CIRCULATORY PROBLEMS OF THE AQUEOUS HUMOR RESULTING FROM ON-SCREEN COMPUTER WORK.

: We present a series of patients suffering from fatigue, photophobia or pain when reading or working on screen. In any case ametropia was well corrected and they had neither insufficiency of convergence, nor dry eyes nor even familial history of glaucoma

vernes institute. rue assas paris france

100 eyes from 58 patients, 38 wonen and 20 men, mean age 52 (24-82), mean refraction: +1.50 D (-0.25-+5.00), 98 phakic and 2 pseudophakic eyes, mean ocular pressure:15mmHg (10-20). Symptoms were in order of frequency: pain, ocular fatigue, visual discomfort, a feeling of pressure, scotoma, red eye, cramps, falling asleep when reading, itching on waking up in the morning. Working on screen was the most commun trigger (46%)any effort required for fixation of near vision (22%) and no trigger identified (32%).

: Dynamic gonioscopy found as following :scattered synechiae (from 90° to 360°) in 40 eyes, closed angle openable none theless from 90° to 270° in 24 eyes, an hidden trabeculum  in34 eyes and pigmented trabeculum in 4 eyes. High frequency B scan found  an open angle (8  eyes), a very narrow angle 24 eyes, a plateau iris 20 eyes, incomplete angle closure 44 eyes, scattered synechiae 4 eyes, an anterior bulge of the iris root at least in one quadrant in every cases but 2 pseudophakic cases with reverse pupillary block. Yag laser iridotomy eliminated symptoms in all cases.

The range of symptoms encountered in this case series is identical to that seen in UGH syndrome linked to uveal and particularly ciliary irritation

attributable to the zonule and/or iris root being put under tension by the aqueous humour due to pupillary blockage.

The human eye has to deal nowadays with extended periods of fixation work focused on lit computer screens,

which can lead to an imbalance in the tear film as well as circulatory problems of the aqueous humor.

Accordingly, any patient reporting visual discomfort while working on-screen should  obviously undergo dynamic gonioscopy.