Managing Eye Fatigue: Tips for Relief and Treatment Options - Ophthalmology

Eye fatigue

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Hello, Doctor.
I apologize for bothering you, but I have a long-term issue that I have not been able to resolve, and I would like to seek your advice.
I am 28 years old and have myopia of about -7 diopters.
Over the past five years, I have experienced multiple symptoms described below, which have become particularly frequent in the last six months.
Every time I work on the computer, read documents, or even use my phone during breaks, I easily feel discomfort, to the point that it occurs almost every workday.
Sometimes, after working for two to three hours, I feel very uncomfortable and need to close my eyes and lie down to rest.
This is truly distressing.
1.
I experience soreness around the eye socket, extending to a feeling of pressure and soreness at the temple, all occurring in the left eye.
2.
In the left posterior neck area, just below the occipital bone, I feel tightness, as if a deep point is being pinched.
3.
The front left side of my neck, around the sternocleidomastoid muscle, also feels very tight.
4.
The lower left teeth and the area below the left eye on my cheek also feel sore.
5.
The left shoulder and the area where it connects to the neck also feel sore and tight.
6.
I find it easier to have blurred vision when looking at things up close, and sometimes my eyes do not focus properly, resulting in double vision.
7.
My eyes tend to have discharge.
8.
At night, I experience glare, meaning that car lights appear particularly bright and cause discomfort to my eyes.
I feel that this is not simply a neck issue (as my eyes do not feel sore when I have a stiff neck), but my eyes also feel uncomfortable.
Therefore, I have previously consulted both ophthalmology and orthopedics, and even visited a traditional Chinese medicine practitioner.
1.
Ophthalmology: During the examination, it was found that my optic cup-to-disc ratio is larger than normal, and my intraocular pressure is around 20.
The doctor initially suspected glaucoma.
After visiting a glaucoma specialist at a major hospital, the doctor diagnosed that it is not glaucoma but rather a physiological large cup, and I only need to follow up once a year.
Later, I continued to follow up at a small clinic, where the doctor mentioned that I am on the "borderline" of a glaucoma diagnosis, but it is still not classified as glaucoma, and I was advised to continue monitoring.
Regarding the symptoms I listed above, the doctor simply stated, "Glaucoma does not present that way" (however, I found online that neck pain could be a symptom of glaucoma, which left me puzzled).
In the end, I was prescribed eye drops to relax the ciliary muscle, but I still frequently feel discomfort, and the improvement from the eye drops is limited.
I have also followed the doctor's advice for warm compresses, but the effect has been average.
Additionally, some doctors suggested that I might have early-onset presbyopia.
When I got my glasses, the optometrist mentioned that my left eye seems to have a slight issue with esotropia, but he said it is not significant enough to require special lenses.
2.
Orthopedics: The orthopedic doctor took X-rays and mentioned that there is "suspected mild disc herniation" in my neck.
However, the doctor also said that it should not cause pain that frequently and that it is always related to my eyes.
In the end, I was prescribed some anti-inflammatory and pain-relief medications.
I have also undergone out-of-pocket physical therapy and learned to correct my posture, but the improvement has been limited, and I still easily feel discomfort when reading or using the computer.
In any case, this has severely impacted my daily work.
However, my experiences during consultations have not significantly improved my issues.
Moreover, the doctors I see are often busy, and they only prescribe medication without providing much advice regarding my condition.
Therefore, I sincerely ask for your help.
Could you please provide me with some suggestions for follow-up consultations (what approach should I take for treatment and how should I communicate with the doctors) and recommendations for improvement (should I consider getting reading glasses)? Thank you.

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Ryan, 20~29 year old female. Ask Date: 2023/06/13