Books & Computers - Surviving Dry Eye Pain

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Getting Comfortable With Books and Computers

People who experience a lot of pain caused by severe dry eyes can make life more comfortable by using some of the products available for people with impaired vision. Here are some options:

Read large-print books
Listen to books on tape
Configure a more readable computer
Place the monitor so that you look down at it
Work on a talking computer

Important! All information on this Web site is based on the experience and opinions of a very small number of individuals with severe dry eye. Your experience or research might determine that you should use other solutions than those presented here. Please see the Disclaimer below.

Read large-print books

Although many people with severe dry eye can see 20:20 on an eye exam (either with or without glasses), in practical terms, they often don't actually see as clearly as someone with healthy eyes. Insufficient tear film on the eye can make vision fluctuate. In addition, mucous can interfere with vision, as can various eye drops and ointments.

If you like to read a lot for recreation, visit the large-print section of your local public library. If your library has only a few large-print books, ask the librarian how to find lists of large-print books and then how to order them through the inter-library loan service.

Listen to books on tape

People in the U.S. who have visual or physical limitations may check out books-on-tape for free from the Library of Congress. Contrary to popular assumption, this service is not only for people who are blind or legally blind. It is also for people who have a physical disability, whether visual or of some other type, that makes reading problematical. (If you live in another country, ask your librarian if a similar service exists in your country.)

In addition to a large number of books for light reading, such as mysteries, the library also has a great many books about history, biography, computers, and many other topics.

This section describes:

Obtaining Library of Congress books-on-tape and tape player
Buying your own tape player

Obtaining Library of Congress books-on-tape and tape player

The following table explains how to contact your local branch of the Library of Congress (LOC) and get permission to access their books on tape.

Step

Description

Find local LOC & request form

In your Internet browser, go to the Web site for the Library of Congress at LOC.gov.
Click the link for Blind Persons. Notice that, even though you clicked the link for blind persons, the heading of the page you go to is "National Library Service for the Blind and Physically Handicapped."
Click the link Where libaries are located, and then, in the drop-down list labelled Choose a material or location, click your state (or, if appropriate, click the link for U.S. Citizens living outside the United States).
Click Start Search. The resulting page shows the address and phone number of your state's library.
(Alternatively, you can also look up your state's Library for the Blind and Physically Handicapped in your phone book.)
Call the library and request the "application for service" form.

Ask doctor to fill out form

Take the "application for service" form to your eye doctor and ask him or her to certify that you have a physical problem.

If dry eye pain or other dry eye symptoms interfere with your ability to read, your doctor can check the option "Reading Disabled: Persons having a reading disability resulting from organic dysfunction and of sufficient severity to prevent their reading printed material in a normal manner."

Here are some examples:

You cannot open your eyes or can open your eyes only for part of the day because you are in too much pain (due to dry eye) to keep your eyes open.
Dry eye causes your vision to be blurred and inconsistent.
You must wear goggles to protect your eyes due to dry eye, but the goggles you need cannot take the prescription that you need.
Any other dry eye complication that your doctor agrees prevents you from "reading printed material in a normal manner."

Ask regional LOC library for tape player

After your doctor has filled out the "application for service" form, take it (or mail it) to the regional LOC libary in your state and ask them to loan you a tape player and to allow you to request LOC books-on-tape.

The regional LOC library loans out a special tape player that you can use to listen to their specially formatted 4-track tapes. You can also change the setting to 2-track and use this tape player to listen to regular books on tape, such as those you can check out from your local town library.

Buying your own tape player

The following tables describes some options for buying a tape player.

Player Type

Possible Vendor

2-track (standard)

To listen to tapes you get from your local library or buy commercially, buy any standard tape player.

4-track (portable and standard size)

The 4-track tape player that you can get for free from the National Library Service for the Blind and Physically Handicapped (if your doctor fills out the form described above) is too large to carry with you easily. You can buy a portable tape player that can play both regular books on tape and Library of Congress (4-track) books on tape.

Contact information:

Buy one of the following tape players only if you have permission to use Library of Congress 4-track tapes. Otherwise, for books-on-tape available from your local town library, use any ordinary tape player.

Society for the Blind Click Catalog - Order by Phone (on left), click Tape Players and Recorders, and then scroll down to the "Sony Walkman 4-track player" or the "Sony Tape Player/Recorder."
BeyondSight.com Click Catalog, and then click Recorders. Scroll down to "Sony 4 Track Player" for a portable player, or scroll to "Narrator 4 Track Player" for a larger but less expensive player. Both of these play both 4-track (Library of Congress) and 2-track (regular) tapes.
Or go to Google.com and search for "4-track player."

Configure a more readable computer

This section describes a few tips to help make your computer easier on your eyes (for PCs running the Windows operating system; for information about the Unix operating system or about Mac computers, see their Help topics).

Note By the time you read this page, this information might be out-of-date. For current information, look in Windows online Help (click Start, click Help and Support, and then search for the term "accessibility" or "monitor") or look at the Help for the application you are using, such as Internet Explorer or Word.

Software	Tips to Make More Readable
Windows — Vision Wizard	Run the Windows XP Accessibility Wizard: Click Start, click All Programs, click Accessories, click Accessibility, and then click Accessibility Wizard. Click Next to start the Wizard, and then choose the options that will make it easier for you to see the screen. If, after you finish, you decide that you chose an option that you don't want after all, or if Windows starts generating error messages after running the Wizard, run the Wizard again and undo the unwanted selection.
Windows — Display	Change display size by using Windows settings: Click Start, and then select Control Panel. Double-click Display to show the Display Properties window. Click the Settings tab. (Optional) Under Screen resolution, slide the slider indicator to the left. For example, if your current screen area is set to 1024 by 768 pixels, slide it to the 800 by 600 pixels setting. Click Apply, click OK, and then click Yes. On the Display Properties window Settings tab, click the Advanced button. On the General tab, under DPI setting, select Large size (120 DPI), click Apply, and then click OK to return to the Display Properties screen. Click OK to exit the Display Properties screen.
3rd Party Screen Magnifier	Change display size by installing a third-party screen magnifier: Go to AISquared.com, read about their products, and then download one of the "Free Trial" versions of their software. Or go to Google.com and search for "screen magnifier" to find information about other products.
Internet Explorer — Text Size	Enlarge text size when working in Internet Explorer: Select View, select Text size, and then select Medium, Larger or Largest. For many Web pages, this enlarges the size of print on the screen. Tip! If you find a Web site that displays only tiny text, try to find their Contact e-mail address and send them a message telling them that their text is too small to read. Changing this setting also enlarges the size of print when you print, so if you want to print normal-size text, remember to change the text size back to smaller or smallest before printing. (A similar option probably exists in the Netscape browser.)
Word — Onscreen Text	Enlarge screen text size in Word: On the Standard toolbar (the one that has the printer icon and the scissors icon), click the arrow on the Zoom drop-down list. Type 125 to make the text in your Word document 125% larger than normal. This option does not affect font size when you print.
Word — Non-Glare Background	Eliminate bright-white background in Word: In Word, select View, select Web Layout (rather than Normal or Print Layout). This makes your typing screen gray instead of bright white. This option does not add any background color to the paper when you print.

Place the monitor so that you look down at it

According to the article "Dry eyes and video display terminals," published by K. Tsubota and K. Nakamori in the February 28, 1993, issue of the New England Journal of Medicine, looking at a computer monitor for prolonged periods of time can dry the surface of the eye. If you already have dry eyes, this can increase dry eye pain. The article recommends decreasing "the exposed ocular surface area ... by placing the [computer] terminal at a lower height, with the screen tilted upward."

One way to accomplish this is to buy an adjustable-height table and an adjustable-height monitor arm from an office supply store.

A more expensive and more complicated option is to buy a special desk built to hold a slanting, recessed monitor. For this latter option, go to Closet-Masters.com, and then click "Nova Desk Solutions."

Work on a talking computer

If you can afford it, you can get a "talking" computer. With the right equipment, you can type with your eyes closed. Because the computer speaks the words as you type, you will know if you typed the words correctly. Even typing only a few minutes out of each hour with your eyes closed can increase the total amount of time you can function productively during the course of the day. In addition, you can close your eyes while having the computer read documents or e-mail to you.

If you buy a scanner, you can also scan in documents, such as letters, newsletters, or books, and have the computer read the documents to you.

For this to work, in addition to a computer, you must have the following adaptive equipment:

Screen Reader A screen reader, such as JAWS for Windows, Windows Eyes, outSPOKEN for Windows, outSPOKEN for Mac, or (for DOS) Vocal-Eyes. For a list of more screen readers, search for "screen readers" on the Product Search page of the American Federation for the Blind at Afb.org/prodSearch.asp.
Speech Synthesizer A speech synthesizer, such as DECtalk, Accent, Doubletalk, or Triple-Talk. (JAWS for Windows now includes its own speech synthesizer, which uses your computer's sound card to speak.) For a list of more speech synthesizers, search for "synthesizer" on the Product Search page of the American Federation for the Blind at Afb.org/prodSearch.asp.
Scanner (optional) A scanner, such as an HP scanner. You can buy a scanner at an office supply store, such as OfficeDepot.com, Staples.com, or Quill.com.

Check for latest technology By the time you read this, some of this information might be out-of-date. Therefore, as with any computer equipment, be sure to research the most recent and most appropriate technology before making any purchases. DryEyePain does not recommend any specific hardware or software.

If you are computer savvy, you can buy the necessary equipment separately and add it to your existing computer. If you are not computer savvy, you can buy a computer already set up with adaptive technology integrated into it. Two sources for this type of technology (both also provide training) are the following:

Freedom Scientific Blind/Low Vision Group Click the Products & Services link, click the icon for Software, and then click Screen Reading to find information about JAWS for Windows, which you can use to make a computer running Windows into a talking computer without having to buy a separate speech synthesizer.
Beyond Sight Click Catalog, and then click LapTalk, DeskTalk and Custom Computer Systems for information about their computers. If you buy, for example, their Beyond Sight Standard Desktop Computer and also buy either JAWS for Windows or Windows-Eyes (another screen reader), the store will install and configure the screen reader software as well as the standard computer software.

DISCLAIMER: Do not use any tip described on these pages without first consulting your physician.
All content on this Web site is for informational purposes only; it is not to be used for diagnosis or treatment; and it should not be construed as personal medical advice. Information published on this Web site is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the user's/viewer's medical care. Every effort has been made to present accurate and safe information, but the creator of the Web site is not a health care professional, does not warrant the correctness of the information, and is not liable for any direct or consequential injury or other damages that could result from the use of the information obtained from this site. Products are mentioned as examples only. No mention of a product constitutes an endorsement for that product; other products may be successfully used for dry eye and other conditions described here. It is not the intent of this Web site to promote any eye care products, procedures, or medications.