Lenses — this method of correction requires adherence to clear rules of use, which is ultimately more costly and risky, but it is very popular because the main dangers do not appear immediately after the start of wearing, but years later.

— I decided to stay on the glasses, but I am afraid that the car's pillow will open in my face and they will become contact lenses. What to do?
In my surgical experience, modern airbags do not injure eyeglasses. Eyes and face are usually damaged by windshield fragments. If you are concerned about the safety of glasses, then think about the modern, with polycarbonate lenses, they are incredibly durable, the car drives on crash tests.

— Is it true that all eye disease from the computer?
No, it's not true. The main cause of problems with optics — myopia, hyperopia or astigmatism — is genetics. Adverse environmental conditions, especially during long-term work at close range, are important in childhood, when the development of the organism is not yet complete. And such diseases as cataract, glaucoma, retinal detachment and other diseases occur with the same frequency in those who work at the computer for hours and in those who do not know where the computer has a power button.

— Can I ruin my eyesight with glasses?
If you see badly and don’t wear glasses, you lose some of the information about the world around you and at the same time create additional strain on the visual apparatus. There is a problem — optical correction is needed. And you can spoil your eyes with glasses as one of our colleagues from the clinic in Marburg- he fell asleep in glasses at the computer at home, fell face down on the keyboard, and a piece of glass entered the lens. My partner, Walter Sekundo, operated on him: the lens was first replaced, then a year later transplantation was needed.

— What else is worth knowing about the glasses?
It is intuitively clear that the glasses should be as wide as possible for the peripheral vision to work (at least somehow). However, it has not yet been clinically proven that the effect of observation through the center of the lenses (and this is how most of those who wear glasses look) creates some problems for the mechanics of the eye. In general, you can not be afraid of this with an arbitrarily long wearing glasses. Chameleon glasses (photochromic) are good for a sunny climate, now they are recommended even to children. In addition, the «chameleons» can be used by drivers, as there are eyeglass lenses that darken behind the windshield. In the north, where the glare of the snow (for example, climbers to protect against the «snow ophthalmia») is traditionally used glasses with a polarizing effect. They are also good for sunny days, but in normal times polycarbonate is better with UV protection. Yellow glasses and glasses with other light filters have almost no effect on vision.

Currently, ophthalmology glasses with yellow filters are prescribed only to those who have certain retinal dysfunctions, or to drivers who drive in fog and rain (only for use during poor visibility).

And finally, there are special glasses for those who often sit at the computer — they are a little pinkish, blocking part of the blue spectrum. They can only be used to work with a laptop-tablet-phone. The point of wearing such glasses is to increase the contrast of the image, namely, the contrast determines how comfortable you will be looking at the screen. In theory, you can slightly tweak the range in the direction of warmer colors — it will give a similar effect.

— What glasses should be ordered?
The choice of frame is a matter of taste, but the quality of your vision and the convenience of using glasses depend on the lenses. Lenses can be spherical and aspherical, which provide better vision (high clarity, reduction of peripheral spherical aberrations). You can choose lenses from polycarbonate — then you will be sure of their maximum strength. Such lenses are put in expensive children's glasses — at least you can dance on them, nothing will happen, the car drives on crash tests on them. Unfortunately, these glasses are expensive — 15-20 thousand rubles for glass plus a rim plus the work of the master.

You need the following coatings for these glasses: UV protection from the outside and inside of the lenses (this is important for the prevention of early cataracts, especially in sunny regions), anti-glare (this is a standard coating), water-repellent and dust-repellent (antistatic) layers and on top — protection from scratching. Almost all professional lines of glasses have the ability to combine this. In extreme cases, you will refuse antistatic agents or something else that is not so important. If you often use glasses at the computer, then you can think about partially blocking the blue spectrum to the level of the so-called E-lens, which are used to work at the computer. The coating corrects the spectral composition of the computer's radiation, “cutting” the high-energy blue and violet parts of the spectrum. This significantly reduces or eliminates eye fatigue syndrome (dryness, redness, loss of clarity of vision) during prolonged work in front of the monitor screen. In addition, the concept of optimized design supporting accommodation is implemented in the E-lens. As a result, the tension of the eye muscles is significantly reduced when working at middle and near distances (tablets, computers, smartphones).

Pay attention to the diagnosis of landing points — this is the vertex distance (the distance of the lens from the eyes) and, simplifying, the level of inclination of the lens relative to the plane of the forehead. As a rule, by correctly diagnosing the landing, you can achieve almost unbelievable comfort from the glasses.

— And if contact lenses — which ones are better?
One-day lenses are better than two weeks, and those are better than long-wearing lenses. Night vision correction with orthokeratologic lenses is a great correction method for children and adolescents, with progressive myopia, suitable for those who want to have no difficulty in wearing glasses during the day, keep an active lifestyle, as well as for those who for some reason do not can do laser correction.

Let it be trite, but we must remember that any contact lenses need to be cared for — always wash your hands before working with lenses. Wipe and rinse contact lenses with special solutions, never use tap water or saliva for this. Use special containers for storing contact lenses and never re-use the solution for washing and storing lenses.

Keep contact lenses away from water, avoid showering, bathing and swimming in the pool or ponds in the lenses — risks of acantamebic kecratitis. And never sleep in soft contact lenses, they are only for daytime wear. Use and change in time only those contact lenses that are prescribed by your ophthalmologist.

— What about perforated glasses?
These are glasses with small holes. This is where the camera obscura effect works; these glasses, due to a significant decrease in the aperture, transmit only conditionally parallel rays into the eye, which sharply reduces the light scattering circles on the retina and the visible part of the image is really sharper. But their application is much more interesting — a good old pseudo-accommodation trick. When focusing (accommodation) of the lens does not work in a person — and these are age changes in people after 60 years or cases of implantation of an artificial lens, it can be achieved by narrowing the field of view of a fairly good effect with such glasses. They do not possess any “simulator” properties.

— What else does an IT professional need to know about vision?
One office worker spends on the computer an average of 7 hours a day, 35 hours a week, 1820 hours a year. And coming home from work uses smartphones and televisions, tablets and laptops. That is, on average, such a person looks at the screen 12 hours a day, 4380 hours a year. Of course, in this mode, so-called “computer visual syndrome” (CVS) may occur. This is a common symptom complex, which can manifest as headaches, blurring of vision, pain in the neck, arms, shoulders and wrists, dryness and irritation of the eyes, their fatigue and tearing. There are basic recommendations that you need to try to follow in order to maintain health when working at a computer. Your workplace should be comfortable, furniture should be comfortable and the correct understanding of the ergonomics of the workplace — these are the main factors which affect your well-being and are one of the most common causes of CVS, which you can easily fix. The computer screen should be located so that it does not reflect the ceiling lights and sunlight. Your eyes should be approximately at the same level or slightly higher with the top of the computer screen at a distance of 50-75 cm from the top of the computer screen.

Something like this:

Of the most important — if you have a screen at your workplace or at home 13-17 inches, then you can improve your life by buying a larger display and placing it a little further than the current one — at least 10 centimeters. And it is better — by 20. Do not move the monitor closer to you when reading small text, but increase the font size if you can transfer it comfortably for reading speed.

Rest, take short breaks, leaving the computer: during lunch, go for a walk, and do not sit at the computer, do not be lazy to go to the printer or have a cup of coffee. Remember the rule 20:20:20 — every 20 minutes, take your eyes off the screen, look at distant objects at a distance of at least 20 feet (6 meters) for 20 seconds.

Your monitor should not be too bright or too dim in relation to the lighting in the room. For comfortable reading, you need to monitor the brightness and contrast of the image on the monitor. You can also use anti-glare filters to reduce the amount of light reflected from the screen.

Before changing the monitor brightness, look at the image below. Do you see all shades from black to white on this scale? They should be 21. If you find it difficult to distinguish shades along the edges of the scale, then you should adjust the brightness on the monitor.

When you blink, the surface of the eye is moistened and cleansed, it provides clear vision. Many people blink at the computer for a long period of time very rarely — instead of 12-15 times, only 4-5 times. This leads to a violation of the stability of the tear film and to the appearance of such a violation as “dry eye syndrome”. It is necessary to blink more often, or use special moisturizing drops, or put a humidifier. The easiest thing to blink a little more often, and for this you need to be distracted and look into the distance. Get into the habit, if you can — when something is loading — look to the side.
Women, by the way, are subject to «dry eye syndrome» more often than men.

Cactus does not help. Carrots with sour cream or butter (because beta-carotene is fat soluble) helps in theory, but there is no current research, and the latter relate to the preparation of snipers from WWII, so they are somewhat peculiar. But in general, intuitively — useful.

Good nutrition helps prevent dry eyes, and also contributes to the later onset of diseases such as cataracts and macular degeneration of the retina. After 50 years, in most cases, additional antioxidants are needed in the form of a change in diet or individual drugs, but strictly by doctor's prescription after diagnosis.

In general, the developer’s eyes are the same as other people’s. For an adult, the danger of working at a computer is greatly exaggerated. There is no particular difference between what you would read 8-10 hours a day in the eighteenth century or sit at a computer today. But, let me remind you, in the eighteenth century, general surgeons provided eye health, there were no antibiotics, ophthalmology was only in its infancy. You are definitely lucky with the twenty first century. But most importantly, you can be calm about the need to change jobs. If you follow the rules, everything will be fine.

— What is changing with the appearance of age farsightedness? Any tips on points?
From a medical point of view, a «man with glasses» is not a patient. Under the influence of an adequate spectacle correction, the optics of the eye are translated into a state of emmetropia, and the person sees well both close and distant. After 45-50 years of age, the appearance of presbyopia (presbyopia) appears. This is manifested by difficulties in focusing objects at a close distance, regardless of whether you can see without glasses or use correction to give glasses or lenses. Presbyopia appears in all people over the age of 50. This condition can be corrected in several ways of surgery, but more on that in the following posts. If we are talking about glasses, then presbyopes are forced to use not one pair of glasses, but 2-3 different points for different distances. If you are too lazy to change glasses, you need progressive compound lenses. They have three zones: top for distance, the middle part is for an outstretched arm, the bottom part is for comfortable reading. The disadvantage (except for a fairly significant price) is slightly larger lateral distortions, but it is often more pleasant than frequent points changes.

— Do I need to talk about the computer during vision correction?
The examination report before laser correction includes a number of questions about the visual load, hours spent per day at the computer and your hobbies. This is also part of the calculated data. Age adjustments are also necessarily made to make you more comfortable at the computer with regard to presbyopic changes.

— Does everyone do with Habr.com ReLEx SMILE?
Most of those to whom this correction method is shown. If you have hypermetropia or mixed astigmatism (plus and minus in one eye) — ReLEx is not done. Many patients who are specially for the SMILE come or come to Moscow. In this case, you must count on three days in Moscow. On the first day we carry out diagnostics, the second day — correction, on the next day — inspection.
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