Asthenopia

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Original article contributed by:

Ayesha Shariff, MSIV, Robert F. Melendez, MD, MBA

All contributors:

Robert F. Melendez, MD, MBA, K. David Epley, M.D., Chrysavgi Adamopoulou, MD, A. Paula Grigorian, MD

Assigned editor:

A. Paula Grigorian, MD

Review:

Assigned status Update Pending

 by A. Paula Grigorian, MD on August 13, 2021.

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Contributing Editors:	add

Asthenopia

ICD-10

H53.1

MeSH

D001248

Disease Entity

Asthenopia

Definition

• Eyestrain
• Subjective symptoms of ocular fatigue, discomfort, lacrimation, and headaches arising from the use of eyes.
• Weakness or tiring of eyes accompanied by pain, headache, blurry vision, sensitivity to light or inability to keep the eyes open.

Etiology

• Accommodative asthenopia: strain of ciliary muscle and refractive error. This is probably the most common form of asthenopia seen in uncorrected presbyopic and pre-presbyopic patients with hyperopia as well as in myopic patients that were overminused prescriptions
• Photogenous asthenopia: excessive or improper illumination.
• Muscular asthenopia: due to imbalance of the extraocular muscles
• Nervous asthenopia: due to functional or organic nervous disease, commonly seen in anxiety

Symptoms

• Pain in and around eyes
• Headache, usually aggravated by use of eyes for closework
• Fatigue
• Vertigo
• Reflex symptoms as nausea, twitching of facial muscles, migraine.

Treatment

Treatment of the underlying cause is first line, therefore an eye exam is warranted with glasses prescription as necessary, correction of strabismus and artificial tears, lid hygiene and warm compresses for dry eyes. By far, the most important component of the management of this condition consists in prescribing the appropriate glasses especially in hyperopic patients, including treatment of presbyopia. Cycloplegia is indicated in patients under the age of 30 years to diagnose the entire amount of hyperopia as well as to prevent overminusing in myopic patients. Avoiding prolonged use of computer devices (more than 2 hours) and short brakes for eye rest helps relieve the symptoms. Analgesic drugs may also be prescribed for this condition.

Additional Resources

• Celia Vimont Laurie Gray Barber. Eye Strain. American Academy of Ophthalmology. EyeSmart^® Eye health. https://www.aao.org/eye-health/diseases/eye-strain-list. Accessed March 29, 2019.

References

1. Taber's Cylocpeic Medical Dictionary
2. Stedman's Medical Dictionary