Dear Editor,I read with interest the article written by Bali et al.,1 on computer
vision syndrome, a study of the knowledge attitude practice
in Indian ophthalmologists. I would like to congratulate
the authors for coming out with a useful article on the most
frequently encountered problem in current ophthalmic
practice and also draw the attention of the readers to some
important therapeutic trials that were published in this regard
to help patients developing fatigue symptoms working with
computers. Periocular warming was found to be associated with
increase in accommodations, with concomitant improvement in
near visual acuity.2 This periocular warming is provided with an
eyelid warming device which provides heat through chemical
reaction of the iron powder inside it upon exposure to air. The
thermal stimulus from periocular warming resulted in increased
blood flow to the ocular region enhancing the parasympathetic
driven responses in the ciliary muscle and the pupil, causing
constriction thereby increasing the depth of focus. In this study
50% of eyes had an increase in the accommodation of amplitude
of at least 0.5 diopter (D) immediately after application of the
warming strips.2 I also agree with the authors that there should
be a grading system and treatment modalities standardized on
this frequently encountered, but not well understood problem
in general ophthalmology practice. This warming device can
be an effective alternative to the current therapeutic modalities
such as artificial tears, analgesics, topical nonsteroidal anti-
inflammatory drugs followed by some to manage computer
vision syndrome.