Reviewed By Gary Vogel, OD

Today's work place, family entertainment, and even household tasks often requires some degree of computer use. For some, this involves short but frequent periods of use, for others computer use entails long hours of word processing, database entry, or programming. Studies have shown that approximately 10 million people seek an eye examination specifically due to computer related concerns. Headaches, blurred vision, eye strain, and focusing difficulty are frequently reported by those workers who use computers as part of their job or hobby.

The Computer Industry Forecast reports that there are about 100 million computer users in the work place. This figure does not include the millions of home users and computer game players. Similar estimates indicate that in the US, over 600,000 patients per month present to eye care professional with computer related symptoms. Unfortunately, almost 21% of these patients do not receive a correct diagnosis and treatment plan. (1 - VDTS and Your Health - Computers In Eye Care)

To date, most eye care professionals evaluate their patient's visual skills and functions using standard eye examination techniques to measure refractive error, focusing skills, eye coordination, and other visual skills. External variables such as glare, lightning, posture, head position, etc. are all easily controlled and well standardized in the examination room. They then attempt to extrapolate the results of these visual tests into the computer environment. Unfortunately, factors like glare, posture, and long term fatigue may not be same in the computer environment as they are in the testing environment. To accurately evaluate a patient's visual skills at the computer screen, an on screen testing method is needed that can be administered directly in the patient's work environment. The Eye-Computer Ergonomic Evaluation (Eye-CEE) System for Computer Users ® is a new software program that attempts to fill this well needed testing niche.

The Eye-CEE program is a Windows based software program that performs an extensive on screen assessment of a computer user's visual performance while actually using the computer. The program was developed in London at the City University Department of Optometry and Visual Science by Dr. W. David Thomson.

Testing begins with an extensive on screen survey that asks in depth questions about any visual discomfort, blur, back, neck, arm or wrist pain/discomfort, as well as questions about the computer display, lighting, glare, and general layout of the work station. The responses to the questionnaire are then analyzed and the results of the survey are reviewed on screen.

The actual visual testing begins next. Several visual skills are tested:

1. Visual Acuity is evaluated using a series of varying sized letter C's. The user is asked to specify which direction the opening points.

2. Search, Scan, and Tracking Skills are evaluated using both a letter search task and a grid search task. Accuracy and search time are used to evaluate the results of these two tests. Decreased eye movement ability, focusing skills, uncorrected refractive error, or eye coordination deficiencies can all cause decreased performance on these tasks and make computer use difficult.

3. Muscle Balance is evaluated by asking the user to align two red and green circles on the screen while wearing red/green glasses. The test is repeated in five different gaze positions and with each eye fixating.

4. Eye Coordination is evaluated using a test procedure using red and green lines in both horizontal and vertical directions. The results reflect the amount of visual stress the eye coordination system can tolerate in the computer environment.

5. Stereopsis, or depth perception is evaluated using computer generated random dot stereogram. Although stereopsis is not a critical skill for visual performance on a flat computer screen, it is an overall measure of the user's quality of binocular visual skills.

6. The central 15 degrees (approximately) Visual Fields are checked for gross blind spots. The testing procedure uses a multiple stimulus screening technique. This is not a test for eye disease or clinical diagnosis but rather a method for determining if the user has any blind areas that would prevent him/her from seeing the entire computer screen.

7. The final procedure rates the user's Subject Impression of the readability of the text display. The font is increased until the user describes the screen text as "easy" to read.

The results of the tests and the initial survey are analyzed and optionally displayed on screen or can be printed. If the health care administrator does not want the employee to see the test results, the screen display can be blocked. Tests results are presented in an easy to understand format and do not require the analysis of a qualified medical or eye care professional for evaluation. Several screen pages of information are then available which discuss the results, potential implication for weak visual areas, and possible remedies. Information is also included describing ways to reduce screen glare and increase postural comfort that is based on the results of the initial questionnaire. There is also an Administrative Menu that allows the Administrator to custom tailor the testing procedures and recommendations for his/her specific workplace.

I found this software easy to use and follow with minimal use of the manual. Installing the software through Windows was straightforward. On screen commands and instructions were simple. A non-health care professional could easily self administer this test and bring the results back for review by the Health and Safety Administrator. I have always thought that one hallmark of well written software is the user's ability to install and run the program without referring to the manual or on screen help files. This program certainly meets that requirement.

This software can fill many niches in the workplace. For example, a computer using employee with vague complaints during computer use could be given a copy of the testing software and instructed to do the test in his or her own workstation. The results could then be returned to the office for the Administrator to review and analyze. If an eye examination is recommended, a report can be generated to accompany the employee to their examination. A second report, which the doctor fills out with results of the test, can accompany the employee.

This software has many direct applications in the corporate environment. With this software, the Health and Safety Administrator can offer on screen visual testing for all computer users in corporate setting. Pre-employment physicals can include a comprehensive on screen visual evaluation allowing an employer to know if a perspective employee has the visual capabilities to handle long term computer use. The employer can also use the software to document pre-employment visual status at the computer to ward off future claims of eye changes/damages from long term computer use. The administrator who is knowledgeable in the use of this software can work directly with the employer to maintain employee productivity, decrease workers’ compensation claims and assure a healthy workplace.

For additional information, contact:
Jeffrey Anshel, OD
Corporate Vision Consulting
842 Arden Drive
Encinitas, CA. 92024
800-383-1202

Reviewed by:
Gary L. Vogel, OD, FAAO
3540 North Belt West Suite C
Belleville, Illinois 62221
618-235-4433

The author of this review has no financial or other interest in Corporate Vision Consulting or the Eye-CEE System software. The author has received no financial or other compensation for writing this review.