Health problems are often complex; solutions can require cooperation amongst different specialties. As chiropractors who treat neck pain, we aren't eye experts, but we appreciate the functional importance vision plays in neck pain. Similarly, optometrists aren't neck experts but have a commanding understanding of the visual system.
The previous two blog posts here & here discussed the relationship between vision and neck pain. We highlighted why understanding this relationship is key to managing patients with neck pain or related complaints such as headaches that originate from the neck (cervicogenic headache). We will discuss these types of headaches in an upcoming post. For now, we will continue to explore the neck pain/vision relationship by sharing a common observation made in our office in patients with neck pain who also wear prescription glasses, most often progressive lenses.
Progressive prescription lenses are great in lots of ways. Progressives allow patients with visual limitations in both near and far sight to escape the inconvenience of having to carry two different prescriptions with them at all times. Instead of flipping between glasses, when progressive wearers need to see far, they simply look through the upper part of a progressive lens. Similarly, patients who need a near vision assist simply look downwards through a progressive lens to enjoy near vision clarity. This wide range of clear vision benefits users for activities where both functions are required. Driving is an everyday example of where a progressive lens shines; viewing gauges is easy through the lower half of a lens, and seeing into the distance through the windshield is clear through the top half of a progressive lens. While great for activities like driving, progressives can cause trouble for the neck when activities involve more sustained near gaze, such as at the computer.
Remember, a progressive lens wearer needs to look down to utilize the magnifying portion of the lens to see near. Problems present when a computer monitor is positioned at eye level straight ahead. Looking straight ahead through a progressive lens is for seeing to the distance, not up close at a monitor. So what happens? Subconsciously, the progressive wearer will tilt their neck backwards. Tilting the neck backwards allows positioning of the magnifying portion of a progressive lens to be in line with their monitor so they can see it clearly. For a few minutes at a time, this is no concern. But for long periods, positioning the neck like this causes overactivity of neck muscles. Cervical (neck) muscular overuse syndromes and symptoms can take weeks to develop, making the immediate connection to a new set of glasses difficult, particularly if the new glasses have improved the patient's vision. Patients enjoying the convenience and improved vision a progressive lens has brought can even be reluctant to acknowledge this connection once made!
If you or someone you know has recently changed to a multifocal or progressive lens and experiences neck pain, our office would be glad to review the situation. We work collaboratively regularly with several optometry offices in Edmonton. We are happy to coordinate the process of developing a better neck vision strategy to allow you to maintain the visual benefits of your lenses without the neck pain and headaches that might be coming along with them! Stay tuned; we'll be discussing neck-based headaches in the upcoming post!