Ask HN: Do your eyes bug you even though your prescription is "correct"?

340 points by jbornhorst ↗ HN
I’m digging into an idea around eyeglasses, screen-time, and vision discomfort. If you wear prescription glasses but still get headaches, eye strain, or blurry vision after long screen days, I’d love to chat briefly (20–30 min).

Pure research, zero selling.

Interested? Drop a comment below or email me directly at jbornhorst [at] gmail.com. I’ll coordinate a convenient time to talk.

333 comments

[ 3.0 ms ] story [ 267 ms ] thread
Not sure if 20-30 mins of discussion is necessary for my case, but my case was simple. When the new prescription glasses arrived, the nose pads are not properly adjusted, resulting in the glasses sitting too high on my face. This means I'm looking through the bottom portion of the lens. This makes things blurry and causes headaches. Fortunately once the problem is noticed, it takes one minute to fix.
I'm amazed at how often I see people with poorly adjusted nosepads. In some cases I can see one or both pads not sitting flush on the nose, but digging in at an angle.
Or people with the temple bridges too short, so the ends don't go over the ears.
If you're over 40 and have been wearing glasses for years, you might now need a pair with a weaker prescription just for computer use.
Or progressives (aka bifocals.)
+1 - computer glasses especially as presbyopia sets in (around age 40) are surprisingly not well known. this has been a huge help for me.
What about computer glasses?
I have progressives and computer glasses.

If I accidentally wear the progressives at my desk, I usually notice within half an hour that I'm not comfortable.

With the computer glasses, everything is clear (including my laptop screen, which is below my monitor).

I have a prescription for "office glasses" which have been great.
What's the reasoning behind being over 40? I recently complained to my optometrist that I was having a harder time seeing things up close and he prescribed me weaker lenses for work/reading. My regular prescription is right around -7 in both eyes. I'm not over 40.
Presbyopia - the lens in our eyes begin to harden at age 40, making it harder for our eye muscles to "squeeze" the lens to focus. Presents itself as blurriness and eye strain. We usually encounter a change in our Rx during this time too, sometimes needing a weaker Rx (counterintuitively).

Would love to chat about your experience in any case. I'm at jbornhorst [at] gmail.com if interested.

Not OP, but would like to try it. How much weaker? And should I weaken the cylinder strength as well?
Don't trust random strangers on the internet!

You should ask a qualified or licensed optometrist or optician or whatever it's called wherever you live.

AIUI:

- you don't adjust CYL

- The amount you add is roughly 0.75, plus an extra 0.05 for each year above 40yo.

For example, at age 50:

Add = 0.75 + 0.05 × (50 − 40) = 0.75 + 0.5 = 1.25

So let's say that this person's regular glasses are -3.25 in each eye. Their computer glasses would be -2.00 in each eye.

Don't trust random strangers on the internet!

My optometrist set the adjustable lenses to what he thought was in the right ballpark and then had me read the chart at my requested distance for the computers lenses. A few adjustments, and done. They're perfect! Bonus: text is a bit bigger now, and I can read smaller fonts than I could before getting computer glasses.

The downside of this is that I now find it very difficult to read computer screens and my phone while wearing my distance lenses. The practice of holding things further away to be able to read them always was, I suppose, inevitable.

I'm nearsighted with no astigmatism, so I have a simple -2/-2 prescription (if I remember correctly).

I sit at a screen 8-16 hours a day. I get strong headaches every single day, for which I keep a supply of ibuprofen at work and home. 400mg a day is generally plenty.

I do not wear my glasses while at the screen, as it's close enough that I don't have any issues.

I suspect my headaches are neck muscle related, not eyesight, but I haven't investigated further.

How much water do you drink? How much are you sleeping? Is your room dark when you sleep?
I get 7-8 hours of sleep, in a very dark and quiet room. No loud neighbors, no room-mates.

I think my water intake is fine, but I don't have a specific measurement.

A good indication that you may be dehydrated is if your eyes are burning after a few hours of work or partway through a long drive.
Hey, thanks for replying! I’d love to chat briefly. Can you shoot me a quick email at jbornhorst [at] gmail [dot] com so we can coordinate?
I'll send a message once I'm home from work, which could be a couple hours.
Get your blood pressure checked just to be on the safe side. Those headaches could be caused by other health issues. Taking that much headache medication all the time is not good.
Does BP vary significantly throughout the day? Do I need to be measuring it while at work, or will a simple visit to a doctor be sufficient?

My last appointment was a couple of years ago, and I don't believe they raised any issues about it then.

I'll see about an appointment.

Taking pain meds daily for life doesn't seem like a good plan.

Maybe try e-ink? There are e-ink monitors on the market if that works, if the problem's the light. You can also try software like Redshift[1] for regular monitors.

If it's your neck, at least put some books under your monitor stand, if you're not able to get better monitor mounts. Or lower your chair. You should be looking straight ahead for your monitor, so your neck muscles shouldn't have to do much work.

[1] https://en.wikipedia.org/wiki/Redshift_(software)

If it's posture related, here's more free advise: try sitting on stools rather than on chairs with a back, and sit up straight and keep your arms actively powered while typing (not laying on a surface). Also, when you need to think for a minute get up and walk around.
A stool without a back would be very uncomfortable, but I do have ergonomic chairs (Herman Miller Aeron) which should do a decent job from what I understand.

The rest I'll consider though, thanks.

The point of sitting on a stool is that you have to use your core strength to sit up straight, and using that core strength reduces all sorts of pain in back and neck.

I didn't start doing that (sitting on stools) till I had been meditating for a long time, so it wasn't that different than sitting on the floor in half lotus position, which I had extensive practice doing.

I've been doing it for >10 years now; I will confess that when I have a meeting in a meeting room with proper chairs, I do really enjoy the chair back. It's all about using your body in a variety of ways.

E-ink isn't possible for either my work or home solutions. I cannot replace any of the work monitors. I do use f.lux while at home, though that only triggers later at night.

My monitor is at the appropriate height (eyes are roughly even with top of the screen) and distance (about arms-length), so I'm looking straight ahead.

>Taking pain meds daily for life doesn't seem like a good plan.

Definitely not a good plan, especially Ibuprofen. My mother took Ibuprofen for years to manage her arthritis and that absolutely wrecked her kidneys. Not to mention Ibuprofen can also cause internal bleeding. It's a quick short term fix but not a good long term solution.

> especially ibuprofen [...] wrecked her kidneys

As opposed to what? It's all metabolised by something, choose what you wreck. Take paracetamol routinely instead and you'll wreck your liver instead.

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IMO neither is good for chronic pain management. Ibuprofen reduces blood flow to the kidneys which causes (chronically) cell death. Weirdly paracetamol is bad for the liver as you mention… unless you already have a bad liver, in which case it’s somehow the recommended pain medicine? (For responses I’ve unfortunately forgotten).

It’s much harder to address the root issue (speaking as someone who’s taken their fair share of pain meds themselves), but it’s infinitely better in the long term.

Certainly didn't mean to suggest they are, especially not without professional medical advice. (Not just to check the dose or have a different one prescribed, but for a PPI to protect stomach lining from taking a lot of ibuprofen for example.) The non-prescription doses on the packaging are suitable short-term, for a one-off headache or to manage a fever, but continued use (a bad injury meaning your taking it several days even) should be with advice, that might differ.
If you haven't already, you should look into some stretches for tension headaches. For me at least, they don't make the headache go away completely (because often dehydration is a factor as well), but they sure take the edge off.
Are you using a laptop (looking downwards) or are you using a proper screen setup?
Proper screen setup, most of the time a 27-inch screen at about arms length.
This is a very important point. Staring down on a laptop screen strains neck muscles but it feels like you are getting headaches from your eyes.

Make sure your posture is correct when sitting in front of a screen before attempting anything else.

"I do not wear my glasses while at the screen, as it's close enough that I don't have any issues."

This could be the problem, especially if you are close to 40 years old. You may be starting to develop presbyopia, which is typical. In the early stages you can still read and focus on closeup things fine, so you may not realize it is starting, but in the background your eyes are, in fact, straining a lot and causing headaches.

I'm not in my 40's, but I'll keep that in mind, thanks.
If you're getting headaches every day and it's related to computer use, it might be worthwhile to talk to a professional about your workstation ergonomics, screen/font size etc. That is not normal. At all. I don't know anyone else complaining about having headaches daily. I put my monitor on an adjustable arm and it made a tremendous difference, just being able to move the monitor up/down half an inch throughout the day. Also as I've gotten older I've gone from 20 to 22 to 27" displays which helps.
I avoided glasses for years because no matter what, wearing them would give me horrible headaches. Then one day I went to a higher end optician, spent $1000, and have been comfortably using glasses since.

So maybe more selling, less research?

What is a higher end optician and how do you find one?
It's an optician that takes you to the cleaners in such a way that you feel good about it afterwards.
My guess is an ophthalmologist as opposed to an optician.
Can't speak for GP, but in my case it was an academic optometry center. Life changing. See my longer toplevel reply.
Sounds like you've solved it, but I'd love to learn from your experience. 20 min chat? Can you shoot me a quick email at jbornhorst [at] gmail [dot] com so we can coordinate?
Yes, I'm very nearsighted. I've worn progressive lenses for years but they continue to drive me crazy. I can see fine with them, but my eyes easily get fatigued and I have to take long breaks to get them to calm down.

Over the summer I added a pair of progressive occupational lenses (not reading glasses). They are focused arms length in front of me. This has been a complete game changer. I can now see my monitor crisply, clearly, and easily in a way that I haven't seen it in a decade.

When I swap back and forth between my regular lenses and my occupational lenses, the difference is stark. With my regular lenses there's a part of the screen that's about a half dollar coin in size that's clear and in focus. The rest of the screen is every so slightly blurry. I have to move my head to constantly adjust the focal point, or move my eyes and struggle to focus.

When I switch to my occupational lenses, the entire screen is clear. I don't have to move my head. I don't have to fight to focus. Where I look, it's crisp.

No wonder I was struggling! I was fighting to focus all day long. I suffer from almost no eye fatigue now. If my eyes are tired, it's usually because I'm tired and it's been a long day.

The downside is I now have to juggle two pairs of glasses instead of one, but that's oh so totally been worth it. I'm not going back.

Hey, thanks for replying! I’d love to chat briefly. Can you shoot me a quick email at jbornhorst [at] gmail [dot] com so we can coordinate?
Same, I have occupational lenses that are also focused to arms length, and it has made a huge difference for me as well when using it for reading things on my computer screens. It makes reading small text easier and feels crisp.

Using it outside of its intended distance will cause eye strain since your eyes won't be able to focus properly.

My provider calls them "computer glasses". It does not have blue light filtering as I do work with implementing web designs and color accuracy does matter to me.

I totally recommend computer glasses for anyone who works all day looking at a computer screen.

They would be a separate prescription / lens type (as in not progressive I think) compared to daily use glasses. I do have to swap to my daily use when not using my computer glasses outside of sitting and looking at a monitor.

Using my daily use for computer monitor reading doesn't feel "right" compared to my computer glasses. There is a clear difference between them.

>Using it outside of its intended distance will cause eye strain since your eyes won't be able to focus properly.

Mine are more useful that I anticipated when I'm not using them for work. I would advise against anybody driving with the wrong pair of glasses, but I can see significantly better with my occupational lenses than without. I would not trust them at night, but during the day I can see well enough I am not concerned about my driving. I don't intend to drive with them, but there has been the occasion here or there when I had to run somewhere quickly and forgot to swap my glasses.

It also helps that mine are progressives, so the very very top part of the lens is my "regular" prescription. I can use that to focus on something at a distance if necessary.

>They would be a separate prescription / lens type (as in not progressive I think) compared to daily use glasses. I do have to swap to my daily use when not using my computer glasses outside of sitting and looking at a monitor.

Like I mentioned above, mine are both occupational and progressive. I'd like to try non-progressive occupational lenses to see if I like them better, but I'm not convinced it would be worth the money.

Same. I've driven short distances sometimes to pick up lunch or something 5-10 minutes away because I forgot to switch my glasses. It wasn't ideal but perfectly doable.

I've only done it a handful of times, though. And also I wouldn't do so at night.

Would love to speak with you for 20 mins to learn from your experience. If interested, ping me at jbornhorst [at] gmail [dot] com and I'll coordinate times.
Me too. My progressive lenses give me eye strain and it is much worse at the computer. I have non-progressive lens for work and they’re much more comfortable. (Especially with my large monitor.)
> Using it outside of its intended distance will cause eye strain since your eyes won't be able to focus properly.

I don't find that at all, personally. I wear my computer glasses almost all the time in the house and just let myself not try to focus on things. If anything it seems to be better than my normal distance lenses for eye strain, for me, because my eyes do try to focus with my normal lenses since it's supposed to be perfectly clear, where I know there's a good reason they're not in focus when I'm not wearing them.

My distance glasses have progressive lenses, which may be part of that, as there's different strength depending on where you're looking at in the glasses. I've been tempted to remove progressive lenses from my next pair, as I tend to take them off to read anyway, and then I'd get a flat prescription like I have on my computer lenses.

this totally works. I also had a someone add in prism, which really did help fatigue. but for reasons I ended up using the occupational almost all the time, and ended up really screwing with my ability to use perspective to gauge distance. now I'm really poor at judging the sizes of things and I used to be able to tell you at half a meter if it was a 10-32 or a 5mm screw
The brain and visual perception system are incredibly adaptable, even to incorrect prescriptions. Some unwanted adaptions can be reversed by slowly changing any problematic parameters, like (un)training wheels. This would have been inordinately expensive before the era of self-service online glasses.
Unsure if this will work for your case, but I am _very_ happy with my implanted contact lenses. They sit behind my iris and optically function as normal contact lenses. No hassle, just a straight up body upgrade.

See https://en.wikipedia.org/wiki/Intraocular_lens

I was very surprised that this is not a more common thing to hear about amongst people with bad eyesight. Laser correction sucks in comparison, with more risks of complications, generally worse vision outcomes, longer recovery, etc. The lens implantation process is even undoable and as safe as cataract surgery which has been done since the 1970s.

Honestly, I'm absolutely terrified of doing anything that might damage my eyesight. I know the common procedures (i.e. Lasik) have come a long way in the last two decades and are very low risk, but they are not zero risk. I won't even wear contact lenses, I long ago fully committed to glasses. That type of procedure doesn't fit my risk tolerance.
I understand the hesitation, but that's the thing about this: It's even simpler than cataract surgery (where they actually _replace_ your own lenses instead of just flopping one in front of it), which is very very common, and very very safe.

See: https://en.wikipedia.org/wiki/History_of_cataract_surgery

IIRC the chance of complications for Lasik is about 10x that of the one for intraocular lens implantation. The nature of the complications for the latter is also more along the lines of "an eye infection for a month" instead of something permanent.

I definitely suggest researching it (and not mentally lumping it in with Lasik, because they are quite different). Cheesy, but my only regret is not having done it years sooner.

>cataract surgery, which is very very common, and very very safe.

Ever since my elderly friend had cataract surgery (5 years ago) she finds bright light painful, so she spends less time outdoors.

> so she spends less time outdoors

Instead of just wearing shades? That's silly.

I perpetually rub/touch my eyes. My big fear around these surgeries is weakening a structure such that damage is more likely.
you need to stop, that can cause keratokonus

try bandaids on your fingers, it takes 21 days to form a habit. buy a few big boxes, 30 bandaids a day is cheaper than a beer

I would still never bifocals or at least reading glasses. Once you reach around 45 everyone day. Lasix probably makes you need them sooner (but we are talking at most a couple years, not very significant)

I get my glasses in ANSI rated safety glasses so wearing glasses all the time doubles as protection from all the things that could get in my eyes. This is useful if you have hobbies where that is a worry, though for most people you are fine without.

> I would still never bifocals or at least reading glasses. Once you reach around 45 everyone day.

What are the rest of the words? Or the auto'correct'-corrections?

You would still wear* and after 45 everyone does* perhaps?

Sigh too late to edit anymore.

never should have been need

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Lasik et al are elective surgery on a critical organ.
>I won't even wear contact lenses, I long ago fully committed to glasses. That type of procedure doesn't fit my risk tolerance.

I feel similarly, but as the thickness of my glasses increases as I age, I'm starting to consider Lasik or similar. If I already had cataracts, implanted lenses as part of the cataract removal would be a non-brainer.

I did the same more than 10 years ago, still perfect vision. It did take around 15 minutes for each eye, with 2 weeks between and 10-15 minutes recovery time
In my case, I've had multiple ophthalmologists recommend against getting IOLs until I'm much, much older, as the risk of side affects (specifically retinal detachment) outweighs the benefit I would get from having them.

I still dream of being able to see first thing when I wake up.

> now have to juggle two pairs of glasses instead of one

This can be mitigated with custom magnetic clip lenses, e.g. Chemistrie. Tiny magnets are implanted into your current frame. Clip lens changes the focal length of your existing glasses by a fixed offset. Computer or reading clip can be changed in seconds. They also have polarized clips for instant sunglasses on your existing frame, which are better than Transitions/photochromic because they work while driving and are instant on/off.

It's an interesting approach. I used clip on sun glasses for years, but you still have the problem of having to juggle the clips and while they are smaller and easier to carry they are also far more fragile and easier to lose. I'm not sure they would provide any benefit over what I have now but it's good to know there are options!
> With my regular lenses there's a part of the screen that's about a half dollar coin in size that's clear and in focus. The rest of the screen is every so slightly blurry.

I have two glasses that have lenses with a similar prescription. The older one has some basic lenses and anything outside the center gets gradually less clear towards the edges. The newer one has aspherical lenses and even the areas near the edges are quite clear. It wasn't expensive either. The best lens I have used was probably a zeiss one but I'm guessing the full featured zeiss is probably quite expensive.

Do you find yourself swapping glasses a lot throughout the day, or do you mostly stick with the occupational ones when working?
I wear my occupational lenses 100% while working at my computer/laptop or doing some up close and small fiddly work (i.e. soldering a circuit board). I wear my regular glasses otherwise, but find myself frequently taking them off to focus on things close to me (i.e. if I want to read something really quick or use my phone for more than a quick glance).
That makes sense! It sounds like the occupational lenses have made a huge difference for screen work, even if juggling two pairs is a bit of a hassle
Yes, but the solution is simple — get up and look at something further away than my screen. I rely on my eyes bothering me to tell me that I need to get up and move.
Hey, would love to chat. Can you shoot me a quick email at jbornhorst [at] gmail [dot] com so we can coordinate?
This is called the 20/20/20 rule: every 20 minutes, look at someone 20ft away (or just close your eyes) for 20 seconds.

I wouldn't call it "the" solution: it's part of a complete breakfast.

I've had the bad luck that my first prescription was quite wrong: incorrect axis for astigmatism, and incorrect spherical (I basically have only astigmatism, no spherical). So for years I was suffering through the days. Optometrists flat out refuse to correct such mistakes (I've been to many!), preferring only minor changes. I finally started ordering a bunch of glasses cheaply online, and eventually found a prescription that works for me. Cannot trust optometrists anymore.
I found an ophthalmologist that gets my prescription right, with optometrists it's a roll of the dice.
I would love to speak with you. This is the exact case I'm interested in. I'm at jbornhorst [at] gmail [dot] com if you have 20-30 mins to spare.
Sometimes when I'm wearing glasses, never when I'm wearing contacts.
would love to chat. Mind dropping me a line at jbornhorst [at] gmail [dot] com and I'll coordinate a time?
I (nearsighted) wear glasses that are quite old at this point, I think ~7 years? My prescription has certainly changed since then, and I have had new glasses made a couple times, but the new glasses always make my eyes feel uncomfortable, despite improving my vision. I try them for a couple days and then give up and return to my 7-year-old glasses. It's been a while, so I don't remember my true prescription, nor the prescription associated with my 7-year-old glasses.
I think you'd be a great candidate for a 20 min interview. Ping me at jbornhorst [AT] gmail [DOT] com if you'd like to chat.
Slightly related: does anyone do eye “exercises”? As in, for 5 minutes, move the eyes all around in a 360 degrees fashion, alternating with left to right (and right to left) movements. I use the computer many hours per day and that means my eyes are usually fixed at a 27 inch monitor for hours. I think the exercises are “strengthening” my eyes muscles… not sure if true though.
This might be vestibular or neurological in nature. I had a vestibular condition that affected my eyesight and did rehab and they gave me eye exercises that helped somewhat. Fast forward a few years of struggling and I found that it was caused by migraines (not the painful kind, just brain disruption). And those migraines are caused by temporal lobe epilepsy. But that part isn’t important, it’s that all sorts of migraines caused by all sorts of issues can disrupt eyesight. And I think it is more common than people realize because there is no pain. It can cause eyesight issues, brain fog, and potentially dizziness. You need that brain to see so if it is disrupted often your sight will be as well. I am surprised people are talking about neurological angles.
The term to Google for this is "vision therapy": there are several tried and true exercises.
I'm nearsighted with a slight bit of astigmatism. (-6 or so). I got progressive lenses the last time around at the optician. I hated the whole process; it was desperate and high-pressure sales. I hate the progressive lenses because using them requires tilting your head at awkward angles. I hate that the near-sighted prescriptions are regulated as much as they are.

I ended up self-serving at eyebuydirect.com. For the price of the highway robbery at the local optician I got 6 pairs of reasonable quality frames with regular lenses stepping along a range I guessed I need for computer work. And I couldn't be happier, even though I ignored the astigmatism bit. It's possible there is a bit of that engineer DIY itch that got scratched in the process as well :-)

I would LOVE to speak with you. 20-30 mins? Drop me a line at jbornhorst [at] gmail [dot] com?
Well done. EBD lenses are made by the same company that sells to local opticians.

Progressive lenses also influence visual perception after years of use, unlike old-school bifocals with a clear shift in focus.

I also recommend eyebuydirect.com. Although it's part of the eyeglass monopoly (Essilor Luxottica), they have frames that are good looking and affordable, and all the single vision lenses are cheap except for the 1.74 high index ones.
> they have frames that are good looking and affordable

Some of their frames are clones of expensive, popular frames from boutique designers. Perhaps that's why they are retired after a while.

Anecdotally related, but, during Covid and remote work I went to an optometrist around age 35 after I noticed my distance vision was blurry, especially at night after working inside all day.

They told me "you have 20/20 vision, your vision is completely fine, you don't need glasses!" But, I responded, my vision is definitely blurry. They politely told me to stop wasting their time.

Dissatisfied, I went to another optometrist, and paid closer attention to the whole process. After some discussion with the doctor, we arrived at the conclusion - I've had essentially 20/7 vision my entire life, and now in certain circumstances my vision has degraded to 20/20!

They gave me a prescription and now I am perfectly happy having laser-sharp vision again when I want it.

How the hell did you convince your optometrist to correct your vision to 20/7?

The past two docs I've been two have ignored me when I've said "I can make out the letters, but they're blurry and fuzzy. Can we go stronger?" with "Well, that's corrected to 20/20 vision.".

I'm very, very strongly considering finding a used eye-testing-headgear thingie like they have in their offices, learning how to use it, and doing the testing for myself.

Search "trial lens set" and "trial lens frame", the portable versions which were used for decades in the past.
Wow...thank you for this phrase. I always thought it was impossible to find prescription lenses online, and there's a box with literally all of them...
As recommended elsewhere in this thread, EyeBuyDirect is quite good if you have enough knowledge to specify your own glasses and fitting. They are owned by upstream BigLens™, so lens quality is comparable to many opticians, with low pricing since they make their margin on frames. If you need custom fitting height for one of their frames, you can measure and return after receiving the glasses, then they will remake a new pair for free within 14 days of receiving the first pair.
I've used GlassesUSA.com before as well. I kind of switch between them depending on who has a better sale for my kids' glasses.
Oh, sweet. Thanks very much for this new and useful vocabulary.
That's odd. Most optometrists I've seen over my life (and specifically here in Canada, BC) will keep trying to adjust and ask you if it's sharper or not before they settle on the numbers. They'll go higher or lower power and/or astigmatism in different increments. They're also generally pretty cool with things like testing with a laptop monitor and getting the sharpest computer prescription.

Maybe this is your sweet spot?

> Maybe this is your sweet spot?

I doubt it. I played around a bit with the hand-lenses and was able to get a much more clear picture by increasing the lens strength more than the doctor was willing to.

If the doctor was making any sort of tradeoff, they were not informing me of it. They kept asserting that I was "corrected to 20/20" when I protested that the letters on the chart were still quite fuzzy. If they'd have informed me of a "close range vs. long range" lens tradeoff, I would have happily informed them of my willingness to have multiple pairs of glasses.

Would love to chat if you’re up for it. I’m at jbornhorst [at] gmail [dot] com
Also look at a doctor specializing in small prisms. Sometimes your eyes don't perfectly align at their resting state so one eye is constantly constantly using muscles to pull it centered. For me, that means when I get tired and those small muscles can't keep up, I get headaches and it gets worse. Neurovisual places can give very tiny prism additions so your eyes don't have to move but the light is "shifted" over.
Also there are very cheap prescriptions sites online which ship. You can try different prescriptions, with varying power (magnification) and see which works for you for computer, reading. I found that the computer glasses prescribed were way to strong (all they do is subtract .25 from the first number on both eyes, often). But if I only subtract .1 it was perfect, helpful for computer sessions but if I look up everything isn't blurry
would love to chat to learn more from your experience. i'm at jbornhorst [at] gmail [dot] com if you have 20-30 mins to spare.
I had this issue until I got a 2nd prescription by a different provider and new lenses. Sometimes lense material etc also matters. Bigger PITA than I thought getting glasses was going to be.

Nearsighted, left eye worse.

Lens material absolutely matters. Glasses suffer from chromatic aberration, and this causes visible rainbows away from the center of the lens. A material with a higher Abbe number will perform better.

For common lens materials, polycarbonate has a low Abbe number, and Trivex is a widely available alternative with a higher Abbe number. You can find tables online for common lens materials.

I will say this: if you're not happy with your current prescription, there are ways to get a more intense workup and better outcomes by going to an academic optometry center. In my case, I went to the New England College of Optometry and got prescribed a special type of contact lenses ("scleral" lenses) which have been a major quality of life enhancement.

They're expensive, there was a learning curve for getting them on correctly, and it took several followup appointments to get the correct fit from the manufacturer, but I can wear the lenses almost all day and they give me clear, sharp, 20/20 vision.

Also, when I'm wearing them I need reading glasses to read up close--my uncorrected vision actually compensates for my slight age related nearsightedness. But my vision is so much better I don't mind at all!

The back story is that I had lifelong astigmatism and 2 eyes with different powers (one more farsighted than the other one) which led to some mild amblyopia (lazy eye) that I've had since childhood. My vision wasn't "that bad" so I got by without using my glasses for a long time. But when I tried using my several year old prescription glasses I found that presbyopia (that age related inability to focus on anything up close) made the glasses almost useless for reading.

Even though I'm a dev who looks at screens all day, I didn't think I minded, but I noticed in recent years that my appetite for reading books had disappeared was partly due to noticeable eye strain, but also due to generalized eye fatigue that I wasn't really acknowledging. I also had to sit up front in meeting rooms to follow along with anything projected on the screen, which was annoying.

A colleague mentioned the book Fixing My Gaze (https://www.google.com/books/edition/Fixing_My_Gaze/Ul16tPVk...) and I bought it. It's partly a personal narrative by a neuroscientist who was stereoblind and taught herself to develop stereo vision in middle age (she was profiled by Oliver Sacks at one point). But it's also a history of research optometry, which focuses on refractive vision correction and visual processing (as distinct from eye diseases) and which I barely even knew was a thing. Which led me to NECO and my big quality of life improvement!

I just recently got sclerals for dry eyes and I'm still going through the adjustment process. Usually they are prescribed for keratoconus (misshaped cornea) and not something most people need. The doctor actually said it's more challenging putting it on someone without keratoconus (like me) because I am used to having fairly good vision with my glasses and sclerals aren't as easy to get right as glasses/normal contacts. They have been amazing for dry eyes so far though.
Two factors worth looking at:

1. Base curve. Some people are bothered by lenses with a high base curve. Talk to an optician.

2. Flicker. Lights that flicker can cause headaches and other issues. This includes many LEDs, especially ones from more than a couple years ago, as well as old CRT monitors. “Driverless” LEDs are a major offender. Some modern “low persistence” displays could also be problematic. (I have no idea why anyone wants a low persistence monitor. I understand why low persistence is useful for VR, but monitors aren’t VR.) There’s a standard called IEEE 1789 that the industry mostly ignores.

have you talked with an opthalmologist?

what's your eye pressure?

I am very nearsighted (-7.5 in both eyes), I've worn daily contact lenses almost exclusively for 20 years. I also have non glaucoma ocular hypertension which puts me at a higher risk for retinal detachment. I have no headaches or eye strain after long screen days, but I do get blurry vision and lots of floaters after long screen days. If you want to know anything else I'd be happy to chat.
would love to chat - i'm at jbornhorst [at] gmail [dot] com if you have 20-30 mins to spare.
Yes, they bug me.

I am nearsighted (-7.5 with astigmatism in left, -6.0 in right).

Recently been experiencing slight spasms and fatigue in the left eye. Always been very sensitive to light changes. Dry eye isn't frequent (yet), but I assume will get more so with age.

Night-time driving is awful even with full correction, it seems like I get afterflashes for a fraction of a second after seeing every single oncoming vehicle.

I would love to speak with you. This is the exact case I'm interested in. I'm at jbornhorst [at] gmail [dot] com if you have 20-30 mins to spare.
My eyes have always bugged me, but I've also had allergies. It's also become clear over time that I have pretty bad astigmatism. I've always been farsighted.

I first got "dimestore readers" specifically for computer use, to reduce eyestrain. When I put them on at the beginning of the day I'd notice some weirdness (phantom artifacts and double vision) but my brain would cancel it out and all was good. After about a decade though, I wasn't noticing those artifacts at the beginning of the day, but while driving home I'd see double. That led to getting prescription glasses, and learning lot about astigmatism.

Until recently, I always tested better than normal at infinity without glasses. At infinity, most of my correction is astigmatism. Corrected, I'm still 20/10. But here's the "weird trick": I've learned that it's something that my eyes / brain are doing combined with the astigmatism. I can still conjure "hot spots" with near perfect clarity even without glasses, but it strains my eyes (I don't get full FOV clarity without glasses anymore).

I can't stand progressive lenses, although I have a pair for super close-in work. All my task glasses are "single pane of glass", my "infinity" glasses are bifocals. These days my eyes are more comfortable wearing the infinity glasses than not. The truly noticeable difference with glasses was night driving: no more stars! Huge reduction in eyestrain and improved basic ability to see when challenged by oncoming headlights; I've combined that with some aggressive rose tint in a pair specifically for night driving (very 70's mod frames. woot!).

I'll never get Lasik because I've been told repeatedly that if I did so they wouldn't be able to correct me to 20/10 any longer.

Would love to chat. Drop me a line at jbornhorst [at] gmail [dot] com and I'll coordinate times.
They won't officially try and correct to that level. I did maintain 20/15 both before and after, but still have a mild astigmatism, so I still wear glasses
I've coloured lenses that sort this out, I have meares irken syndrome.
I'm in my 50s and about 3 diopters farsighted. I had trouble getting a good prescription for screen glasses. My optometrist insisted that +1.25 was the right correction for desktop screens, but it gave me eye strain. I like my screen a little closer, or else my corneas are extra-stiff. Anyway, I tried a few versions and found that +1.75 was better for my desk setup.

Tip: Zenni.com lets you order pairs with custom corrections in 0.25 diopter increments for under $100 each, so you can try a few and find what feels best for several hours of screen time.

Up to +3 can easily be tried on and bought at a drugstore.

I’m severely myopic (-11), though that is corrected completely by contacts. Presbyopia, alas, hits us all.

Well, I need a substantial astigmatism correction too. I've tried combining both -- my prescription distance glasses with drug-store reading glasses over top -- but it's wobbly and limits my field of view to less than a whole big monitor.
I'd love to speak with you, especially given that you've already tried multiple test Rx's. Email me at jbornhorst [at] gmail.com if interested?
You can also just get an optical trial lens set like they have at the optometrists for less than 200$.
Could also be something as simple as lacking proper hydration.
The solution for me to eliminate headaches when working at computer screens was getting an extra set of intermediate distance glasses specifically for computer work. The "computer screen distance" of 3 ft is in between book-reading distance of 1 feet and driving distance 20'+ feet. I also avoid progressive lenses or high-index lenses for computer work. I commented about how arrived at this solution previously: https://news.ycombinator.com/item?id=15375221

Reading glasses work fine when the screen is very close to your face such as a laptop screen. However if it's a separate monitor that's ~30 inches away, reading glasses are slightly blurry which can lead to eyestrain and headaches.

https://www.warbyparker.com/learn/wp-content/uploads/2023/04...

Look into it if you suspect it's a contributor to headaches: https://www.google.com/search?q=computer+glasses+%22intermed...

> I also avoid […] high-index lenses for computer work.

Yes! You're the first to mention this.

It's not refractive index itself that's the problem, it's dispersion (roughly, the degree to which refractive index varies across the visual spectrum, described by ‘Abbe number’). We've all seen pictures of a prism splitting a beam of white light into a rainbow — for visual purposes, the less split the better.

Higher-index materials tend to have poorer dispersion, but especially in the mid-range 1.6ish, there are wide variations in quality at the same index. Glass tends to be best, if your prescription is light enough that you can handle the weight. Polycarbonate and acrylic are awful. MR-8 is in the middle, and what I've settled on for recent computer glasses.

Hear, hear!

Here's a good way to test your glass's refraction index. On your desktop find a small red icon with something white in the center. Stare directly at it. Now turn your head until the icon is at the edge of your vision. If your lenses are cheap polycarbonate, the white part of the icon will appear to move towards the edge of the icon or even out of it.

Most non-cheapo glasses today in the US use Trivex. It's a polymer, not glass, but its Abbe number is 43, which is perfectly adequate.

Crown glass, with its Abbe number of 59, is superior, but the eyeball can discern differences only up to 45-50, so most of Crown glass's improvement over Trivex is imperceptible.

This is partly why it's not offered in glasses (again, in the US, at least according to my optometrist). It is also twice as heavy, shatters (polymers like Trivex don't), and scratches more easily.

Among non-glass options, CR-39 is a good choice for computer glasses with prescriptions weaker than -5:

  - high (58) Abbe number
  - thick (1.5 index)
  - cheapest
Thickness and weight can be mitigated with a smaller frame, e.g. vintage options.

Actually buying CR-39 lens might require solving a dark pattern maze of online or offline options, since the cost is so low.

My indoor (non Transitions™) multifocus² glasses are CR-39¹.

I'd used the same material for my outdoor/sports/driving frames but it's higher density caused them to slide down my nose during activity so the next pair I opted for Trivex.

--

¹–CR-39 requires full frame spectacles, as drilling holes is verboten.

²–Shamir Autograph III, awesome & highly recommended.

I don't know which type of glass my glasses have, but I know I had to pay a ton for it, because the cheaper sort can't handle my prescription without being really thick and/or heavy. But as someone that actually wears my glasses all the time and not just randomly, it's worth the extra expense.
Interesting, is the lens ultra high-index? How's refraction? As far as I'm aware, high-index, as the index becomes higher, generally will have a progressively worse Abbe number.
A fun fact I learned recently, after years of casually skimming color science, is that our eyes cannot focus the entire visual spectrum at once.

That’s why our cone response to the spectrum looks like https://en.m.wikipedia.org/wiki/Cone_cell#/media/File%3ACone... instead of having cleanly segregated red vs. green responses. If it was segregated, we could only focus on red or green but not both. By having a heavy overlap, we can get a sharp focus on yellow. And, the visual system makes the full spectrum work by deriving the red vs. green concepts from the difference between the two cone responses. Blue focus is accepted as a necessary sacrifice.

>instead of having cleanly segregated red vs. green responses.

I suppose that's why r/g colorblindness is so common.

One problem I have (well, one of many these days, including some double vision, sigh) is that I'm very far sighted in one eye, and near sighted in the other, so one lens is barely anything, and the other is a coke bottle.
It's not just about the material. It's also about how the lens is made. For me, choosing "freeform" over "aspheric" was night and day.
Where are you ordering glasses from that you can make selections like this?
Firmoo for example. Probably a local optician should also be able to make this choice.
A few years ago an optician convinced me to get some fancy 1.67 index lenses, but I couldn't deal with the chromatic abrasion. The text at the peripheral parts of my monitor were clearly split into their RGB components. For frontend work it was impossible, as I couldn't tell if something was not aligned or it was just the chromatic abrasion.

Now I always go for the thickest lenses (which are also usually the cheapest) for this reason. My prescription is -3.75, and there isn't any noticeable difference with thinner lenses.

All the high index lens materials suffer from chromatic aberration.

The lens material you've now chosen actually has the best optical properties out of all the plastic lens materials. Its only downside is that the refractive index is only 1.5 which does mean they will be a little bit thicker than the high index ones.

You could also try a material called Trivex which also has low chromatic aberration while being a little thinner than the material you are using which is called CR-39

You could also try Trivex instead of MR-8. Lens thickness should be similar but it has a higher ABBE value.
This worked for me as well. I just asked the eye doctor for something that would work just past my out stretched finger tips which is where my monitor lives.

What kills me is going into the office where I am switching between glasses. Different rooms with different Zoom screens. At home is much nicer where I just have one big monitor to watch.

I take my glasses off to read my phone most of the time. Technically my primary glasses are progressives but it is nicer to take them off.

> I take my glasses off to read my phone most of the time. Technically my primary glasses are progressives but it is nicer to take them off.

Same. I wear progressive lenses and I feel like they do fine as far as being able to read the text on my phone or for reading a book. But I tend to take off my glasses anyway to do these things. I'm not entirely sure why this is since I seem to be able to read the text fine with the glasses. My hypothesis is that I like being closer to the text so that it fills up more of my visual field which helps me mentally focus on the text better.

Same - the funny thing is that right now my 3-foot prescription is zero (plus a bunch of astigmatic correction). Apparently my mortal frame has accepted its purpose.
I use a 60" TV and get farther from it. Stopped needing glasses.
I don't wear glasses (yet) but came to this thread to ask what effect this would have. (I do a good chunk of my computing on a 65" display at 2m.)
I also regularly look farther away out the window and back inside. That kept me going back and forth on needing glasses for years, but when I set up the monitor, no more need for glasses. (I'm 65)
I'm in a similar boat.

I'm nearsighted and don't need glasses to see my computer screen clearly at all. But nevertheless I started getting headaches from eye strain.

Went to the optometrist, got a pair of glasses just to reduce eye strain at screen distance. Zero difference in sharpness, but I can work all day long with zero eye fatigue.

I use different corrections for laptop at about 18-28" and reading in an armchair at 15-23" -ish. It's really not a big difference in distance!! - and still very noticeable.

It's not for avoiding outright headaches (I don't get vision headaches) but it's clearly more comfortable. It's quite possible that what's pleasant is in part the change of pace - but it is also better adapted for sharpness.

Same here: my reading glasses are great for reading, but when I work with computers, my screen is halfway between wrist and knuckles on an extended arm. That's too far for reading glasses. So I got a set of intermediates and things are great. I use them for working with a screen or a laptop, while I use the reading glasses for reading, soldering and other work where the objects I'm looking at are within 40cm of my eyes.
> book-reading distance of 1 feet

12 inches?

that's way too close

Can’t find the message you’re replying to but I think you’re imagining the person sitting up.

Imagine them lying down or propped up on their elbows with the book on the floor. Then that distance seems about right.

That's way too close for books or screens. Long term it can cause myopia.
I thought this had been debunked as the cause of myopia?

(Or am I totally misremembering something...)

What sort of prescription is right for Oculus?
You can get specific insets for the headsets from places like VR Optician. I’ve had some made with my normal prescription and they work perfectly. The people running VR Optician are actual opticians so you can also ask them if any correction factor would be needed for your particular situation.
I can second this, after getting PRK I ended up slightly farsighted after being majorly nearsighted, I did a intermediate pupillary distance between my distance PD and near PD and its great for how I use a computer which is 99% of reading I do.
I only need a basic 1.0 reading prescription but I have about 5 pairs of glasses. I'm hyper-sensitive to even the slightest deviation in prescription.

Currently wearing, to look at arms-length monitor screen, add +1.0. Will move out to the porch to read and switch to add +1.5. Will come back to cook and switch to my basic prescription.

I must put on and take off 300 pairs of glasses a day. But I don't care. I can't do anything else.

I’d love to speak with you - your experience is right in my target zone to research. If interested ping me at jbornhorst [at] gmail.com
That makes a lot of sense. I've heard of people using computer-specific prescriptions, but I never really thought about how much difference that intermediate distance can make. I wonder how many cases of "mystery" eye strain are just from using the wrong focal range all day
I do the same. In fact I usually just wear the intermediate distance glasses all the time around the house, and only switch to my primary glasses when I leave the house. Considering I work from home that can mean that I wear my intermediate glasses almost all day long most days.

That almost seems to reduce eyestrain as well, at least for me, as they're still good enough to see everything (I can't read text across the room but I can halfway across the room), just not without some light blur on things, and I seem to have trained my brain to stop trying to focus on things, just let it stay in the blur (at least while I have my intermediate glasses on), and that seems to relax my eyes more.

But the intermediate glasses are super clear for when I'm on the computer, which is a good chunk of the day and where I really need to see nice and sharp, as I'm manipulating things with pixel precision at times (game ui, web ui, board game graphic design).

How do you do with driving and seeing smaller things on your automobile dashboard? I'm up around 7 diopters nearsighted so maybe it depends on the range of needed focusing.
I have a very weird situation where my right eye was fine but my left, for reasons unknown, has a thicker lens. This can be happen with cataracts but I'm just under 50 and have zero clouding. The eye doctor said it's not myopia in the "usual" sense but the end result is the same: myopia prescription lens.

Thing is, I ignored it for about 10 years and my brain simply ignored whatever signal was coming from that eye. I'd look at things and see no blurring unless I closed my right eye. However, at a certain crossover distance my brain "switches over" because my left eye has amazing close vision and my right eye doesn't. I can actually feel it when this happens, like a physical sensation. No headaches, but it is "odd".

Anyway, I decided to get glasses, and it turns out I need two different prescriptions. One is close up (not longsightedness, it is still a myopia lens). The other is for 1m-∞

A myopic prescription can actually be good for seeing things close up but not in the distance- explains why you’re able to see close up with that eye OK
I got a pair of these just before Christmas and they've really helped - I tried "occupational lenses" which are a strange bifocal with a central focus of 3ft and then outwards it changes to the reading prescription, did not work with how I use the display in that my head is usually fixed and I move my eyes.

The intermediate distance lenses are great and my headaches have vastly reduced - because they were specific for VDU, my work paid for a portion of them.

>The solution for me to eliminate headaches when working at computer screens was getting an extra set of intermediate distance glasses specifically for computer work.

My wife is getting bifocals for basically this same reason.

I'm not sure I'm entirely on board with the idea that we've got optometry down to the point where anyone can claim to have arrived at the correct prescription without the wearer having tried a bunch and finding what works in reality. Having worn glasses for over 75% of my 40-ish year life, I've come to the conclusion that optometry is as much art as it is science. I think every time I've gone to a new optometrist, I've been told something along the lines of "wow, your old prescription is way off" and ended up with a half diopter or more change.

I don't sit at a screen much these days, but for a while when I did, I had a computer prescription pair that I swapped on every day when I sat down at my desk, and swapped off when I went to leave. The distance vision with it was good enough to walk around the office or down the road to lunch, but not good enough to drive to and from the office.

After moving and getting a new optometrist, I got a different main prescription, and was told to try wearing them at the computer instead of swapping. Lo and behold, they worked without causing headaches, which is why I ended up with a computer pair previously.

For all of the time I've been in glasses, I've read books without them.

I'm probably not interesting to talk to, because I'm no longer in front of a computer when I can avoid it and I'm in my 40's so I'm staring down (pun intended) some vision changes in the near future anyway.

Minus 2 or 3 in both eyes with a cylindrical correction as well.

I recently made an optometrist appointment, and was surprised to discover that I could do virtual appointments. And they were a lot easier to get.

I'm skeptical that that can work. I suppose you can administer a basic eye test and get a close-enough prescription, but this is really important and I want to get it exactly right.

I kinda wish I could give it a try, just to see what they can manage to do without all of the tools that an optometrist would apply. But I've got some concerns (which is why I made the appointment) and I'd rather have somebody look closely.

Getting your correct prescription is easy. They have had machines that do that for 30 years. The optometrist might tweak that a little, but the machine is good enough.

What you also need though is someone to look into your eye and machines still don't do everything an optometrist does there. (though there are other machines that do things your optometrist cannot)

There is no way that some computer or smartphone app can replace optometrist equipment. I have different prescriptions for reading glasses and occupational glasses, the distance difference is about 20" and it does call for different lens.

Furthermore an assessment by an optometrist should also check for glaucoma and macular issues.

I’d still love to chat for 20 mins if you’re up for it. Want to better understand your frustration with the typical optometry process. I’m at jbornhorst [at] gmail.com.