It is often heard in medical circles that ‘the eyes lead the body’. Nature has made our visual system so dominant that we will alter our body posture to ease any deficiency in the way we see.

This situation can be seen in many office situations where the vision of a worker is compromised and they must adapt their posture to ease the strain on their eyes. If you are using glasses (single vision) which are designed for a 16 inch viewing distance, you must lean in toward a screen which may be 20-25 inches away in order to clear the image (see back pain). If you are using traditional bifocals, which are designed to see the near object in the lower visual field, you must tilt their head backward and lean forward to put the viewing section of the lens into proper position to see the screen. If you are viewing hard copy most often which is off to one side, you might need to keep moving your head back and forth to view the screen alternatively with the hard copy. This will also lead to neck discomfort.

These and many other situations are all too common in the office environment and cause excessive postural accommodations which lead to the symptoms of neck and back discomfort. Several studies have found that doing computer work for about three hours contributed not only to eye muscle fatigue but also muscle pain in the head, neck and upper back regions. One study found the highest area of complaints for heavy computer users was the head. One of the main reasons for this problem is the setup of the workstation- most often the position of the monitor. All too frequently the monitor is placed either on top of the Central Processing Unit (CPU) or on a monitor stand. This places the screen in a position where the user must look either straight ahead or actually upward in their gaze.

Eye level is often determined with the user sitting ‘tall’. However, in normal, upright sitting (without a visual target), studies have found that subjects tilted their head and neck an average of 13 degrees forward form the upright position. If the monitor is set to eye level, the user is presented with a choice: either assume a more erect head/neck posture than preferred or employ a gaze angle that is too high.

When the head-erect posture becomes tiring, computer users have limited possibilities for relief. One option is to tilt the head backward (extension). Another alternative posture available to computer users with eye-level monitors is the forward head position, in which the head remains erect while jutting forward from the trunk (see back pain). Users sometimes assume a forward head posture in a counterproductive attempt to relieve muscle tension caused by contracted neck muscles.

There is no ‘perfect’ screen height but, in general, when sitting in your chair gazing straight ahead, you should be able to look OVER your monitor. Most monitor positions are too high and that is the leading cause of neck pain.