Astenopia of the eye: accommodative, muscular, nervous

Rapid fatigue of the visual apparatus indicates the development of asthenopia. Consider the causes of discomfort in the eyes, symptoms, types, methods of treatment and prevention.

The syndrome of visual fatigue or asthenopia, is known to every person whose activity is connected with a computer. After 4-5 hours of continuous work, a painful sensation appears in the eyes. This problem is faced by people who read books in bad artificial light or from screens of tablets, smartphones and other electronic devices.

This pathology has a wide range of subjective signs that manifest themselves with an increase in eye strain that does not correspond to the potential volume of productivity. Asthenopic syndrome has several categories, which are based on their primary signs:

1. Visual difficulties - the quality of visual perception deteriorates, especially with low illumination or continuous operation.
2. Ophthalmic problems are manifested by increased eye fatigue, a feeling of heaviness of the eyelids, photophobia (does not pass when wearing dark glasses), the sensation of a foreign body under the eyelids, conjunctivitis, in rare cases, blepharitis and barley.
3. Additional difficulties - frequent headaches of varying intensity, migraine, nausea, pain in the neck and shoulders, lumbago in the temples.

Such manifestations of the syndrome very often lead to sleep disorders and a depressive state. Due to the poor quality of the resulting image, the voltage of higher visual centers increases, which is accompanied by subjective complaints.

[1], [2]

Epidemiology

Medical statistics provided by the World Health Organization indicate that around 135 million people worldwide have various visual defects, including asthenopia, and about 45 million are blind. In 75% of cases, blindness is associated with untimely treatment of diseases or non-compliance with preventive measures. Forecasts in this case are not comforting, so in 10-20 years the number of people with ophthalmic problems will increase to 200-300 million people.

The problem of visual fatigue is getting younger every year. Statistics show that 5% of children entering the first class already have astenopia due to increased strain on the muscles of the eye. By the middle school this pathology grows into short-sightedness and more serious problems requiring medical intervention.

[3], [4]

Causes of the astenopia

Visual fatigue is a certain discomfort in the eyes that occurs during visual work. The causes of asthenopia are associated with various factors. Very often, pathology is manifested when the eyes are working at close range to the object. But the main cause of the disorder is prolonged tension and fatigue of the eyes without rest. Considerable importance in the development of the disease is played by nutrition and the presence of bad habits.

There are a number of factors that most trigger the development of the disorder:

• Long work at the computer.
• Daily long watching TV.
• Reading in low light.
• Driving with poor visibility.
• Work in constant visual tension.
• Incorrectly chosen glasses for sight.
• Non-observance of hygiene of the organs of sight.
• Insufficient workplace lighting.

The causes of asthenopia can be associated with accommodation spasms of various origins. Also, various miotic drugs (medications that cause a narrowing of the pupil) can cause artificial spasm and sensations as in visual fatigue.

[5],

Risk factors

There are certain risk factors that contribute to the development of the syndrome of visual fatigue. Asthenopia occurs with prolonged exertion of the eyes and concentration of attention in the process of work. Most often this is a long work at the computer, work with documentation, with various small details, driving at night, reading in poor light.

Isolate certain groups of people who are primarily prone to frustration:

• People with binocular ophthalmologic disorders.
• Office staff (70% of PC users develop the disease regardless of the type of screen).
• Patients of advanced age who spend a lot of time reading books or watching TV.

The development of the disease can contribute to various endocrine pathologies, intoxication of the body. Painful sensations arise from incorrect selection of glasses for reading or permanent wearing. At first it leads to visual weakness, and as progression causes a violation of accommodation.

[6], [7]

Pathogenesis

Focusing of vision is carried out by the muscles of the lens, which is the natural lens of the eye. The pathogenesis of asthenopia is associated with fatigue of the ciliary muscle. If a person holds a glance at a single point for a long time or quickly translates it between objects that are located at different distances from the eyes, then the muscles overextend, and asthenopia develops.

That is, the pathological condition is associated with uncorrected hypermetropia, presbyopia, astigmatism or congenital weakness. In some cases, the disorder of the ciliary muscle is promoted by certain diseases of the body and its intoxication.

[8], [9], [10],

Symptoms of the astenopia

Rapid eye fatigue in most cases is associated with increased stress and lack of rest. Symptoms of asthenopia are so diverse that they can cause difficulties in the process of diagnosis. Most often, patients complain of such problems as:

• Sensation of sand or foreign body in the eyes.
• Cutting and burning.
• Doubling.
• Periodic blurring of vision.
• Increased tear.
• Headaches and dizziness.
• Redness of one or two eyes.
• Progressive deterioration of vision.
• Discomfort when moving with the eyes.
• Increased temperature.
• Inflammatory processes in the organs of vision.
• Deformation of the shapes and sizes of objects perceived by the eyes.

All of the above symptoms combine the fact that they are in different combinations or individually, arise with a certain visual load. In addition, patients complain of increased irritability and frequent severe headaches. In most cases, unpleasant sensations disappear or weaken after rest or sleep.

First signs

The danger of asthenopia is that very often its first signs are not taken seriously. Light blurred vision or dry eyes are associated with temporary hard work or fatigue, rather than an evolving disease.

Ophthalmologists distinguish 7 first signs of the syndrome of visual fatigue, which should alert, especially if they appear simultaneously:

1. A peculiar shroud, haze or film appears before your eyes. With overexertion, such turbidity can be so strong that a 1-3 second loss of vision occurs.
2. There is a double vision in the eyes and a vague image. This sign depends on how tired your eyes are, so it can manifest itself to a greater or lesser extent.
3. The size and shape of objects are distorted. In particularly difficult cases, it is difficult to determine the contour of a particular object.
4. There are signs of an inflammatory process, although there are no prerequisites for this. The eyes turn red, and the redness touches the eyelids and squirrels.
5. Frequent lacrimation, especially after overexertion of visual muscles.
6. Feeling tired and fever. Touching the eyelids, there may be a feeling that they are pulsating and burning.
7. Frequent burning and rubbing, increased dryness. When the eyes are washed with cool water, there comes a short-term relief.

In addition to the above signs, at first the visual effect of McCalach appears. If you translate the view to an example, from the monitor screen to a black or white color / object, then it is painted in the color that was on the screen. Objective changes in ophthalmic parameters occur after two hours of continuous eye strain.

[11], [12],

Stages

Specific impairment of vision, i.e. Asthenopia, has certain stages of development, consider them:

1. Compensation (fatigue) - this stage is characterized by short-term functional changes. Visual fatigue occurs with increased stress and passes after rest.
2. Subcompensation (overfatigue) - occurs with a stable compensation, which lasts about 1-3 days. The condition does not normalize even after a long rest. There is discomfort and characteristic for the syndrome signs.
3. Decompensation (overstrain) - at the last stage, there is a development of persistent pathological changes and irreversible refractive-accommodative disorders. If the disease is associated with the peculiarities of the work, the patient is diagnosed with professional ophthalmopathy. This disease has several forms: myopic, hypermetropic and mixed.
   • Myopic - most often occurs in patients aged 18-30 years. Characterized by the development of late axial myopia (nearsightedness) or progression of the available.
   • Hypermotropic - occurs after 30 years. There is a significant shift towards hypermetropia, which causes early presbyopia.
   • Mixed - this form develops in quite mature years. It is characterized by myopic refraction and early presbyopia (senile hyperopia).

Such violations have a negative impact on the ability to work, limiting it.

[13], [14]

Forms

According to the ICD-10 classification, all types of asthenopia belong to point H53.1 "Subjective visual disorders". In medical practice, these types of visual fatigue are distinguished:

1. Accommodation is the most common type of asthenopia. It can occur because of hyperopia, weakened accommodation in chronic diseases of the body or with a spasm of accommodation. Most often associated with overwork, exhaustion of the body, stress. The patient can not read for a long time, as the letters begin to merge. There are pain in the eyes, temporal and frontal parts of the head.
2. Muscular - develops when the internal muscles of the eye, which are necessary for a full binocular vision, are slightly weakened. The patient has to forcefully cut them and keep them in a state of tension for a long time. This form is characterized by such symptoms: eye fatigue, pain in the head, double image. Without timely correction and treatment leads to a divergent or converging strabismus.
3. Mixed is a combination of accommodation with muscular visual fatigue. It is manifested by the instability of binocular vision, the duplication of letters during reading, and headaches.
4. Nervous (retinal) - manifested in the form of hysteria and neurasthenia. The patient is not able to do anything for a long time, as the surrounding objects become clouded and unclear. Sometimes darkens in the eyes, there are signs of photosensitivity.
5. Symptomatic - manifests itself as signs characteristic of inflammatory diseases of the nose and eyes. Because of this, the relationship of visual fatigue with such symptoms is practically not traced.

[15], [16],

Accommodation asthenopia

One of the most frequently diagnosed types of visual fatigue syndrome is accommodation asthenopia. Fatigue of the ciliary muscle can be associated with its increased stress, uneven contraction, acquired or congenital weakness. The pathological condition occurs with general diseases of the body and strong intoxication.

Symptoms of the disorder:

• Rapid eye fatigue.
• Feeling of heaviness.
• Cutting and burning.
• Pain in the eyes and head.
• Vagueness of contours of details, letters, objects.

In children, asthenopic phenomena can gradually decrease simultaneously with a decrease in hypermetropia and an increase in the functioning of the ciliary muscle. In adults, on the contrary, intensify, as progression of presbyopia (farsightedness) progresses.

Accommodation asthenopia is diagnosed on the basis of patient complaints and the results of a skiascopic examination. If as a result of diagnosis high or medium hypermetropia is detected, astigmatism, weakness of the ciliary muscle, then the diagnosis is confirmed.

To normalize the patient's condition and restore vision, it is shown wearing corrective glasses. They should be worn not only when reading or working at a computer, but on an ongoing basis. Particular attention should be given to physiotherapy and exercises that stimulate accommodation. In some cases, the doctor prescribes a number of medications - drops. Timely diagnosis and treatment can eliminate asthenopic phenomena, so the forecast of this form in most cases is positive.

[17]

Muscular astenopia

Visual disorders caused by defects in the binocular visual system are muscular asthenopia. Most often occurs due to the absence or incorrect correction of myopia, astigmatism. It is associated with the weakness and strain of the muscular apparatus of the eyes, that is, the muscles that are attached to the eyeball from the outside, ensuring its movement.

Symptoms of the disorder:

• Fast fatiguability.
• Pain in the eyes, giving to the head.
• Sensation of foreign body.
• Vagueness of contours and objects.

Against the background of the above symptoms gradually lose binocular vision. It is replaced by a converging or divergent strabismus. It is these signs that are the basis for the diagnosis.

Restoration of vision is possible only in the early stages of the disease. For this, it is necessary to create favorable hygienic conditions for visual work and perform physiotherapy procedures for the development of convergence and the normal amplitude of fusions. If the disease has a high degree of heterophoria, it is shown wearing glasses with prisms directed towards the eye's deflection. Timely treatment and prevention of muscular asthenopia is a guarantee of a favorable outcome of the disease.

Asthenopia in hypermetropia

Very often the syndrome of visual fatigue is associated with other ophthalmic problems. Asthenopia in hypermetropia, that is, farsightedness, is an anomaly of refraction, in which rays gather behind the retina, forming an unclear image.

In the early stages of the pathological condition is manifested by such symptoms:

• Tiredness and aches in the eyes.
• Sensation of a foreign body under the eyelids.
• Headache.
• Feeling of bursting in the eyeball.
• Lachrymation.
• Intolerance to bright light.
• Decreased concentration of attention.
• Periodic blurring of vision.

If these symptoms appear, you should seek medical help and get a diagnosis to prevent further progression of the disease.

The main method of treating asthenopia with hypermetropia is a correction with glasses. The patient is picked up glasses for permanent wearing with the maximum tolerable collective lenses.

[18], [19]

Complications and consequences

Like any disease, asthenopia can cause certain consequences and complications. As a rule, they arise because of ill-treatment of medical help. Most often, patients face such a negative outcome of ophthalmic pathology:

• Strabismus.
• Conjunctivitis.
• Inflammation of the eyelids (blepharitis).
• Impairment of vision quality.
• Nervosa and migraine due to frequent and severe headaches.

Proceeding from this, it can be concluded that asthenopia can not be neglected, since it threatens quite serious diseases.

[20], [21], [22], [23], [24], [25],

Diagnostics of the astenopia

To identify the syndrome of visual fatigue, the patient is assigned a set of laboratory and instrumental studies. Diagnosis of asthenopia can be performed only by a qualified ophthalmologist. The doctor collects an anamnesis, analyzes the patient's complaints and assesses the severity of the pathological symptoms.

Diagnosis consists of:

• Determination of visual acuity.
• Measurement of the angle of strabismus (Hirschberg's method, synoptophor).
• Refractometry for different pupil states.
• Measurement of the accommodation reserve.
• Identification of fusional reserves.
• Ultrasound diagnostics.
• Lab tests.

Based on the above surveys, the ophthalmologist makes the final diagnosis and appoints the most appropriate methods of treatment.

Analyzes

Laboratory diagnostics of asthenopia is carried out in the event that it is suspected that the disease is caused by various disorders on the part of the body. Analyzes are necessary for lesions of the connective membrane of the eye, since conjunctiva account for about 30% of ophthalmologic pathologies.

Patients are assigned a complex of tests:

• General analysis of blood and urine.
• Biochemical studies of biological fluids.
• Bacteriological and virological analyzes from the eye or scrapings of a detachable conjunctiva to identify a bacterial pathogen.

In addition to the above studies, the patient may be given serological tests to identify adenovirus antigens. Immunological tests are performed with suspicion of fungal infections of the eyes.

[26], [27], [28]

Instrumental diagnostics

Examinations of the eyes with the help of various equipment and evaluation of their physiological parameters are instrumental diagnostics. When suspected of asthenopia, such examinations are prescribed:

• Visometry, that is, the definition of visual acuity, both with correction, and without.
• Perimetry - evaluation of visual fields.
• Sciascopia - the study of refraction with the help of an indirect ophthalmoscope and rulers on the nature of the movement of the shadow in the pupil.
• Ultrasound examination of the eye and determination of its anteroposterior axis.
• Refractometry is the definition of the refractive power of the eye in the state of cycloplegia.
• Ophthalmoscopy.
• Examination of the ophthalmic two with the use of the Goldman lens to identify concomitant disorders.

According to the results of instrumental diagnostics, an ophthalmologist can draw conclusions about the degree and form of visual fatigue.

Differential diagnosis

Since asthenopia has several species, differential diagnostics is indicated for their detection.

• The accommodative and muscular forms are manifested by the severe fatigue of the eye apparatus. Differentiation is carried out with diseases characterized by weakened accommodation and spasms. During the diagnosis, congenital inertia of the internal muscles, violation of binocular vision is determined. Also, strabismus, refractive cramps, nerve paralysis responsible for eye movement, a decrease in the elasticity of the lens.
• Mixed form (characterized by a combination of muscle and accommodative fatigue) is diagnosed with unstable binocular vision, unstable focusing of images, bifurcation of objects.
• With a nervous type the doctor diagnoses severe photophobia, frequent attacks of darkening in the eyes.
• Symptomatic forms are characterized by various inflammatory lesions of the structures of the vision apparatus.

Differential diagnosis is carried out using instrumental and laboratory methods. In the course of examinations, such pathologies can be detected: astigmatism, myopia, ciliary muscle weakness, hypermetropia, which require additional treatment.

Treatment of the astenopia

The syndrome of visual fatigue is characterized by a fairly long-term therapy. Asthenopia treatment is aimed at eliminating and preventing the causes of the disorder, as well as restoring the normal functioning of the eye. Success and speed of recovery largely depend on the desire of the patient.

• At the first stage of therapy, correction is performed with the help of contact lenses or glasses. This allows you to eliminate the rapid eye fatigue and, if necessary, improve the quality of vision.
• To relax the ciliary muscle and relieve the spasm of accommodation, drug treatment is indicated. Most often, patients are prescribed drops with an active component - atropine or mydriatic. Also recommended the intake of vitamins and vitamin complexes to maintain eye health.
• As a hardware treatment and training reserve apply such techniques: divergence, convergence, accommodation. For this, various simulators, prisms, plus lenses of different strengths are used.

Various computer programs are used to relieve muscle tension and prevent the development of fatigue syndrome: EyeDefender, Safe eyes, Relax. If the pathological condition is accompanied by strabismus, nearsightedness or farsightedness, then the following software packages are recommended: EYE, Strabismus, Blade.

Medications

For the treatment of asthenopia, medications can be prescribed that relieve accommodation spasms and relax the ciliary muscle. Medicines are chosen by an ophthalmologist, individually for each patient.

Consider the most effective medications to eliminate the syndrome of visual fatigue:

1. Digitoxin

Low-polar cardiac glycoside from digitalis. It has inotropic properties, increases the concentration of intracellular sodium, regulates the exchange of calcium and sodium. Promotes the formation of actomyosin and increased myocardial contractions.

• Indications for use in ophthalmic practice: presbyopia, astenopia, latent hypertension and eye fatigue, pain in the eyes with migraine, impaired intraocular circulation. The drug is used to treat pathologies of the cardiovascular system: chronic heart failure, ciliary tachyarrhythmia, heart failure with low cardiac output, paroxysm, sinus tachycardia.
• The method of administration and dosage are completely dependent on the treatment regimen and indications. Eye drops are used 3 times a day for 3-6 days, 1 drop in each eye.
• Contraindications: hypersensitivity to the components of the drug, impaired liver function, acute myocardial infarction, glycosidic intoxication.
• Side effects: headaches and dizziness, allergic reactions, temporary reduction in visual acuity, sleep disturbances.

Digitoxin is available as an eye drop in a 10 ml dropper and in a tablet form for oral use.

2. Irifrin

The drug with the active substance is phenylephrine. Included in the category of selective a-adrenomimetics, with a predominant effect on a1-adrenergic receptors. Has a mydriatic effect. It stimulates a1-adrenergic receptors, localized in the postsynaptic membranes of the vessels and the radial muscle of the iris. Improves intraocular pressure, dilates the pupil, without affecting accommodation.

• Indications for use: elimination of spasm of accommodation and myopia with high visual load, treatment of iridocyclitis and red eye syndrome. The drug can be used for diagnostic manipulations. It provides mydriasis in ophthalmoscopy. It is used to conduct provocative tests with suspicion of closed-angle glaucoma and in patients with a narrow anterior chamber profile of the eye
• How to use: one drop in each eye before going to sleep. The course of treatment is determined by the attending physician. In most cases, to achieve a persistent pharmacological effect, a single use of the drug is sufficient.
• Side effects: inflammation and temporary reddening of the conjunctiva, swelling, pain and burning in the eyes, lacrimation, narrowing of the pupil, increased intraocular pressure. Systemic side effects are also possible: allergic reactions (most often dermatitis), an increase in the number of heartbeats, increased blood pressure, reflex bradycardia.
• Contraindications: hypersensitivity to the drug components, zakratougolnaya or narrow-angle glaucoma, diseases of the cardiovascular system, tachycardia, high blood pressure, violation of the integrity of the eyeball. The drug is not prescribed for patients with type 1 diabetes, thyroid disease, hepatic porphyria, during pregnancy and lactation, for the treatment of children.
• Overdose: anxiety, excessive sweating and nervousness, dizziness and headaches, vomiting, increased heart rate, shallow breathing. As an antidote, alpha-adrenoreceptor blockers are shown - Fentolamine 5-10 mg intravenously.

The drug is available in the form of eye drops of 2.5% for 0.4 and 5 ml in a vial and 10% for 5 ml in a vial.

3. Mesatone

Vasoconstrictor, stimulator of a-adrenergic receptors of blood vessels. Causes spasms of arterioles and increased blood pressure. Promotes dilatation of the pupil and a decrease in intraocular pressure without affecting accommodation. Has weakly expressed mydriatic properties.

• Indications for use: increased blood pressure in hypotension and collapse, asthenopia, infectious diseases of the eyes, dilated pupil in irites, iridocyclitis, secretory renal anuria.
• Method of application: 1-2% solution is injected into the conjunctival sac by 2-3 drops. The duration of treatment is determined by the attending physician.
• Side effects: headaches and increased irritation, irritability, arrhythmia, paresthesia, pain in the heart, tremor of the extremities.
• Contraindications: hypertension, propensity to vasospasm, age of patients under 15, hepatitis, atherosclerosis.
• Overdose: short attacks of ventricular tachycardia and extrasystoles, a feeling of heaviness in the head, increased blood pressure.

The drug is available in the form of a 1% solution in 1 ml ampoules and as a dry powder for the preparation of a solution for injections.

4. Midratsil

A medicinal preparation with an active component is tropicamide. Refers to anticholinergic drugs blocking M-holinoretseptory, including in the sphincter of the pupil and ciliary muscle. The maximum therapeutic effect develops 20 minutes after instillation.

• Indications for use: increased visual fatigue, ophthalmoscopy, determination of refraction. Very often the drug is used in preparation for eye surgery and laser therapy. The drug is effective in the complex therapy of ophthalmic pathologies and as the prevention of synechia in the postoperative period.
• The method of application and dosage is determined by the attending physician. Most often, patients are prescribed instillation of 1-2 drops of a 1% solution once a day.
• Side effects: increased intraocular pressure, temporary deterioration of vision, an attack of closed angle glaucoma, headaches, photophobia, psychotic reactions, hypotension, allergic reactions, tachycardia, fever.
• Contraindications: primary glaucoma and a tendency to this pathology, individual intolerance of the components of the drug. With special care is prescribed with increased intraocular pressure, inflammatory diseases of the eyes, during pregnancy and lactation.
• Overdose: anticholinergic intoxication, dry skin and mucous membranes, violation of heart rhythm and coordination of movements, hallucinations, behavior change, collapse.

Midratsil is available in the form of drops of 0.5% and 1% of 15 ml in a vial.

5. Tropicamide

A drug that dilates the pupil. It blocks the structural formation of the eye, causing a disruption in the motor function of the ciliary muscle and visual impairment.

• Indications for use: diagnosis of mydriasis, cycloplegia, examination of the fundus, determination of the refractive power of the eye. Complex therapy of inflammatory pathologies of the organs of vision and elimination of adhesions of eye tissues with surrounding tissues.
• Method of application: drops are instilled in the lower conjunctival sac in a single dose of 1-2 drops. For the treatment of asthenopia, a 0.5% solution should be used 3-6 times a day.
• Side effects: increased intraocular pressure, visual impairment, photophobia, headaches and psychopathic reactions, palpitations, a sharp drop in blood pressure, fever, temporary burning in the eyes, various allergic reactions.
• Contraindications: hypersensitivity to the components of the drug, zakratougolnaya glaucoma.

The drug is available in the form of eye drops of 0.5% and 1% of 10 ml in a vial.

6. Emoxipine

Medication used in ophthalmology. Contains the active ingredient - methyl ethyl pyridinol, which contributes to the protection of the eye tissues. The drug reduces the level of permeability of the vascular endothelium, accelerates resorption of intraocular blood and dilutes blood.

• Indications: inflammation of the cornea, cataract and its prevention, hemorrhages in the anterior chamber of the eye or sclera, retinal dystrophy, diabetic retinopathy, myopia complications, glaucoma, ophthalmic operations.
• Method of administration: subconjunctivalally 1-3 drops of 1% solution once a day or every other day, parabulbar for 1-3 drops of 1% solution once a day or every other day. Duration of treatment is 10-30 days. If necessary, the therapy can be done several times a year.
• Side effects: burning and rubbing in the eyes, reddening of the mucous membrane.
• Contraindications: individual intolerance to the components of the drug, pregnancy and lactation.

Emoksipin for ophthalmic use is available in the form of a solution of 1% for instillation in the eyes of 5 ml in a vial.

Drops with asthenopia

Most drugs to remove eye fatigue and combat their dryness are over-the-counter. But drops with asthenopia should be used only for medical purposes. This is due to the fact that it is quite difficult to choose an effective medicine yourself.

Consider popular drops to relieve eye strain:

1. Vizin

Contains tetrisolin - a-adrenostimulator, which contributes to the narrowing of blood vessels. Reduces edema of the conjunctiva, dilates the pupil and reduces the formation of intraocular fluid. The therapeutic effect develops a couple of minutes after instillation and persists for 4-8 hours. Medicinal substances are not absorbed and do not penetrate into the systemic bloodstream.

• Indications for use: redness, lacrimation and eye swelling due to exposure to physical or chemical agents, allergic conjunctivitis.

• Method of application: drip 1-2 drops of medication 2-3 times a day in the conjunctival bag. Before using the product, contact lenses should be removed. Drops are not recommended for continuous use for more than 4 days.
• Side effects: burning, redness and dilated pupil, irritation of the conjunctiva, blurred vision, pain in the eye, allergic reactions.
• Contraindications: hypersensitivity, angle-closure glaucoma, patients younger than 2 years, corneal dystrophy. With special care is used for arterial hypertension, diabetes, during pregnancy and lactation.
• Overdose is possible when the drug enters the digestive tract. In this case, symptoms of tachycardia, convulsions, pupil dilated, nausea, febrile condition, respiratory disorders, pulmonary edema, circulatory arrest, coma are observed. For treatment, gastric lavage, activated charcoal, oxygen inhalation are shown.

2. Systein

Ophthalmic topical. Has moisturizing properties, reduces discomfort due to insufficient moisturizing of the eyes, eliminates itching, burning and sensation of sand in the eyes. Does not have a mechanical or chemical effect on the mucosa. The therapeutic effect quickly develops and persists for a long period of time. Does not have a systemic effect, is derived with tears.

• Indications for use: dryness and irritation of the eyes, contact conjunctivitis, dry eye syndrome, visual fatigue syndrome. Elimination of discomfort when wearing lenses.
• Method of application: the drug is applied to the eyes 1-2 drops 1-3 times a day. The course of treatment is determined by an ophthalmologist, individually for each patient.
• Side effects: allergic reactions, temporary burning in the eyes. There have been no cases of overdose.
• Contraindications: intolerance of components of drops, pregnancy and lactation.

3. Taufon

A solution for the eyes with the active substance is taurine (sulfur-containing amino acid). Improves energy processes, participates in the metabolism of fats. Slows the transmission of nervous excitement, has anticonvulsant and cardiotropic properties.

• Indications for use: decrease in intraocular pressure, acceleration of recovery in dystrophic lesions of the retina or traumatic disorders of the tissues of the organs of vision, cataracts, open-angle glaucoma.

• Method of application: 2-3 drops 2-4 times a day. The course of treatment is 10-30 days with repetition in a month.

• Contraindications: hypersensitivity to the components of the drug. Side effects or symptoms of an overdose are not fixed.

4. Oxyal

Drops for use in ophthalmology. The drug contains hyaluronic acid and electrolytes, which effectively eliminate dryness of the cornea and eye irritation. According to rheological properties, the medicine is close to human tears. Promotes the regeneration of the cornea due to the preservation of the integrity of the tear film. Supports the natural level of mucin production.

• Indications for use: contact conjunctivitis, dryness and irritation of the cornea with increased visual loads and medication. Condition after laser correction of vision and other ophthalmologic surgical interventions.

• How to use: Drops are added to the conjunctival sac as needed. As a rule, the drug is recommended not to be used more often 4-5 times a day.
• Side effects: reactions of allergic genesis. If they occur, stop using the drops.
• Contraindications: hypersensitivity to the components of the drug. The medication can be used during pregnancy and lactation, but only for the purpose of the ophthalmologist. Symptoms of overdose are not fixed.

5. Ottagel

Synthetic replacement of tear fluid with high-molecular weight carboxyvinylpolymer. Increases the viscosity of tear fluid, forms a moisturizing and protective film on the cornea. Reduces dryness, itching and pain in the organs of vision.

• Indications for use: dry eye syndrome, reddening of the eyes and their prolonged stress, dry keratoconjunctivitis.
• Method of application: 1 drop is not more often 4 times a day, the treatment is determined by the attending physician.
• Side effects: hyperemia, pruritus and tingling in the eyes, a temporary decrease in visual acuity.
• Contraindications: intolerance of the components of the drug, pediatric practice. With special care is prescribed during pregnancy and driving (you can drive 40 minutes after installation). There have been no cases of overdose.

In addition to the above drops, for the treatment and prevention of visual fatigue syndrome, you can use a natural tear drop and a synthetic tear.

Vitamins

One of the most common causes of impaired vision and development of ophthalmic diseases is the deficiency of nutrients in the body. Vitamins are necessary for the normal functioning of all organs and systems. So, for example, lack of vitamin A leads to the development of "night blindness", low content of B6 - the cause of involuntary jerking of the eyelids. If the body lacks vitamin B2 or fatty polyunsaturated acids, then there is a feeling of sand in the eyes or foreign body under the eyelids.

Vitamins for the treatment and prevention of asthenopia:

• Retinol - vitamin A is a component of the visual pigment of rhodopsin, which improves visual acuity and color perception. This substance positively affects the cornea and conjunctiva, protecting them from dryness.
• Thiamin - vitamin B1 is involved in the conduct of visual impulses for neurons. Participates in metabolic processes in the retina of the eye. Reduces intraocular pressure, prevents the development of glaucoma.
• Riboflavin is a component of the visual pigment. Vitamin B2 saturates the tissues of the cornea and the lens with oxygen, and feeds them. Performs prophylaxis of keratitis, glaucoma and cataract.
• Cyanocobalamin - vitamin B12 provides a normal blood supply to the eye tissues, takes part in the restoration of optic nerves and retinal cells. It is a preventive remedy for retinal detachment and the appearance of a thorn.
• Ascorbic acid - vitamin C strengthens the walls of blood vessels, prevents pinpoint hemorrhages, participates in oxidation-reduction processes. Reduces the risk of developing glaucoma and cataracts.
• Tocopherol - vitamin E accelerates the regeneration of tissues, accumulates in the retina and affects metabolic processes. It has antioxidant properties, significantly slows down the age-related changes in the tissues of the organs of vision. Stimulates the synthesis of collagen, supporting the muscle tone of the eye.
• Lutein and zeaxanthin are carotenoids that support the retina of the eye and its functions. Provide protection from the corrosive effects of ultraviolet radiation. Have antioxidant properties.

Also there are vitamin complexes that support normal functioning of the organs of vision and act as prevention of ophthalmologic pathologies. Consider effective drugs to eliminate eye strain and prevent asthenopia:

1. Vitrum for Eyes

Contains lutein and zeaxanthin, which protect the eye cells from peroxide compounds and free radicals. The drug reduces the risk of development and further progression of diseases of the eye. Improves the cardiovascular and nervous system, reduces the risk of atherosclerosis and cerebral blood flow disorders.

• Indications for use: prevention of age-related visual impairment, beriberi, increased eye fatigue, visual impairment. Complex treatment of diseases of the optic nerve, cataract, retinopathy. Acceleration of recovery after ophthalmic operations.
• Directions for use: 1 tablet 1 time per day with meals. Duration of treatment is 2-3 months.
• Side effects: skin allergic reactions, itching, hives.
• Contraindications: hypersensitivity to the components of the drug. With caution is prescribed for pregnant and lactating women, for children under 12 years.
• Overdose: nausea, vomiting, diarrhea, pain in the epigastric region. Treatment is symptomatic, shows the reception of enterosorbents and gastric lavage.

2. Optix

Combined drug, which includes minerals, vitamins and plant carotenoids. It has antioxidant properties, replenishes the deficiency of vitamins and minerals in the body.

• Indications for use: replenishment of the supply of useful substances necessary for the full operation of the organs of vision, with age-related degenerative changes in the retina, pathologies of the optic nerve. Prevention of visual disorders in patients with diabetes mellitus. Used in the complex treatment of night vision disorders and prevention of retinal degeneration. Accelerates the recovery period after ophthalmic surgery.
• Dosing: for adults and children 1 tablet a day, regardless of food intake. The course of treatment is 2-3 months.
• Side effects: various skin allergic reactions. Overdose is manifested by increased side effects. Treatment is symptomatic.
• Contraindications: individual intolerance of the components of the drug, the age of patients younger than 12 years. With special care is prescribed during pregnancy.

3. Strix

Biologically active additive with retinoprotective properties. It improves visual functions, increases the tone of the eye capillaries, restores visual pigments, increases visual acuity, reduces the severity of asthenopia, slows the development of age-related degenerative changes.

• Indications for use: myopia and its complicated forms, fatigue and fatigue of the eyes while working at the computer and long reading, hemorrhagia, primary glaucoma, recovery period after ophthalmic surgical interventions, peripheral and central retinal dystrophy, diabetic retinopathy.
• The method of administration and dosage depends on the age of the patient. The drug is taken orally with a sufficient amount of liquid. The average dosage is 1 tablet per day for 2-3 months.
• Side effects: various allergic reactions.
• Contraindications: individual intolerance of active ingredients. Use during pregnancy is only possible according to the doctor's prescription.

4. Okyuwait Lutein Forte

Combined product, which includes minerals (zinc, selenium), vitamins C and E, carotenoids, antioxidants.

• Indications for use: restoration and maintenance of the function of the visual apparatus, increasing visual acuity, improving the perception of colors for patients with ophthalmic diseases or the risk of their development.
• Directions for use: tablets are taken orally after meals. Recommended dosage of 1 capsule 2 times in bitches. The average duration of treatment is 2-3 months.
• Side effects occur most often in patients with intolerance to the components of the drug and manifest as allergic reactions.

5. Blueberry forte

Complex biologically active drug. Contains bilberry extract, B and C vitamins, zinc and rutin. Such a composition hinders the reduction in visual acuity due to eye strain, improves microcirculation, has an antioxidant effect and strengthens the capillaries of the organs of vision.

Regular use of the vitamin complex helps normalize the intraocular pressure. The drug is not recommended for patients with hypersensitivity to its components, for children under 3 years. In rare cases, there is a development of allergic reactions. There have been no cases of overdose.

Physiotherapeutic treatment

Complex therapy is shown to effectively eliminate the syndrome of visual fatigue. Physiotherapy treatment for asthenopia consists of hardware techniques for increasing the reserve of accommodation and special gymnastics.

Hardware methods:

1. Synoptophor - used for asthenopia on the basis of weak fusional reserves, with pronounced violations of binocular vision or friendly strabismus. The principle of this technique is based on the separation of fields of vision. For example, one eye can see a vase, in another flower and a patient should place it in a vase, combining the eye axes and training the eye muscles.
2. Helium-neon laser therapy - is prescribed for spasm of accommodation with ametropia and asthenopia. Treatment is effective in diseases and atrophy of the optic nerve, corneal dystrophy, pathology of the eyelids. Helium-neon laser stimulates the structure of the eye with a light beam of low intensity.

The beam affects the organs of vision at the molecular, cellular, organ and tissue levels. Increases the protective properties of retinal pigment epithelial cells, improves blood circulation and metabolism of the eye. Strengthens the processes of regeneration of the epithelial cells of the cornea, activates local immunity and eliminates the spasms of the ciliary muscle.

3. Software-computer treatment - asthenopia, amblyopia of any degree, initial presbyopia, spasm of accommodation, violation of binocular vision, friendly strabismus. During the procedure, retinal irritation (local and general) occurs with bright dynamic color pulses. The therapy is based on the methods of perception of the visual image, the development of the muscular reserves of the eyes and their coordinated work. The main curative programs are: Flower, Contour, Chibis, Relax, Blade-2, Shulte Table.

To ensure that the vision organs are always healthy and function well, it is necessary to ensure their good blood supply. For this, the following exercises are recommended:

• Sit up straight, close your eyes and relax. Imagine that the tip of the nose is a pencil. Draw it in the air for 30-40 seconds.
• Bend your hands in the elbows so that your hands are below eye level. Arrange your fingers and perform smooth turns with your head from side to side. During the exercise, you should look through your fingers, not detaining the sight of outside objects.
• Take a deep breath and look in the interbrow, hold your eyes in this position for 10-20 seconds. Slowly exhale, return your eyes to their original position, close them and massage.
• While taking a breath, slowly turn your eyes to the right, on exhalation return to the starting position. Take a deep breath and turn your eyes to the left. After the exercise, close your eyes for 20-30 seconds.
• Lower your eyes down, and slowly turning clockwise, stop at the top point. Take a deep breath and keep turning down. Perform 2-3 circles, then close your eyes and turn your eyelids apart.

There are exercises that allow you to quickly remove fatigue from the eyes. They can be performed at any time and in any place.

• Carefully rub your hands and cover their eyes. Heat will give instant relaxation and comfort.
• Close your eyes and roll them up. Exercise is best done in a prone state, when the muscles of the neck are as relaxed as possible.
• Alternately, change the focus from the tip of the nose to the distant object. Delay in each position no more than 3-5 seconds.
• Close your eyes and describe them circles - 2 clockwise and 2 against, while changing the intensity of the movements.
• Relax and start blinking often, gradually change the pace of exercise.
• Shave the eyeballs in polar positions - right-left, up-down. Hold each position for up to 10 seconds.

In addition to physiotherapy, do not forget about observing the daily routine and rational nutrition. With prolonged visual exertion, interrupt to perform a couple of exercises and relax the muscles of the eyes.

Alternative treatment

You can remove eye fatigue at home. Alternative treatment allows not only to relax the visual muscles as much as possible, but also to get rid of external signs of fatigue (redness, bags under the eyes, inflammation).

• Take the fresh cucumber, cut it into circles and attach them to the eyes. Also, the chilled vegetable can be peeled off, grated on a large grater, wrapped in cheesecloth and put on the eyes. Useful cucumber substances are pulled up and cool the skin, moisturize, remove inflammation.
• Brew two sachets of black or green tea and refrigerate them. Attach the bags to your eyes for 3-5 minutes. If desired, you can wet cotton swabs and also apply to the eyelids. This method quickly removes irritation and eye fatigue.
• Slice a couple of slices of raw potatoes and attach them to the eyes. Potatoes can be grated, wrapped in gauze and put on eyes. Starch, which is contained in the vegetable, will remove puffiness and bleach dark circles under the eyes.
• Cut the fresh strawberries into large slices and attach them to the closed eyes. The berry contains useful substances and acids, which make the skin more fresh and young, relieve fatigue.
• Wrap a dense, but soft cloth a handful of ice cubes. Apply a compress to tired eyes. Instead of ice, you can use chilled metal tablespoons. After such procedure the skin will be tightened and will come to tone, fatigue will leave.

Despite the effectiveness and availability of alternative methods for eliminating visual fatigue, only a doctor should treat asthenopia.

[29], [30], [31], [32], [33]

Herbal Treatment

In the fight against visual fatigue, herbal treatment proved to be very effective. Consider effective recipes for herbal therapy:

• Take 50 g of dry chamomile and pour it 300 ml of boiling water, cook on low heat. Wrap the container with broth and let cool. After this, moisten with a sterile cotton swab in the liquid, tilt the head back and gently squeeze the medicine into the eyes. Repeat 8-10 times for each eye.
• Fresh birch leaves pour cold water and let it brew for 8 hours. The resulting infusion is used for lotions and washings. Such a remedy helps with tired eyes and swollen eyelids.
• Handful of fresh parsley finely chop, wrap in gauze and dip into boiling water for 7-10 seconds. Once the compress has cooled, it can be applied to the eyelids for 10 minutes. To eliminate fatigue and redness of the eyes, the procedure should be carried out 3-4 times.
• Cut the aloe stalk and chop it. Fold the flesh in the cheesecloth, wring out the juice. Dampen the cotton wheels in the liquid and attach them to the eyelids for 10-15 minutes. Aloe removes redness and smooths mimic wrinkles around the eyes.
• The decoction has a decoction of mint. 35 g of mint leaves pour 150 ml of water and cook over low heat for 20 minutes. Strain the liquid. Dampen two cottonwools in it and apply to tired eyes for 10-15 minutes. After such a procedure, you can wash with herbal decoction of chamomile or mineral water.

Standing and broths from herbs have antibacterial and relaxing properties, tone the skin and improve blood microcirculation.

Homeopathy

The treatment of asthenopia is not only concerned with classical medicine, but also with homeopathy. Most often, to combat the syndrome of visual fatigue, prescribe such drugs:

• Agaricus - asthenopia due to spasm of accommodation and prolonged strain of the organs of vision. Difficulties arise during reading, letters and objects blur, there are headaches.
• Asarum - pain in the head and eyes, burning, rubbing, lacrimation.
• Carboneum sulphuratum - heaviness in eyes and eyelids, sharp deterioration of vision, color blindness.
• Cina - a violation of accommodation and color perception, with the tension of the visual system, a veil appears, which passes after a short massage or rubbing the eyes.
• Kali carbonicum - acute pain and dark spots before the eyes. The upper eyelids are edematic, there is expressed fatigue after a brief visual work.
• Lachesis - asthenopia in combination with other visual impairments. Sclera yellow or reddened, glazed look, oppressed. Extended pupils, increased lacrimation.
• Lithium carbonicum - visual syndrome is accompanied by signs of photophobia. Black eyes appear before your eyes.
• Rhododendron - muscular astenopia, painful lumbago from the eyes through the head, heat and tension in the eyelids, one pupil is dilated, the other is narrowed.
• Secale - all signs of an asthenopic state. Pupils are spastically dilated or narrowed, marked painful sensations. Sharp reduction in visual acuity, a veil before the eyes and a foreign body sensation under the eyelids.

You can take homeopathic preparations only for medical purposes. The homeopath selects the drug, its dosage and determines the duration of treatment.

Surgery

To date, there is no surgical treatment for asthenopia. This is due to the fact that a complex of therapeutic and preventive methods can completely eliminate the disorder and prevent its possible manifestations in the future.

With the help of the operation, accommodation cramps are also not treated, corrective lenses, physiotherapy procedures, eye drops and vitamin therapy are used to eliminate them.

With weakness of the ciliary muscle and severe farsightedness or nearsightedness, laser treatment is possible. The operation allows you to fully restore your eyesight and eliminate the symptoms of visual fatigue. But without compliance with preventive measures, a painful condition will not keep you waiting again.

Prevention

Any disease, including ophthalmic disorders, is much easier to prevent than cure. Prevention of asthenopia is based on the following recommendations:

• Regular preventive examinations at the ophthalmologist.
• Timely treatment of ophthalmic and any other diseases of the body.
• Correct correction of vision loss.
• Work and read under the right light.
• Do not read lying in the transport.
• Observance of the rest regime for the visual system with its prolonged stress. After each hour of work, the eyes should rest for 10-15 minutes. During this time, you can perform special exercises or massage.
• Periodically use perforating glasses, which relieve the tension of accommodation.
• Observe a balanced diet and intake of vitamin complexes to maintain eye health.
• Adhere to a healthy lifestyle, spend more time in the fresh air.

Observance of the above rules, will allow for a long time to preserve the health of the eyes.

[34], [35]

Forecast

Asthenopia is often diagnosed in young patients, and recently in childhood. The disease brings considerable discomfort and pain. The forecast of the syndrome of visual fatigue depends entirely on the timely application of medical care and treatment. With proper therapy and observance of preventive measures, pathology has a favorable outcome.

[36], [37], [38], [39]