In the previous text, we shared a study on headaches in children and the lack of relevance to either having to wear glasses or changing the lens power of the glasses. One of the issues discussed was the biased scientific methodology and the art of making such statements without seeing further than one’s nose…
Contrary to the statement of the authors and of the American Association of Ophthalmology, there is a source more relevant and of more scientific relevance about headaches and vision of children that is free of any bias examiner. In 2009, a major study both from optometrists and ophthalmologists concerning convergence insufficiency and its symptoms, the CITT study (Convergence Insufficiency Treatment Trial) began. They created a questionnaire called CISS (Convergence Insufficiency Symptom Survey) to link the symptoms to convergence insufficiency. All one has to do to determine if the visual requirements are linked to headaches is to ask! The CISS questionnaire showed that it could be done reliably. You will find the questionnaire at the end of the text. Note the number of items that relate to visual discomfort. You can also download it from: http://www.aoa.org/x13917.xml
Q1: Do your yes feel tired when reading or doing close work?
Q2: Do your eyes feel uncomfortable when reading or doing close work?
Q3: Do you have headaches when reading or doing close work?
Wait a second! Why is it that the best standardized questionnaire in the history of joint studies of optometry and ophthalmology, studies funded by the U.S. government, directly ask a question about headaches associated with visual tasks, while the recent study talked about “proofs beyond doubt” that it is not relevant?
Let’s dispense with the simplistic notions of the latest press release, and set the record straight:
- Headaches can be associated with vision problems. Unless you ask the question, you can’t get an answer.
- Pediatrician screening is not a substitute for a complete eye exam performed by an optometrist. A child who complains of headache associated with visual tasks near (reading, writing, drawing, etc.) might show a functional problem (alignment problem like convergence and/or focusing), while having no problem with distance visual acuity (vision of 20/20 or 100%).
- A change in glasses may sometimes not completely solve the headache. But often wearing new glasses for an individual who was not wearing any will solve the problem.
- If the underlying cause of headaches is a functional problem, the treatment of choice according to proved scientific studies is proven optometric vision therapy.
Adapted from VisionHelp Blog (a super blog!): http://visionhelp.wordpress.com/
The abstract of the study on the CISS questionnaire can be found here: http://www.ncbi.nlm.nih.gov/pubmed/19289977
Even in ophthalmology, here is what is said about eyestrain and headaches:
“The visual symptoms are caused by because focusing of the eyes becomes increasingly difficult due to fatigue especially at the end of the day after prolonged reading. Vision becomes blurred and sometimes even double. Vision at near can be uncomfortable.
Eyestrain occurs mainly in the late afternoon as near vision is constantly at work by efforts of focusing in work and in leisure with particularly computer screens, mobile phones, television, console games…
Eye symptoms reflecting visual fatigue include a feeling of discomfort, tension, and heaviness in the region of the eye, orbit or eyelids. There may be feeling of irritation, burning, stinging, and itching, sometimes with red eyes, some tearing or irritation due to dry eye. The subject may feel dull pain but not very intense that may become acute generally behind the eyes.
Headaches can be felt around the eyes, on the forehead above the eyebrow line, temples or behind the head. These headaches are related to eye strain, occur after a certain period of work at the end of the day, fade and disappear after cessation of work.” (Source: http://www.ophtalmologie.fr/fatigue-visuelle-yeux.html)