How to prove chronic eye strain to get a PH certificate?

[nav43242]

Hi. I've had myopia since 1997, and didn't have any issue other than the usual eye power increase. Eye power is currently -4.5 (R) and -4.75 (L). From 2009 to 2012 I suffered severe sleep loss (able to sleep only 4 hours at night) which resulted in chronic eye strain of the extraocular muscles. Twelve ophthalmologists have checked me and found nothing else wrong with my eyes. Not even astigmatism. But any work (like computer work or even driving) that requires holding the eyes in position for a long time or sleep loss makes my eyes (extraocular muscles) feel sore and they remain sore for two weeks and I also get sharp stabbing pains behind, above and at the sides of my eyeballs. The ONLY cure I've found is to get at least 7 hours of sleep and to close my eyes for 10-20 minutes after each hour of computer use and working for not more than 6 hours everyday. Ever since I've started getting better sleep, my eye strain has been reducing extremely gradually. Being a software engineer, I'm now unable to do the requisite amount of work, so am unable to find employment. Is there a way to prove that I have chronic eye strain? The eye surgeon who has been treating me said she couldn't give me any medical certificate. At least the oblique extraocular muscles are more easily accessible, so shouldn't there be some way to prove it?

[JohnHaganMD]

First of  the eye muscles have 10 times the muscle power needed to move the eyes so they are plenty strong.  Second there is a world wide increase in the amount of time people spend doing near tasks reading but especially the use of video screens (computers, phones, ipads, etc.)  as a result of this several things are happening:   1.  an increase (epidemic actually of myopia,  prolonged near work especially in the young causes myopia.  2. An epidemic of dry eyes even in the young.  Normally we blink about every 5-7 seconds. When we read or use a electronic screen near us we blink about once every  15-20 seconds.  3. Eye discomfort and strain.   If you had a job where you were on your feet all day your legs would get tired and you would want to sit down and rest. If you look at a screen for hours on end same thing happens with your eye but it is not usually the extraocular muscles but the internal (ciliary body) focus muscle that get tired.

ALSO  there are some difficult to diagnose eye muscle problems  1. strabismus  or latent strabismus and 2. convergence insufficiency that can cause problems with near vision.

I suggest you see an strabismus specialist (sometimes call a pediatric ophthalmologist) to be sure you don't have the latter.   Suggest also you discuss computer glasses.

Finally follow the 10-10-10 rule  (there are many variants one is 15-15-15)  that means when you use a computer, read a book, play video games. Every 10 minutes look away from the screen to the farthest point you can see (further than 10 feet) and blink forcefully 10 times.  You can also insert artificial tears every 2-4 hours.

JCH MD