Anxiety and Eye Pain

The easiest way to tell if a pain or feeling is a symptom of anxiety is to determine whether or not it appears to get worse during times of stress. Still, for some that can be tricky - those with generalised anxiety disorder, for example, are often feeling stress, and this can make it difficult to tell when their eye pain is or is not connected to their stress. For some it may feel like the eye pain is what's causing the increase in stress - and this is entirely possible as well.

Most stress-caused eye issues are temporary—if you have a consistent issue with your eyes, no matter what’s going on in your life, the problem is likely with your eyes instead of your stress level. Make sure to see an eye doctor if you have persistent eye trouble.

Stress may be causing your eye twitching (also known as a lid myokymia) This lid “twitching” is a result of the continuous contraction of the orbicularis oculi muscle. The twitching is typically in just one eye, benign and temporary.

You may have a sudden or gradual dull or sharp pain in one or both eyes. This eye pain might last for a moment, a few seconds, or persist for minutes or hours. Sometimes a dull pain or ache in the eyes can persist for days before it subsides. Eye aches or pains can also be accompanied by redness in the eye or eyes, or show no signs of redness at all. This symptom is often associated with the pain of “eye strain.”

This symptom can affect one eye only, can shift and affect the other eye, can migrate back and forth between eyes, and can affect both eyes at the same time. Anxiety eye pain can come and go rarely, occur frequently, or persist 24/7 day after day. For example, you have eye pain once in a while and not that often, have it off and on, or have it all the time for many hours or days. Anxiety eye pain can precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself. It can also precede, accompany, or follow a period of nervousness, anxiety, fear, and stress, or occur "out of the blue" and for no apparent reason. Eye pain anxiety symptoms can range in intensity from slight, to moderate, to severe. It can also come in waves where the pain is severe one moment and eases off the next. Anxiety eye pain can change from day to day and from moment to moment.

WHY ANXIETY CAN CAUSE EYE PAIN:

1. Stress response

Anxious behaviour activates the "stress response," which causes many body-wide changes that enhance the body’s ability to deal with a threat – to either fight or flee.

When you get anxious, frightened, or stressed, your body’s instinct is to go into what scientists call “fight or flight” mode. Your body will start producing hormones like adrenaline, which speed up your heart rate, and your brain will direct more blood to essential functions like your internal organs and less blood to your extremities.

The reason your body takes these actions is to protect you. Your brain detects a threat when you worry about something, so its response is to gear up for either fighting the threat or running away from it. While this is a great response to physical danger, like an intruder in the home or a dangerous animal, it isn’t helpful for most problems that cause stress, like an argument with your spouse or a big project at work.

Though your brain’s response to stress isn’t helpful for non-physical problems, it still happens. When you’re in fight or flight mode, your eyes can suffer because your brain will cause your pupils to dilate. The idea behind this response is to get more light into your eyes so you can see any potential threats more clearly.

However, when you’re stressed out for a long time, the constant dilation makes you sensitive to light and can cause serious strain on your eyes. Additionally, when you’re very tense, as many stressed-out people are, the muscles in and around your eyes can tighten, causing twitching and soreness.

Some of these changes include:

• Tightens muscles so the body is more resilient to harm, including those that control eye movement.

• Dilates the pupils in the eyes so that we can take in more visual information.

• Reduces peripheral vision so that we can focus solely on the threat.

• These sudden changes in eye function can cause pain in the eyes if the response is dramatic.

• Constant, severe stress levels and subsequent releases of adrenaline lead to consistent dilated pupils and an eventual light sensitivity. This can lead to the twitching and tightening of eye muscles, which causes stress-related vision problems and eye discomfort.

• With stress comes cortisol and adrenaline spikes, which means potential vision problems or loss can be caused by stress over time. When we forget to breathe on top of all of this stress, our oxygen blood levels dip even lower, leading to less oxygen transporting to vital blood cells in the brain and eyes.

• As a result of the retina not receiving enough oxygen, potential cell damage and eventual death occur. While it’s not always easy, practising breathing treatments in times of perceived crisis could make a world of a difference.

2. Hyperstimulation

When stress responses occur too frequently, however, such as from overly apprehensive behaviour, the body has a more difficult time recovering.

Incomplete recovery can cause the body to remain in a state of semi stress response readiness, which we call “stress-response hyperstimulation" since stress hormones produced by the stress response are stimulants.

Hyperstimulation can cause the changes of an active stress response even though a stress response hasn’t been activated. Chronic anxiety and eye pain are common indications of hyperstimulation.

Moreover, in addition to causing muscle tension-related eye pain, hyperstimulation can also irritate the nerves associated with the eyes, which can cause nerve-related eye pain.

As the degree of hyperstimulation increases, so can the prevalence and persistence of eye pain.

Furthermore, hyperstimulation can exacerbate eye strain pain.

For instance, long hours looking at a computer screen or reading can tax the muscles that control eye movements. Strained eye muscles can present as “eye strain.”

Hyperstimulation can cause chronic muscle tension, which can cause eye strain faster than usual and make eye strain pain worse.

3. Muscle Tension

Anxiety may also lead to tension spreading throughout the muscles in your body, and in some cases this can lead to severe muscle tension around your eyes and face. That muscle tension can occasionally lead to very intense pain that may radiate around any single eye or both eyes, depending on where the tension occurs.

How to get rid of anxiety eye pain

When the eye pain anxiety symptom is caused by apprehensive behaviour and the accompanying stress response changes, calming yourself down will bring an end to the stress response and its changes.

As your body recovers from the active stress response and its changes, anxiety eye pain will subside.

Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. This is normal and shouldn’t be a cause for concern.

When eye pain is caused by hyperstimulation, such as anxiety-caused hyperstimulation, it might take much longer for the body to recover, and to the point where this anxiety symptom subsides.

Nevertheless, when the body has recovered from hyperstimulation and its effects, anxiety-caused eye pain will subside.

You can speed up the recovery process by containing your anxiousness, reducing stress, practising relaxed diaphragmatic breathing, regularly practising a deep relaxation technique, increasing rest, and getting regular good sleep, to name a few.

As your body recovers from hyperstimulation, it stops presenting symptoms, including anxiety eye pain.

Worrying about anxiety symptoms, such as this one, often causes anxiety symptoms to persist, since worry stresses the body. It’s best to accept and tolerate this symptom as your body recovers. Not reacting to this symptom with worry and angst will allow your body to recover…in time.

Some people find that closing their eyes for a while can help - especially if there is some eye strain involved.

If you think that your eye problems are stress-related, you can start by trying to relax. Think about your symptoms as warning signs—your body is obviously trying to respond to a threat, and it’s hurting you. The best thing to do is to try to calm down your brain’s response to danger.

You probably know what de-stresses you better than anybody. However, if you need some ideas, try:

• Taking a long, warm bath and focusing on how it feels

• Meditating

• Taking slow, deep breaths, sending the air into your belly instead of your chest

• Writing in a journal

• Exercising

As always, you’ll feel better if you make sure to get enough sleep and eat well. Even though you’re busy, taking at least a few minutes to consciously relax will help your body calm down.

If you feel stressed or worried most of the time, you may need to make bigger changes. You may be trying to do too much in too little time and need to cut back. Alternatively, you may have an anxiety disorder, which is highly treatable. If you constantly feel like you’re on edge, it might be time to speak with a doctor or counsellor to make sure that you’re emotionally and physically healthy.

Once you’ve found a way to deal with your stress, your eyes should go back to normal. Stress-related eye issues should be temporary and easy to fix. However, if you continue to have problems, make sure to visit your eye doctor.

Your eyes feeling 'weird' and having some blurred vision is common for people with anxiety, this is due to the high levels of adrenaline caused from the anxiety, and also because people with anxiety tend to strain their eyes. It probably also doesn't help if you stare at a screen for several hours a day.

DIGITAL EYE STRAIN:

Symptoms of digital eye strain include:

• Eye fatigue and discomfort

• Dry Eyes

• Headaches

• Blurred vision

• Red Eyes

• Eye twitching

• Neck and shoulder pain

Research sponsored by The Vision Council showed that 59% of people who routinely use computers and digital devices experience symptoms of digital eye strain (also known as computer eye strain or computer vision syndrome).

Here are 10 easy steps you can take to reduce your risk of eye strain and the symptoms involved

1. Get an Eye Exam.

An annual comprehensive eye exam is the most important thing you can do to prevent or treat computer vision problems. During your exam, be sure to tell your eye doctor how often you use a computer and digital devices at work and at home.

Measure how far your eyes are from your screen when you sit at your computer, and bring this measurement to your exam so your eye doctor can test your eyes at that specific working distance.

2. Use proper lighting.

Eye strain often is caused by excessively bright light either from outdoor sunlight coming in through a window or from harsh interior lighting.

When you use a computer, your ambient lighting should be about half as bright as that typically found in most offices.

Eliminate exterior light by closing drapes, shades or blinds. Reduce interior lighting by using fewer light bulbs or fluorescent tubes, or use lower intensity bulbs and tubes.

Also, if possible, position your computer screen so windows are to the side, instead of in front or behind it.

Many computer users find their eyes feel better if they can avoid working under overhead fluorescent lights. If possible, turn off the overhead fluorescent lights in your office and use floor lamps that provide indirect "soft white" LED lighting instead.

Sometimes switching to "full spectrum" fluorescent lighting that more closely approximates the light spectrum emitted by sunlight can be more comforting for computer work than regular fluorescent tubes. But even full spectrum lighting can cause discomfort if it's too bright.

Try reducing the number of fluorescent tubes installed above your computer workspace if you are bothered by overhead lighting.

3. Minimize Glare

Glare from light reflecting off walls and finished surfaces, as well as reflections on your computer screen also can cause computer eye strain. Consider installing an anti-glare screen on your display and, if possible, paint bright white walls a darker colour with a matte finish.

If you wear glasses, consider buying lenses with anti-reflective (AR) coating. AR coating reduces glare by minimizing the amount of light reflecting off the front and back surfaces of your eyeglass lenses.

4. Upgrade your Display

If you have not already done so, replace your old tube-style monitor (called a cathode ray tube or CRT) with a flat-panel LED (light-emitting diode) screen with an anti-reflective surface.

Old-fashioned CRT screens can cause a noticeable "flicker" of images, which is a major cause of computer eye strain. Even if this flicker is imperceptible, it still can contribute to eye strain and fatigue during computer work.

Complications due to flicker are even more likely if the refresh rate of the monitor is less than 75 hertz (Hz). If you must use a CRT at work, adjust the display settings to the highest possible refresh rate.

When choosing a new flat panel display, select a screen with the highest resolution possible. Resolution is related to the "dot pitch" of the display. Generally, displays with a lower dot pitch have sharper images. Choose a display with a dot pitch of .28 mm or smaller.

Also, choose a relatively large display. For a desktop computer, select a display that has a diagonal screen size of at least 19 inches.

5. Adjust your Computer Display Settings

Adjusting the display settings of your computer can help reduce eye strain and fatigue. Generally, these adjustments are beneficial:

• Brightness: Adjust the brightness of the display so it's approximately the same as the brightness of your surrounding workstation. As a test, look at the white background of this Web page. If it looks like a light source, it's too bright. If it seems dull and grey, it may be too dark.

• Text size and contrast: Adjust the text size and contrast for comfort, especially when reading or composing long documents. Usually, black print on a white background is the best combination for comfort.

• Colour temperature: This is a technical term used to describe the spectrum of visible light emitted by a colour display. Blue light is short-wavelength visible light that is associated with more eye strain than longer wavelength hues, such as orange and red. Reducing the colour temperature of your display lowers the amount of blue light emitted by a colour display for better long-term viewing comfort.

6. Blink more often.

Blinking is very important when working at a computer; it moistens your eyes to prevent dryness and irritation.

When staring at a screen, people blink less frequently — only about one-third as often as they normally do — and many blinks performed during computer work are only partial lid closures, according to studies.

Tears coating the eye evaporate more rapidly during long non-blinking phases and this can cause dry eyes. Also, the air in many office environments is dry, which can increase how quickly your tears evaporate, placing you at greater risk for dry eye problems.

If you experience dry eye symptoms, ask your eye doctor about artificial tears for use during the day.

By the way, don't confuse lubricating eye drops with the drops formulated to "get the red out." The latter can indeed make your eyes look better — they contain ingredients that reduce the size of blood vessels on the surface of your eyes to "whiten" them. But they are not necessarily formulated to reduce dryness and irritation.

To reduce your risk of dry eyes during computer use, try this exercise: Every 20 minutes, blink 10 times by closing your eyes as if falling asleep (very slowly). This will help rewet your eyes.

7. Exercise your eyes.

Another cause of computer eye strain is focusing fatigue. To reduce your risk of tiring your eyes by constantly focusing on your screen, look away from your computer at least every 20 minutes and gaze at a distant object (at least 20 feet away) for at least 20 seconds.

Some eye doctors call this the "20-20-20 rule." Looking far away relaxes the focusing muscle inside the eye to reduce fatigue.

Another exercise is to look far away at an object for 10-15 seconds, then gaze at something up close for 10-15 seconds. Then look back at the distant object. Do this 10 times. This exercise reduces the risk of your eyes' focusing ability to "lock up" (a condition called accommodative spasm) after prolonged computer work.

Both of these exercises will reduce your risk of computer eye strain. Also, remember to blink frequently during the exercises to reduce your risk of computer-related dry eye.

8. Take frequent breaks.

To reduce your risk for computer vision syndrome and neck, back and shoulder pain, take frequent screen breaks during your work day (at least one 10-minute break every hour).

During these breaks, stand up, move about and stretch your arms, legs, back, neck and shoulders to reduce tension and muscle fatigue.

9. Modify your workstation.

If you need to look back and forth between a printed page and your computer screen, place the written pages on a copy stand adjacent to your screen.

Light the copy stand properly. You may want to use a desk lamp, but make sure it doesn't shine into your eyes or onto your computer screen.

Poor posture also contributes to computer vision syndrome. Adjust your workstation and chair to the correct height so your feet rest comfortably on the floor.

Position your computer screen so it's 20 to 24 inches from your eyes. The centre of your screen should be about 10 to 15 degrees below your eyes for comfortable positioning of your head and neck.

10. Consider computer glasses.

For the greatest comfort at your computer, you might benefit from having your eye doctor modify your eyeglasses prescription to create customised computer glasses.

Also, you may want to consider photochromic lenses or lightly tinted lenses for computer eyewear to reduce your exposure to potentially harmful blue light emitted by digital devices. Ask your eye doctor for details and advice.

How computer glasses work

Basically, computer glasses reduce how much focusing your eyes must do when viewing digital devices. This is comforting for people of all ages. It's particularly helpful if you’re over age 40. This is when we begin to experience symptoms of presbyopia — the normal age-related loss of near focusing ability.

Computer glasses should also correct any near-sightedness, farsightedness or astigmatism you have. Research shows that even small amounts of uncorrected refractive errors can cause computer vision problems and reduced productivity.

Computer glasses vs reading glasses

Computer glasses differ from regular eyeglasses or reading glasses in a number of ways.

For greatest comfort, your computer screen and digital devices should be about 20 to 26 inches from your eyes. This is considered the intermediate zone of vision — closer than driving (“distance”) vision, but farther away than reading (“near”) vision.

Focusing on intermediate and near objects still requires effort by the ciliary muscle in your eye. The longer you stare at your computer and phone screens, the more fatigued this muscle and your eyes become.

If you are beginning to experience presbyopia, bifocals can provide clear distance and near vision. But intermediate vision (needed for computer use and seeing your smartphone) often remains a problem. Progressive lenses and trifocals offer some help for intermediate vision. But they often don’t have a large enough intermediate zone for comfortable computer work.

For these reasons, many people try reading glasses for computer use. But these, too, have limitations.

Generally, computer glasses have about 60% the magnifying power of reading glasses. (The optimal magnification depends on how far you prefer to sit from your computer screen and how close you hold your digital devices.)

Store-bought reading glasses are simply magnifying lenses in a frame.

Good computer glasses, on the other hand, do three things:

1. Correct any refractive errors you have,

2. Provide the optimum amount of magnification for viewing your digital devices,

3. Protect your eyes from blue light

Also, custom computer glasses position the optical centre of the lenses directly in front of your pupils when using your devices. This intermediate pupillary distance is not customized in store-bought reading glasses.

And store-bought reading glasses typically provide little or no protection from blue light.

Custom computer glasses provide a wide, clear view of your digital devices, reduce focusing effort, and offer the added benefit of blue light protection.

Lens designs for computer glasses

There are several types of eyeglass lens designs for computer glasses. Because these lenses are prescribed specifically for computer use, they are not suitable for driving or general purpose wear.

Single vision computer glasses

The simplest computer glasses have lenses with the same power throughout the entire lens. These are called single vision lenses. This lens power is customized for your specific needs and preferred computer viewing distance.

Single vision computer glasses reduce the risk of eye strain, blurred vision and unnatural posture that can cause neck and back pain. They are comfortable for young and older computer users alike.

Progressive computer glasses

Progressive computer lenses are no-line multifocal lenses. They have different powers for your distant, intermediate and near vision needs.

Progressive computer lenses have a larger intermediate zone than regular progressive lenses. This provides a wider view of your computer screen. But these lenses have a smaller zone for distance vision and therefore are not recommended for driving.

Bifocal and trifocal computer glasses

Other lenses used for computer glasses include occupational bifocal and trifocal lenses. These multifocal lenses have larger zones for intermediate and near vision than regular bifocals and trifocals. Also, the position of the intermediate and near zones of these glasses can be customized for computer use.

Your optometrist or ophthalmologist can help you decide which lens design will best suit your needs for computer glasses.

Lens coatings and tints

For greatest comfort, the lenses of your computer glasses should include anti-reflective coating. Reflections from the front and back surfaces of eyeglass lenses can cause eye strain. Anti-reflective (AR) coating eliminates these annoying reflections.

A blue light filter is another essential to protect your eyes from potentially harmful high-energy blue light emitted by digital devices.

Your eye doctor might also recommend adding a mild tint to the lenses of your computer glasses to reduce glare from overhead lighting.

Where to buy computer glasses:

Resist the temptation to buy cheap, over-the-counter reading glasses for computer use.

Start by having a comprehensive eye exam to rule out vision problems or update your eyeglasses prescription.

Before scheduling your eye exam, measure how far you like to sit from your computer. Measure from the bridge of your nose to the surface of your computer screen.

Bring this measurement with you to your eye exam. It will help your eye doctor determine the best lens power for your computer glasses.