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Employers should be prepared for what some experts see as the next wave of computer-related injury claims.
Computer vision syndrome, a condition marked by tired and sore eyes, blurred vision, headaches and neck, shoulder and back pain, afflicts nearly 90% of workers who use computers, according to the American Optometric Assn.
The condition costs nearly $2 billion a year to diagnose and treat, according to the AOA, but there is no data available on how much CVS contributes to lost work time or decreased worker productivity.
And few, if any, occupational injury claims have been filed in connection with the disorder, workers compensation experts say. This may be because the symptoms of eye strain from computer use disappear quite quickly once the sufferer leaves his or her workstation, they point out.
But computer-related eye and vision problems meet most of the definitional requirements of cumulative trauma disorders, points out James Sheedy, an optometrist and director of professional development at SOLA Optical in Petaluma, Calif. Dr. Sheedy also is a clinical professor of optometry at the University of California at Berkeley.
CTDs are largely the result of using a part of the body that functions well under normal activity or workloads but develops problems when used repetitively and stressfully.
"Likewise, the visual and ocular problems that result from work at a computer are the result of stressing some aspect of the eye or visual system to the point that it causes symptoms," Dr. Sheedy said.
And, because the eyes lead the body, computer-related back and/or neck injury claims often can be traced to the need for vision correction, said Pam Simonian, an assistant vp at Sedgwick of California Inc. in Orange. Ms. Simonian specializes in ergonomic evaluations in workers compensation cases.
"If an employee experiences upper back and neck pains, it may not be the furniture; it may be their glasses. We need to consider that possibility in the ergonomic assessment," she said.
Ms. Simonian described as typical a recent case in which an employer would not provide coverage of corrective lenses for an employee who requested the lenses until after she began complaining of neck and back pain.
"They didn't want to provide glasses for that employee because then the other employees would ask for them," she explained.
"A lot of employers are ignoring the problem, hoping it will go away," contends Dr. Jeffrey Anshel, an optometrist and president of Corporate Vision Consulting in Encinitas, Calif.
But the problem is growing and cannot be ignored, he said.
"When I first looked at computer vision syndrome in 1990-91," approximately 10% of employees complaining of vision problems were diagnosed with CVS, Dr. Anshel said. "Now it's up to 17%. That's a growth rate of 1% per year."
If this trend continues, "CVS is going to be the carpal tunnel of the next century," he warned.
Recognizing the connection between computer use and vision disorders, the World Health Organization now recommends an eye examination for all computer users before they begin work for a new employer, and subsequent examinations beyond age 40, especially for persons who report musculoskeletal or eye strain symptoms.
But it's only the progressive employer that today follows this prescription, Sedgwick's Ms. Simonian says.
"Employers can't see the tangible benefits," she said. "You're either going to pick up a repetitive motion claim for back and neck, or you can be a progressive employer and realize you've got to address the issue" at its root cause, she said.
For the most part, employers are hesitant to acknowledge computer vision syndrome because no long-term disability is involved, according to a spokeswoman for the Center for Office Technology in Alexandria, Va. The COT is a coalition of large manufacturers and corporate users of high-tech equipment.
"Your eyes get tired, you rest your eyes, then you're fine," she said. "We haven't seen any permanent damage occurring."
However, she acknowledged that adjusting computer monitors and office lighting can make computer work more comfortable.
Furthermore, the COT's "new 'Comfortable Computing' book recommends that people who use computers tell their eye doctors how much they use them and discuss the possibility of corrective eyewear if necessary," Ms. Saunders said.
While it's easy to blame computers for visual discomfort, improper office lighting may be the biggest contributor, ergonomics experts say.
"The biggest problem with CVS is glare," asserts Edmund Cameron, chief executive officer of Spectracom Technologies Corp. in Scottsdale, Ariz. Spectracom makes glare filters for fluorescent light fixtures and computer monitors.
In partnership with Arizona State University, Spectracom conducted a yearlong, double-blind study of the effects of lighting on productivity involving 150 people who worked in a high-tech firm's customer service call center.
"There was a natural wall dividing the room in half, so we closed the door and put filters on half of the facility without telling anyone," Mr. Cameron recounted.
After collecting data on the number of computer keystrokes, time spent on calls and complaints about eye strain, researchers found that "productivity on the filtered side increased by almost 3%, while complaints dropped significantly," he said.
The cost of preventing and treating computer vision syndrome need not be prohibitive, experts say.
"You don't have to send everybody to the eye doctor," said Dr. Anshel of Corporate Vision Consulting. Instead, he said, "you can do a workplace screening."
For example, Dr. Anshel distributes a software program that can provide a basic screening. The self-directed program asks computer users questions on computer habits, gives a vision test and then makes recommendations that take into consideration the survey responses and test results.
For example, if the employee reports complaints but passes the vision test, environmental adjustments may be recommended, Dr. Anshel explained. Conversely, if the employee has complaints and fails the vision test, the program would print out recommendations to give to an eye doctor.
Employers that provide general eyecare benefits as part of an overall employee benefit program should encourage computer users to have their vision checked regularly, Dr. Sheedy advises.
Such employers also should provide coverage for an additional pair of glasses designed specifically for viewing computer screens, he added.
"The employer needs to be assured that a second pair of glasses for use at a computer is, indeed, different from dress eyewear and not just a spare pair of glasses for the employee," Dr. Sheedy advised in a September 1997 article published in the Journal of the American Optometric Assn.
Recognizing the growth of computer vision syndrome, the American Optometric Assn. recommends that the following information be obtained during routine eye examinations:
* A detailed history of symptoms, nature of computer work, position and working distances of the screen and other materials as well as the other visual characteristics of the work environment such as lighting and reflections.
* Assessment of accommodative abilities, assessment of ocular coordination, refractive determination for the required viewing distances at the computer workstation and design of occupational lenses, if indicated.
* Consulting regarding the visual environment at the workstation.
"For proper eyecare of computer users, it is important that the providers understand the eye and vision problems of computer users, be able to diagnose the underlying causes of these problems and be able to implement proper care for these conditions," said Dr. Sheedy.
For example, employees who wear bifocals for presbyopia, or far-sightedness, often report computer vision problems because their glasses are designed for looking down rather than at the angle required for proper computer monitor viewing, he said.
In addition, contact lens wearers often suffer from dry, irritated eyes because the blink rate is significantly reduced when working at a computer, he added.
"Too many employers try to sweep this problem under the rug," Dr. Sheedy observed. "But they should acknowledge it. While it's not a terribly serious problem, treating it can enhance employee comfort and productivity.'