How does the patient describe vision changes related to strain?

The patient's description of vision changes as "fuzzy letters" indicates a common experience during visual strain, particularly associated with prolonged activities like reading or staring at screens. When the eyes are subjected to strain, often from focusing on near tasks for extended periods, individuals may begin to notice a loss of clarity, resulting in text or objects appearing blurred or indistinct. This symptom aligns with visual fatigue, commonly seen in conditions such as digital eye strain or presbyopia, making it a significant concern and helping healthcare providers understand the specific nature of the patient's visual problems.

The context for this symptom distinguishes it from others, such as the idea that vision worsens with distance; this typically suggests refractive errors rather than strain. Similarly, improvements with rest can indicate that the symptoms are indeed related to overexertion, but they don't capture the specific quality of the vision change. Noticing issues only at night could relate more to low-light conditions or night vision problems rather than the direct effects of visual strain. Hence, the "fuzzy letters" description directly reflects the subjective experience of vision changes due to strain, making it the most appropriate choice.