Ghosting shortly after computer or close work

[m_k_kelly]

I experience vertical ghosting after approx 10 minutes of close reading-related or computer-related work. This effect will "wear off" gradually over an hour after stopping the reading or computer work. The ghosting happens in each eye, and does not go away when I cover the other eye. The ghost images are slightly offset from the solid images 10-20% opacity, which makes it difficult to read signage or recongnize people I know in the hallway or on the street. The offset of the ghost image increases or decreases depending upon the angle of my gaze (up or down). I can make the ghosting go away by squinting. When it is really bad, I seem to see a ghost image above AND below the solid image. I believe that the ghosting effect is with me all of the time, but when my eyes are rested (such as in the morning or when I have not been reading for several hours), the offset is very small, and tends to give everything a slight "blurred" look. Perhaps it is just much more pronounced after close work.

I have seen two optometrists, one opthamologist, and one neurological opthamologist. Neurological issues have been ruled out. The ghosting is not present when viewing through a pin-hole. The doctors tell me that I have no cataracts or other eye health problems. I have astigmatism, and have glasses which correct it. Wearing the glasses certainly makes the text on the computer screen or in a book clearer, and extends the amount of time I can read without the ghosting occurring, but it still does occur after 15 to 20 minutes. I try to look away from the screen for about 10 seconds every 10 minutes, and try to blink more often when I am viewing a computer screen. These strategies help, but only a little bit. The final result is the same vertical ghosting in a frustratingly short amount of time. At the advice at least two of the doctors, I have used artificial tears help alleviate dry eyes. I had good hopes for this, but the artificial tears do not help the condition at all.

I have the feeling that we just have not hit upon the right refractive correction that will stop the ghosting from occurring (or increasing) in the first place. Is it possible that the astigmatism correction is close but not exact? I very recently read a paper suggesting that objective refraction is the preferred method of evaluating some cases of astigmatism, particularly where monocular diplopia is present. Can you tell me more about objective refraction as opposed to subjective refraction, and if this might be a prudent next step?

[Ray T Oyakawa, MD]

You are very observant.  You are probably around 40 and hyperopic with astigmatism.

Get a cycloplegic refraction.  This paralyzes you focusing muscle and will give you an accurate distance prescription without the effects of focusing.


Dr. O.

[m_k_kelly]

Thank you for your response, Doctor.

Yes, you are close on the age.  I am 50.  I just got out of my optometrist's office, and he has proposed cycloplegic refraction as well. We have made an appointment to have that done within a week.

After researching this a bit, it certainly makes sense to me. Thanks for your participation in this forum.  I've learned a lot in the short amount of time since I have joined.  This is really a great tool for patients!