Ophthalmic Lenses

OD’s Device Advice: Help Patients Optimize Use of Electronic Devices

By Teresa Narayan, OD

SYNOPSIS

ODs can lead the discussion of how to optimize use of electronic devices by prescribing and selling eyewear and making other recommendations.

ACTION POINTS

ASK ABOUT DEVICE USE ON IN-TAKE. Find out on the patient intake form what devices the patient is using and follow-up in exam room conversation.

OFFER EYEWEAR & DEVICE USE SOLUTION: Offer eyewear like anti-glare progressives, along with recommended adjustments on device settings.

HAVE DEVICES IN OFFICE FOR TESTING. Having tablets in the office can allow a patient with a new prescription to test out their real world visual acuity and performance.

Tablets and smartphones are great conveniences–provided you can see what’s on the screen. ODs have the opportunity to help patients better enjoy their devices by prescribing eyewear and working with patients to find settings on the devices that ease vision.

Optimize Vision When Using Devices

Lens Solutions
Progressives
Near-Only Rx
Anti-Reflective Treatments

Device Solutions
Matte Screen Protectors (as long as they’re kept clean)

Remove dirty screen protectors
Adjust brightness
Increase font size
Flip the contrast to make letters white on black
Make text speak out loud

PATIENT INTAKE: ASK ABOUT DEVICE USE

You can bring up device use on the history intake form, before the exam even begins. There could be a few brief questions regarding computer, tablet and other device use and an area to detail which devices are most used and the average daily or weekly usage. The next place would be in the exam room during the history portion of the exam. A thorough history usually involves asking the patient about their occupation and hobbies. A logical follow-upis to discuss electronic device use and how it fits into a patient’s daily life. Finally, I bring up electronic device use near the end of the exam when I am discussing lens recommendations. Knowing about a patient’s use of these devices will guide recommendations such as specialized progressives or anti-reflective treatments.

OFFER EYEWEAR & DEVICE USE SOLUTION

Eyewear

If I have a presbyopic patient who frequently uses her tablet outdoors, I would recommend some type of near prescription, generally progressives or a near-only Rx, if the patient needs an add. However, I would also make sure to recommend good anti-reflective treatments on their standard spectacles to cut down on the glare that a screen like that produces outdoors. There are also matte screen protectors that can be purchased and applied to the tablet screen to cut down on glare, but they sometimes cut down contrast and readability, especially after they’ve been on for a while and scratches have accumulated. And this would be the one instance where I caution the patient against polarized sunglasses. Polarized lenses do not work well with many tablet screens and often blacken out the screen in certain orientations. Some tablets and phones have eliminated or minimized this problem by using various techniques, but the iPad is still not compatible with polarized sunglasses when in portrait mode.

Sometimes patients will return to our office after finding that their new glasses are not sufficient for their devices. When this happens it is usually a flat bifocal wearer who was hesitant to switch into progressives, maybe due to cost or sometimes because they heard of others having trouble with adaptation, so they are wary. However, as the add is increased in a flat top bifocal, the no man’s land between the distance and near prescription becomes greater and electronic dashboards and tablet viewing fall right into this range. Most of the time these patients are happy with progressive lenses after they are educated about their decreasing accommodative ability and why flat top bifocals are no longer working well for them.

Device Use Solutions

Many patients are unaware that their devices have settings that, if tweaked, could greatly improve their comfort while using the device. Brightness can be adjusted and dirty screen protectors can be removed, and I also suggest increasing the font size. Flipping the contrast to make the letters white on black or even making the text speak out loud are also options that might be useful in certain situations. There are also numerous accessibility settings which are usually targeted toward the low vision patient but can be taken advantage of to improve readability for every patient. I make sure that I know how to highlight these settings on my Android phone and am fairly familiar with the iPhone settings, as well, so that I can at least point patients in the right direction. Even if you don’t know exactly how to change the settings, just letting the patient know that those options are available can be very helpful as they can then check their manual or go online to find out how to change the settings for their phone.

One thing that doesn’t directly apply to specific eyewear or device recommendations, but is important to mention to patients is the effect of ergonomics on patient comfort. Computer vision syndrome is well known and proper workstation set up can help alleviate many of the associated symptoms. I would take that the same idea and apply it to everyday electronic device use by suggesting that patients try to remember to use optimal posture and device screen positioning not just when at work and viewing their desktop monitor but also when at home or on the go and using a tablet, e-reader or smartphone. This seemingly simple thing can have a big effect on overall visual fatigue and will likely improve a patient’s quality of life, especially with the extended device and screen use that has become the norm today.

HAVE ELECTRONIC DEVICES AVAILABLE IN OFFICE

I definitely see the benefit of having some electronic devices available in the office for patient testing purposes. First of all, they can be used for the patient to demonstrate their usual working distances and usage patterns so that appropriate eyewear recommendations can be made. Secondly, once the patient receives their eyewear, they will be able to test out their new lenses in a much more real world experience than simply reading a distance or near VA chart. Most patients usually have their mobile phone with them at all times, but some useful devices to have for patient testing use in the office include a tablet, an e-ink device, a laptop and a desktop computer.

In addition, by having a variety of electronic devices available to the patient, the optometrist can test the patient’s vision in real world situations with a trial frame or with trial contact lenses. Testing mobile phone use has been a staple of mine when fitting patients with multifocal contact lenses. If they can comfortably read their phone notifications then they will likely be OK with most real world near-vision demands. Having other devices around to test with such as tablets, laptops and desktop computer screens can help to ensure the patient’s comfort with their spectacle or contact lens prescription.

Related ROB Articles

Computer Eyewear: Provide Relief from Computer Vision Syndrome

Hand-Held Device Advice for Multifocal Contact Lens Patients

Free-Form Lenses: Address the Needs of Your Patient at Work and Play

Teresa Narayan, OD, is an associate at Shoreline Eye Associates, P.C., in East Haven and Guilford, Conn. To contact: teresanarayanod@gmail.com

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