Bifocals a Pain in the Neck

Bifocals Can Be a Pain in the Neck
By Matthew Shulman


When it comes to reading small print and seeing oncoming traffic from a distance, bifocals are a sure bet. But the dual-purpose lenses aren't great at "in between" distances—for example, from chair to computer screen.

So bifocal wearers commonly adopt a working posture that can strain the neck muscles and result in neck pain and piercing headaches. They extend the neck forward to bring the screen into closer view, tilting the head to focus through the lower segments of the lenses, says Richard Guyer, a spine surgeon with the Texas Back Institute and a past president of the North American Spine Society. In some people, the pain extends beyond the neck to the shoulder and can radiate down the nerves to the hands, sometimes resulting in shoulder and elbow injuries and carpal tunnel syndrome, according to Joseph Kleinkort, a spokesperson for the American Physical Therapy Association and an ergonomic consultant.

It doesn't take a spine surgeon, though, to correct the problem. Kleinkort recommends getting a pair of trifocals—essentially bifocals with a third, middle lens for the intermediate zone some 18 to 24 inches away. Another option is progressive lenses, which are typically prescribed for older patients with presbyopia and are made with a single, seamless lens that changes magnification depending on the angle. These lenses "allow you to find the best region in the glasses for whatever distance your task demands," says Lynn Gordon, a neuro-ophthalmologist at the Jules Stein Eye Institute at the University of California-Los Angeles. Progressive contact lenses are also available.

The ergonomics of your workspace also play a role in relieving the aches. Simply changing the position of the computer monitor, in fact, may do the job. According to Richard Bunch, a physical therapist and clinical associate professor at Tulane University Medical School who consults on ergonomics, lowering the monitor so that the head and neck can remain in a neutral position and the chin level to the floor—whether or not you wear corrective lenses—can work wonders for neck pain. And be sure to sit up tall with your head centered over your shoulders to increase blood flow and lessen the burden on your neck.