Stress Reduction


There is an intimate relationship between posture, working distance, desk surface and lenses. Pioneering experiments by Dr. Darrel Boyd Harmon and subsequent research by Drs. John Pierce and Steven Greenspan clearly prove a reduction of stress and improved performance when conditions are arranged properly for near-point visual activities. The following changes were observed: reduced heart rate, more regular and deeper breathing, and reduced neck muscle and overall body tension.

To achieve these benefits the following must be arranged:

keyWorking Surface: A sloping working surface must be used that is tilted between 20 and 23 degrees from the horizontal.

Posture: Seated comfortably, relatively erect, feet flat on floor or box.

Working Distance: The “Harmon Distance” is the optimal distance from the eyes to the working surface. It is the distance from the elbow to the first knuckle. This can only be assured with a proper chair height to desk relationship.

Nearpoint Lenses: A specific, low power prescription not used to correct a defect in the eyes but to put the eyes into better balance for near tasks. This enhances and integrates the posture, working distance, and surface relationship.

Instructions for Visual Hygiene

  1. Do all near point activity at HARMON distance or slightly further. This is the distance from the center of the middle knuckle to the center of the elbow measured on the outside of the arm. Working at the Harmon distance reduces near point visual stress.
  2. Be AWARE of space between self and the page when reading. Also, be aware of things around and beyond the book.
  3. When reading, occasionally look off at a specific distant object and LET its details come into focus. Maintain awareness of other objects and details surrounding it. Do this at least at the end of each page.
  4. When studying, place a bookmark 3 or 4 pages ahead. Get up and move around for at least one minute each time you reach the bookmark.
  5. Sit UPRIGHT. Practice holding your back arched while you read and write. Avoid reading while lying on your stomach on the floor. Avoid reading in bed while lying on your stomach on the floor. Avoid reading in bed, unless sitting reasonably upright.
  6. Provide for adequate general illumination, as well as good central illumination, at the near task. The illumination on the task should be about three times that of the surrounding background.
  7. Tilt the book up about 20 degrees (this slopes up about 4 inches in 12). A tilt top for the desk can be made by screwing two door stops to the back of a piece of 1/2 inch plywood or a drawing board, and two rubber knobs to the near end so it doesn’t slip off the desk. This can be used for reading, studying, writing. It usually enables working farther away from the task than when the task is flat on the desk.
  8. Do not sit any closer to TV than 6 to 8 feet, and be sure to sit upright. Maintain good posture.
  9. When riding in a vehicle, avoid reading and other near activity. Encourage looking at sights in the distance for interest and identification.
  10. Encourage outdoor play or sports activities that require seeing beyond arm’s length.
  11. When outdoors, sight a distant object at about eye level. At the same time, be aware of where things are on all sides.
  12. Walk with head up, eyes wide open and look TOWARD, not at, objects.
  13. Become very conscious of the background of the objects you look TOWARD, be it a person, print on a page, an electric sign, the TV, or any other object.

What Should You Ask Your Doctor?

Why can a child who is having difficulty in school be screened at school and told their vision is fine, go to an ophthalmologist or optometrist and be told there is nothing wrong, but go to another optometrist another time and be told they have significant visual problems?

It is important to be tested for both “eyesight” and “vision,” since HOW you use your vision is sometimes more important than how CLEARLY you see. Click here to Find a Doctor

Not all eye care professionals are the same. Many optometrists and ophthalmologists test, diagnose and treat eye health problems and refractive problems, such as nearsightedness, but do not emphasize the function of vision. Patients can have healthy eyes and clear vision and still have problems in these other areas, but most eye doctors providing a standard eye exam do not identify functional vision disorders. Why? They do not run the additional tests to identify these types of problems in a routine eye exam.

Learn how to find a doctor that assesses vision related learning difficulties by asking the right questions about the type of vision exam they give.

There are optometrists that specialize in learning-related vision problems, lazy eyes, wandering eyes, vision and special needs, sports vision and vision rehabilitation. They are often called Developmental Optometrists, Pediatric Optometrists or Behavioral Optometrists. Eye doctors who specialize in children’s vision receive their professional credentialing through the College of Optometrists in Vision Development, becoming board-certified Fellows (FCOVD). They will determine if you need glasses and if your eyes are healthy, but they will also run additional tests to evaluate how efficient your visual system is working when you perform your daily tasks, especially at work, school and in sports. Sometimes a behavioral optometrist will prescribe glasses or contact lenses differently than a traditional eye care professional, even for refractive problems such as nearsightedness. Behavioral optometrists are trained to prevent, slow the progression of, or remediate visual problems. Often, this means prescribing for near activities, such as computers or reading.

Approximately 1 in 4 children in a classroom have not developed adequate visual skills needed to function properly, especially when working up close during tasks such as reading, writing and computer use, which places high demands on our visual systems. Parents and teachers often attribute their children’s symptoms to other problems, such as learning disabilities or attention deficit disorders, when the real source of their difficulties in the classroom is an undiagnosed vision problem.

The entire brain is involved with vision and vision integrates with all the other senses. It takes up two-thirds of the brain pathways, while all other senses combined take up the remaining one-third. Behavioral optometrists look at visual input skills, visual processing skills, storing visual information and getting it back out again. Here are just a few of the visual skills that can impact academic performance described below:

1. Eye tracking, known as oculomotility or eye movement control, requires that the eyes move together with exquisite precision. This allows for moving the eyes along the lines of print in a book, quick and accurate shifts from far to near, and sure tracking in sports when they are well-integrated.

2. Focusing, known as accommodation, is the ability to sustain and maintain clarity on targets at different distances, such reading and writing, as well as rapidly and efficiently change clarity from distance to near, such as copying from the board. You can think of visual focus like changing the f-stop on a camera. The closer the target, the more focusing power needed to see it clearly. Visual focus is intimately related to the ability to sustain visual attention.

3. Eye teaming ability, known as binocularity, is the ability to keep a target single. The closer the target, the more your eyes have to turn in to keep it single, such as when reading. If the eyes are not accurate in where they target, or cannot maintain its ability to target, it takes more effort to take in and process visual information, can reduce visual attention, negatively impact spatial judgments, and can cause crossed or wandering eyes.

4. Depth perception is intimately related to eye teaming. If the eyes do not work together efficiently as a team, the brain will not perceive depth accurately. This can impact sports, riding bikes, scooters, etc. (driving), and cause more clumsy behaviors such as knocking over glasses and tripping down or up stairs.

5. Eye-hand-body coordination, known as visual motor integration, is essential for accurate and stress-free writing and efficient performance in sports. It is important that the visual system is sending a signal OUT to the body’s motor centers for good gross and fine motor coordination and overall balance.

6. Visual form perception are a group of visual abilities needed for quick and accurate identification and discrimination of objects, for comparing similarities and differences, recognizing and generalizing forms, and coming to valid conclusions based on the accurate analysis of available visual information. This is important for science, mathematical reasoning and overall learning.

Visual memory and visual sequential memory is essential for optimal academic and athletic performance too. The ability to retain maximum visual information in an adequate period of time is essential for proficiency in abilities such as reading comprehension and spelling.

To know if your child is being evaluated for possible vision related learning problems, ask your eyecare professional if they evaluate at least the following visual skills:

  • Eye tracking (eye movement control)
  • Focusing near to far
  • Sustaining clear focus up close
  • Eye Teaming Ability
  • Depth Perception
  • Visual Motor Integration
  • Visual Form Perception
  • Visual Memory

Remember, behavioral optometrists are specialists in their field and are not always widely available in some areas. Click here to Find a Doctor.