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Computer Vision Syndrome
Presbyopia and Dry Eye

Document from the American Optometric Association

Criteria for Determining Whether the Need for Eyeglasses or Other Treatment is Related to Computer Use

There are many aspects of computers and the work environment in which they are used that may cause or contribute to the development of eye or vision difficulties. To obtain optimum visual comfort and work efficiency, all computer operators who could benefit from a visual correction should wear it. One way to help ensure this is to remove financial barriers to the employee for obtaining an eye examination and, when needed, treatment for eye and vision problems. This can often be accomplished by having an employer or third party sponsored program that provides eye care services for employees who work at computers.

As part of an eye care program for computer operators, it may be necessary to determine whether any treatment, usually in the form of eyeglasses, is specific to the computer task or whether the same glasses or treatment would be required for general vision needs. This may establish whether the employee is eligible to receive occupationally related eye care services under the program.

Whether a particular vision condition requires correction with eyeglasses or other treatment depends upon the clinical findings and the judgment of the examining doctor. However, the following criteria are recommended to help determine whether the care provided is computer related. These criteria are based upon the individual diagnosis and/or prescribed treatment. Since it is necessary for computer operators to have an eye and vision examination to determine whether these criteria are met, it is recommended that an examination be provided as part of the computer eye care program.

Glasses or other therapeutic eye care services may be considered to be computer related if:
  • The person would not require the use of glasses or other treatment for a less visually demanding job, or
  • The glasses required for work at the computer are different in prescription power or design from those that would be required to meet the other general daily vision needs of the individual.

Individuals with the following diagnosed conditions (with accompanying ICD-9 codes) often require occupationally related eyewear or other therapeutic services in order to comfortably and efficiently work at a computer.

Presbyopia (367.4) Glasses for the correction of presbyopia are considered to be computer related if they are of a prescription power or lens or frame design, which is different than that required for everyday visual needs.

In general this includes:

  • Single vision lenses prescribed specifically for the computer working distance;
  • Intermediate/near bifocals prescribed for use at the computer workstation;
  • Other special multifocal lenses prescribed for use at the computer workstation.

Computer related glasses would not include:

  • General purpose single vision or multifocal lenses prescribed for everyday wear;
  • Progressive addition lenses, except those designed specifically for computer operators.

Hyperopia (367.0) Glasses for the correction of hyperopia (farsightedness) are considered to be computer related if:

  • � The individual would not otherwise require correction of their hyperopia for everyday visual needs.

Myopia (367.1) Glasses for the full correction of myopia (nearsightedness) are generally not considered to be computer related.

Astigmatism (367.2) Because of the visual demands of computer work, individuals with low amounts of astigmatism may require correction for computer tasks.

Glasses are considered to be computer related if:

  • The individual would not otherwise require correction of their astigmatism for general vision needs.

Glasses would generally not be considered computer related if:

  • The individual has moderate to large amounts of astigmatism (generally 1.00 Diopter or greater) which require correction for habitual wear.

Heterophoria (378.4) Glasses, which are prescribed for the correction of a clinically significant near heterophoria causing computer related symptoms, are considered to be computer related.

Convergence Insufficiency (378.83) A convergence insufficiency causing work-related symptoms is considered to be computer related. Vision therapy would be the treatment of choice for clinically significant convergence insufficiency.

Disorders of Accommodation (367.5) Treatment for disorders of accommodation causing work related symptoms are considered as computer related:

  • Glasses may be provided for the correction of clinically significant accommodative disorders in persons younger than age 40.
  • Vision therapy for accommodative disorders may also be prescribed based upon the judgment of the eye care provider.

Dry Eye (375.15) Treatment for dry eye should be considered as computer related if:

  • The symptoms occur most frequently during or are exacerbated by computer work.

Other conditions or treatment options may also be considered computer related under specific circumstances. The above criteria are not intended to limit the range of eye care services provided to computer operators. They can, however, be helpful in establishing minimum criteria for the reimbursement of eye care services for computer operators.

The above criteria are recommended to determine whether glasses are �computer glasses�, or whether other treatment is related to working at a computer. This is often important for determining whether the glasses will be covered by the patient�s eye care program.

 

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