Symptom descriptors and locations were able to distinguish discomfort on the basis of causative condition. Results support two different symptom constellations and, hence, at least two different afferent pathways for symptoms of asthenopia.

The luminance surrounding a computer display can potentially reduce visibility of the display (disability glare), result in sensations of discomfort (discomfort glare) and result in transient adaptation effects from fixating back and forth between the two luminance levels. The study objective was to measure the effects of surround luminance levels upon these functions in younger and older adults to determine recommended surround luminance levels. The younger age group comprised 20 subjects (mean age 27.9 years, range 23 - 39) and the older group 17 subjects (mean age 55.5 years, range 47 - 63). The central task was presented with luminance of 91 cd/M(2), tested surround luminance levels were 1.4, 2.4, 8.9, 25.5, 50, 91, 175, 317, and 600 cd/M(2). Disability glare was tested with low contrast (20%) visual acuity charts, transient adaptation was tested with a task that required regular fixation between the two luminance levels, discomfort was measured with a questionnaire after reading stories with different surround luminance levels, and preferred luminance was measured by method of adjustment. The surround luminance significantly affected transient adaptation (p < 0.0001), optimal performance occurred at 50 cd/M(2) and above for the young group and at 91 cd/M(2) and above for the older group. Neither low contrast acuity (disability glare) nor symptoms when reading were significantly affected by surround luminance. There was wide variation in preferred surround luminance; however, average preferred surround luminance was 86.9 cd/M(2) for the young group and 62.2 cd/M(2) for the older group, slightly below the central luminance of 91 cd/M(2). The effects of the surround luminance within the tested range are not large; however, the data show that the lowest surround luminance levels should be avoided and that surround luminance levels at or slightly below that of the central task are preferred.