BY DR. KIMBERLY DOUGLAS
If there is one thing the pandemic has taught us, it is that
even in our best attempts to be accommodating and fl exible
to our “new normal,” stressors have a way of making
their presence known. Whether it is the occasional eye
twitch, blurred vision, headaches, or dry eyes, stress can
manifest itself right within our eye. Here is what to expect and tips
on how to manage it all.
Stress can be characterized as any change that disrupts the body’s
normal mental, physical, or emotional balance. If you consider the
compounding of prolonged quarantines, remote learning obligations
for students, changing social climate, everyday risk of contagion,
along with regular stressors as the holidays approach, it is no
wonder that your eye may experience an involuntary twitch or two.
Th e ocular eff ects related to stress can be numerous. Th ey range
from mild visual discomfort to severe vision loss. During the pandemic,
increased use of digital devices, longer working hours, and
fatigue from the demands of everchanging circumstances may induce
increased eye stress.
COMPUTER VISION SYNDROME
Contrary to popular belief, computer vision syndrome is a real
problem. It is caused by increased visual eye strain and fatigue due
to extended periods of time on electronic devices such as computers,
e-readers, tablets, and video gaming devices. Th e symptoms
can be both musculoskeletal from improper posture to visual
changes including blurred vision, double vision, eye dryness,
redness, and irritation. Digital eye strain can also cause eye soreness,
fatigue, and even trigger headaches. Treatment of this issue
includes ergonomic adjustments to your workspace, anti-glare,
blue blocking fi lters, proper lighting, increasing font size, taking
frequent breaks, glasses correction, and lubricating drops.
BLURRED VISION
As the adrenaline increases within our body during stressful events,
it causes the pupil to dilate, allowing more light in, which causes
increased light sensitivity and more blurred vision. Th is can also
trigger headaches or migraines that can lead to episodes of blurred
vision or blurred spots in vision.
VISUAL STRESS DURING
THIS COVID MESS
A less common occurrence is hysterical vision loss, a type of
vision impairment without a known structural or pathological
cause. Th is is otherwise known as “conversion disorder.” Th e suppressed
physical emotions (i.e. fear or anger) are manifesting as a
true reduction in vision. We oft en see this in younger individuals
who are undergoing stressful home or environmental changes.
Certain periods of high stress can also cause a condition called
“Central Serous Chorioretinopathy.” Increased cortisol in the body
can create fl uid build-up in the portion of the back of the eye responsible
for your central vision, called the macula. Mild cases can
be treated with stress management and observation, but more severe
cases are managed by a retinal specialist. Please see your eye care
provider immediately with any sudden onset of blurred vision. It is
important to determine the cause and fi nd appropriate treatment.
OCULAR MIGRAINES
Migraine headaches are a common neurovascular disorder associated
with stress or a release of stress. Visual auras frequently
precede or accompany these headaches. People experience a variety
of symptoms such as fl ashes of light, areas of blurred or missing
vision, tunnel vision, lights, and a kaleidoscope eff ect. Oft en these
symptoms can occur with or without the actual headache. If you
experience these, it is essential to have a comprehensive eye exam
to monitor for more serious problems aff ecting the back of the eye.
Uncorrected refractive error or binocular vision problems can contribute
to these symptoms as well. Some of the more serious problems
that need to be ruled out include retinal and vascular disease,
along with compressive brain lesions or tumors. It helps to keep a
headache journal to monitor the triggers which sometimes can
include food, alcoholic beverages, and caff eine. In addition to getting
the correct glasses prescription, vision therapy, blue blockers,
anti-glare fi lters, and tinted lenses can help minimize the frequency.
MYOKYMIA
One of the most common complaints we hear is “my eyelid has
been twitching for weeks.” Th is is called myokymia and is caused
by the involuntary, continuous contraction of the orbicularis oculi
muscle that surrounds the eye. Th is can be very persistent, oft en
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