Neck pain brought into focus

Abstract

A time honored dictum states that the eyes "lead the body", i.e. that the body typically adjust its position to compensate for an impoverished retinal image (e.g., as due to optical blur, and/or inappropriately sized visual target). But only moderate or low level of evidence exists in support of this view. Inconclusive evidence does not, however, equal negative evidence. The accommodation/vergence system does exhibit signs of overload in contemporary working life, including eye discomfort, transient myopia, altered pattern of eye-lens oscillations, and associated phoria. Accommodation/vergence overload, caused by non-ergonomic near work, may also emerge as quickly as within one regular workday. Long-term musculoskeletal consequences of high accommodation/vergence demands have nevertheless not yet been studied in any detail. A research agenda which aims to provide multi-scientific evidence for eye-neck/shoulder interactions with public health implications and which also, in addition, study the eye-neck/shoulder mechanisms and elucidates the operating characteristics, should consequently be highly warranted. This new knowledge would be useful for physiotherapists, ergonomists and opticians, who in their profession treat patients experiencing vision-and musculoskeletal disorders. If both visual and the musculoskeletal aspects are given full and equal weight in the design and evaluation of work places, it is predicted to lead to an improved quality of life for the individual worker, and an enhanced productivity for the employer.

Viewing distance and eyestrain symptoms with prolonged viewing of smartphones

“…Future research could investigate whether people with binocular vision problems report a greater number of eyestrain symptoms under similar experimental conditions. People with self‐reported neck and back discomfort were also excluded from this study but including them in future research could add to the body of knowledge, which debates a link between gaze stability and physical posture …”

Is it possible to relate accommodative visual dysfunctions to neck pain?

“…Neck dysfunction can be the result of permanent compensation to the service of visual comfort; to paraphrase Richter, "the eyes steer the body." 1 Other authors justify the neck-eye relationship, based on the innervation of both by the sympathetic nervous system (SNS). There is double innervation of the ciliary muscle by the SNS and parasympathetic nervous system (PSNS), 70,71 the SNS tends to adapt the eye for the vision of distant objects and, as such, contrasts with the PSNS, which tends to adapt the eye to the vision of nearby objects, stimulating accommodation.…”

“…The U.S. National Occupational Safety and Health Institute reports that more than 80% of people working with computers suffer from these complaints. 1 The increase in new technologies implies visual and neck/shoulder musculature symptoms. On the one hand, the eyes are subjected to continuous overexertion of accommodation and vergence, thus distance vision and far-near-far exchange are exercised less.…”

Effect of ciliary-muscle contraction force on trapezius muscle activity during computer mouse work

“…Eye-lens accommodation is achieved by contraction of the ciliary muscle, an intraocular muscle that regulates the focal point of the eye-lens, adjusting it to objects at different distances. Previous studies (Richter 2014 ; Richter et al 2010 , 2011 ; Zetterberg et al 2013 ) that applied indirect optometric measures of eye-lens accommodation, have demonstrated a relationship between accommodation/vergence load and neck muscle activation level (trapezius muscle). According to the “Cinderella hypothesis” (Hägg 1991 ), a sustained low-load muscle activity can be a risk factor for musculoskeletal complaints.…”

“…The mentioned studies by Richter ( 2014 ), Richter et al ( 2010 , 2011 ) and Zetterberg et al ( 2013 ) were the first to objectively and continuously measure eye-lens accommodation while simultaneously measuring trapezius muscle activity. However, those studies were conducted in laboratory settings that were different from typical working conditions.…”