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Focusing on a document requires the muscles in your eyes to contract to keep the image sharp. Each time your eyes shift from the document to the monitor they must refocus. Eventually they become fatigued. Ultimately, the result is eye fatigue, eyestrain, or headaches which can affect productivity and accuracy.

When the document is placed flat on the work surface, you will use head and neck movements to shift your view between the document and the monitor. These movements can cause neck strain if performed repeatedly, or day after day.

When the document holder is properly placed
11a.   The document is off the flat work surface and in your line of vision.
11b.   The document is directly next to the monitor,or between the monitor and the keyboard.
11c.   The document is at the same distance as, or closer than, the monitor.
11d.   You can look at the document and the monitor by moving only your eyes, not your head.

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Department of Industrial Relations   Cal/OSHA Consultation Service   Research and Education Unit