@murphai/murph 1.3.0 → 1.3.2

package/node_modules/ink/package.json

@@ -0,0 +1,126 @@
+{
+  "name": "ink",
+  "version": "6.8.0",
+  "description": "React for CLI",
+  "license": "MIT",
+  "repository": "vadimdemedes/ink",
+  "author": {
+    "name": "Vadim Demedes",
+    "email": "vadimdemedes@hey.com",
+    "url": "https://github.com/vadimdemedes"
+  },
+  "type": "module",
+  "exports": {
+    "types": "./build/index.d.ts",
+    "default": "./build/index.js"
+  },
+  "engines": {
+    "node": ">=20"
+  },
+  "files": [
+    "build"
+  ],
+  "keywords": [
+    "react",
+    "cli",
+    "jsx",
+    "stdout",
+    "components",
+    "command-line",
+    "preact",
+    "redux",
+    "print",
+    "render",
+    "colors",
+    "text"
+  ],
+  "peerDependenciesMeta": {
+    "@types/react": {
+      "optional": true
+    },
+    "react-devtools-core": {
+      "optional": true
+    }
+  },
+  "ava": {
+    "workerThreads": false,
+    "serial": true,
+    "files": [
+      "test/**/*",
+      "!test/helpers/**/*",
+      "!test/fixtures/**/*"
+    ],
+    "extensions": {
+      "ts": "module",
+      "tsx": "module"
+    },
+    "nodeArguments": [
+      "--import=tsx"
+    ]
+  },
+  "xo": {
+    "extends": [
+      "xo-react"
+    ],
+    "plugins": [
+      "react"
+    ],
+    "prettier": true,
+    "rules": {
+      "react/no-unescaped-entities": "off",
+      "react/state-in-constructor": "off",
+      "react/jsx-indent": "off",
+      "react/prop-types": "off",
+      "unicorn/import-index": "off",
+      "import/no-useless-path-segments": "off",
+      "react-hooks/exhaustive-deps": "off",
+      "complexity": "off"
+    },
+    "ignores": [
+      "src/parse-keypress.ts"
+    ],
+    "overrides": [
+      {
+        "files": [
+          "src/**/*.{ts,tsx}",
+          "test/**/*.{ts,tsx}"
+        ],
+        "rules": {
+          "no-unused-expressions": "off",
+          "camelcase": [
+            "error",
+            {
+              "allow": [
+                "^unstable__",
+                "^internal_"
+              ]
+            }
+          ],
+          "unicorn/filename-case": "off",
+          "react/default-props-match-prop-types": "off",
+          "unicorn/prevent-abbreviations": "off",
+          "react/require-default-props": "off",
+          "react/jsx-curly-brace-presence": "off",
+          "@typescript-eslint/no-empty-function": "off",
+          "@typescript-eslint/promise-function-async": "warn",
+          "@typescript-eslint/explicit-function-return": "off",
+          "@typescript-eslint/explicit-function-return-type": "off",
+          "dot-notation": "off",
+          "react/boolean-prop-naming": "off",
+          "unicorn/prefer-dom-node-remove": "off",
+          "unicorn/prefer-event-target": "off"
+        }
+      },
+      {
+        "files": [
+          "examples/**/*.{ts,tsx}",
+          "benchmark/**/*.{ts,tsx}"
+        ],
+        "rules": {
+          "import/no-unassigned-import": "off"
+        }
+      }
+    ]
+  },
+  "prettier": "@vdemedes/prettier-config"
+}

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "@murphai/murph",
-  "version": "1.3.0",
+  "version": "1.3.2",
   "private": false,
   "description": "Murph is a personal health assistant you run locally. Install this package to get the murph CLI.",
   "license": "Apache-2.0",
@@ -43,21 +43,24 @@
     "node": ">=24.14.1"
   },
   "dependencies": {
+    "@alcalzone/ansi-tokenize": "^0.2.4",
     "@cfworker/json-schema": "^4.1.1",
+    "@elevenlabs/elevenlabs-js": "2.62.0",
     "@junction-api/sdk": "1.2.0",
+    "@linqapp/sdk": "0.34.0",
     "@modelcontextprotocol/server": "^2.0.0-alpha.2",
     "@murphai/assistant-cli": "1.0.0",
     "@murphai/assistant-engine": "1.0.0",
     "@murphai/assistantd": "1.0.0",
     "@murphai/clinical-records": "1.0.0",
-    "@murphai/contracts": "1.3.0",
+    "@murphai/contracts": "1.3.2",
     "@murphai/core": "1.0.0",
     "@murphai/device-syncd": "1.0.0",
     "@murphai/exercise-library": "1.0.0",
-    "@murphai/gateway-core": "1.3.0",
+    "@murphai/gateway-core": "1.3.2",
     "@murphai/health-commons": "1.0.0",
     "@murphai/health-metrics": "1.0.0",
-    "@murphai/hosted-execution": "1.3.0",
+    "@murphai/hosted-execution": "1.3.2",
     "@murphai/importers": "1.0.0",
     "@murphai/inbox-services": "1.0.0",
     "@murphai/inboxd": "1.0.0",
@@ -69,13 +72,39 @@
     "@murphai/setup-cli": "1.0.0",
     "@murphai/vault-usecases": "1.0.0",
     "@toon-format/toon": "^2.1.0",
+    "ansi-escapes": "^7.3.0",
+    "ansi-styles": "^6.2.1",
+    "auto-bind": "^5.0.1",
+    "chalk": "^5.6.0",
+    "cli-boxes": "^3.0.0",
+    "cli-cursor": "^4.0.0",
+    "cli-truncate": "^5.1.1",
+    "code-excerpt": "^4.0.0",
+    "es-toolkit": "^1.39.10",
+    "exa-js": "2.17.0",
     "grammy": "1.42.0",
     "incur": "0.4.5",
+    "indent-string": "^5.0.0",
     "ink": "^6.8.0",
+    "is-in-ci": "^2.0.0",
+    "openai": "6.45.0",
+    "patch-console": "^2.0.0",
     "react": "^19.2.6",
+    "react-reconciler": "^0.33.0",
+    "scheduler": "^0.27.0",
     "sharp": "0.34.5",
+    "signal-exit": "^3.0.7",
+    "slice-ansi": "^8.0.0",
+    "stack-utils": "^2.0.6",
+    "string-width": "^8.1.1",
+    "terminal-size": "^4.0.1",
     "tokenx": "^1.3.0",
+    "type-fest": "^5.4.1",
+    "widest-line": "^6.0.0",
+    "wrap-ansi": "^9.0.0",
+    "ws": "^8.18.0",
     "yaml": "^2.8.2",
+    "yoga-layout": "~3.2.1",
     "zod": "^4.4.3",
     "zxing-wasm": "3.0.3"
   },
@@ -99,6 +128,7 @@
     "@murphai/runtime-state",
     "@murphai/setup-cli",
     "@murphai/vault-usecases",
-    "incur"
+    "incur",
+    "ink"
   ]
 }

package/node_modules/@murphai/assistant-engine/dist/assistant/group-phone-call-preview-authority.d.ts

@@ -1,24 +0,0 @@
-import type { HostedPhoneCallBrief } from '@murphai/hosted-execution/phone-calls';
-export declare const ASSISTANT_GROUP_PHONE_CALL_PREVIEW_HEADING = "GROUP CALL PREVIEW";
-export declare const ASSISTANT_GROUP_PHONE_CALL_NO_TRANSFER_LINE = "Transfer to a participant: no";
-export interface AssistantGroupPhoneCallPreviewAuthority {
-    assistantInputId: string;
-}
-export declare function hasDeliveredAssistantGroupPhoneCallPreview(input: {
-    acceptedInputIds: readonly string[];
-    brief?: HostedPhoneCallBrief;
-    channel?: string | null;
-    confirmationInputId?: string;
-    sessionId: string;
-    vault: string;
-}): Promise<boolean>;
-export declare function resolveDeliveredAssistantGroupPhoneCallPreviewAuthority(input: {
-    acceptedInputIds: readonly string[];
-    brief?: HostedPhoneCallBrief;
-    channel?: string | null;
-    confirmationInputId?: string;
-    sessionId: string;
-    vault: string;
-}): Promise<AssistantGroupPhoneCallPreviewAuthority | null>;
-export declare function renderAssistantGroupPhoneCallPreview(brief: HostedPhoneCallBrief): string;
-//# sourceMappingURL=group-phone-call-preview-authority.d.ts.map

package/node_modules/@murphai/assistant-engine/dist/assistant/group-phone-call-preview-authority.d.ts.map

@@ -1 +0,0 @@
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package/node_modules/@murphai/assistant-engine/dist/assistant/group-phone-call-preview-authority.js

@@ -1,125 +0,0 @@
-import { readAssistantInputEvent } from './input-store.js';
-import { compareAssistantOutboxDeliverySequenceOrder, listAssistantOutboxIntents, } from './outbox.js';
-export const ASSISTANT_GROUP_PHONE_CALL_PREVIEW_HEADING = 'GROUP CALL PREVIEW';
-export const ASSISTANT_GROUP_PHONE_CALL_NO_TRANSFER_LINE = 'Transfer to a participant: no';
-export async function hasDeliveredAssistantGroupPhoneCallPreview(input) {
-    return await resolveDeliveredAssistantGroupPhoneCallPreviewAuthority(input)
-        !== null;
-}
-export async function resolveDeliveredAssistantGroupPhoneCallPreviewAuthority(input) {
-    const channel = input.channel?.trim().toLowerCase() ?? '';
-    if (channel !== 'linq' && channel !== 'telegram') {
-        return null;
-    }
-    const confirmationInputId = input.confirmationInputId ?? input.acceptedInputIds.at(-1);
-    if (!confirmationInputId
-        || input.acceptedInputIds.at(-1) !== confirmationInputId) {
-        return null;
-    }
-    const confirmationInput = await readAssistantInputEvent({
-        inputId: confirmationInputId,
-        vault: input.vault,
-    });
-    if (!confirmationInput
-        || confirmationInput.sourceRef.kind !== 'hosted-mailbox'
-        || confirmationInput.sourceRef.lane !== 'conversation') {
-        return null;
-    }
-    const confirmationConversation = confirmationInput.conversation;
-    const confirmationThreadId = confirmationConversation?.threadId?.trim() ?? '';
-    if (confirmationConversation?.source?.trim().toLowerCase() !== channel
-        || confirmationConversation.threadIsDirect !== false
-        || !confirmationThreadId) {
-        return null;
-    }
-    const confirmationReceivedAtMs = Date.parse(confirmationInput.receivedAt ?? '');
-    if (!Number.isFinite(confirmationReceivedAtMs)) {
-        return null;
-    }
-    const routeIntents = (await listAssistantOutboxIntents(input.vault))
-        .filter((intent) => intent.sessionId === input.sessionId
-        && intent.operation === null
-        && intent.threadIsDirect === false
-        && intent.channel?.trim().toLowerCase() === channel
-        && intent.threadId === confirmationThreadId);
-    const previewTurns = groupAssistantOutboxIntentsByTurn(routeIntents)
-        .filter((turn) => normalizePreviewText(joinAssistantOutboxTurnMessages(turn))
-        .includes(normalizePreviewText(ASSISTANT_GROUP_PHONE_CALL_PREVIEW_HEADING)))
-        .sort((left, right) => compareAssistantOutboxTurnCreationOrder(right, left));
-    const latestPreviewTurn = previewTurns[0];
-    if (!latestPreviewTurn) {
-        return null;
-    }
-    const answeredInputIds = new Set(latestPreviewTurn.flatMap((intent) => intent.answeredMailboxItemIds));
-    if (answeredInputIds.size === 0
-        || latestPreviewTurn.some((intent) => {
-            const sentAtMs = intent.sentAt ? Date.parse(intent.sentAt) : Number.NaN;
-            return intent.status !== 'sent'
-                || !Number.isFinite(sentAtMs)
-                || sentAtMs >= confirmationReceivedAtMs;
-        })) {
-        return null;
-    }
-    if (input.brief !== undefined
-        && !assistantOutboxTurnContainsPhoneCallBrief(latestPreviewTurn, input.brief)) {
-        return null;
-    }
-    return {
-        assistantInputId: confirmationInputId,
-    };
-}
-function groupAssistantOutboxIntentsByTurn(intents) {
-    const intentsByTurn = new Map();
-    for (const intent of intents) {
-        const turnIntents = intentsByTurn.get(intent.turnId);
-        if (turnIntents) {
-            turnIntents.push(intent);
-        }
-        else {
-            intentsByTurn.set(intent.turnId, [intent]);
-        }
-    }
-    return [...intentsByTurn.values()];
-}
-function joinAssistantOutboxTurnMessages(intents) {
-    return [...intents]
-        .sort(compareAssistantOutboxDeliverySequenceOrder)
-        .map((intent) => intent.message)
-        .join('\n');
-}
-function compareAssistantOutboxTurnCreationOrder(left, right) {
-    const leftCreatedAt = Math.max(...left.map((intent) => Date.parse(intent.createdAt)));
-    const rightCreatedAt = Math.max(...right.map((intent) => Date.parse(intent.createdAt)));
-    return leftCreatedAt - rightCreatedAt;
-}
-function assistantOutboxTurnContainsPhoneCallBrief(intents, brief) {
-    if (brief.allowTransferToUser) {
-        return false;
-    }
-    return normalizePreviewText(joinAssistantOutboxTurnMessages(intents))
-        === normalizePreviewText(renderAssistantGroupPhoneCallPreview(brief));
-}
-export function renderAssistantGroupPhoneCallPreview(brief) {
-    return [
-        ASSISTANT_GROUP_PHONE_CALL_PREVIEW_HEADING,
-        `Destination label: ${JSON.stringify(brief.to.label ?? null)}`,
-        `Destination phone number: ${JSON.stringify(brief.to.phoneNumber)}`,
-        `Caller name: ${JSON.stringify(brief.callerName ?? null)}`,
-        `Goal: ${JSON.stringify(brief.goal)}`,
-        `Instructions: ${JSON.stringify(brief.instructions)}`,
-        `Shareable facts: ${JSON.stringify(sortRecord(brief.shareableFacts))}`,
-        `Success criteria: ${JSON.stringify(brief.successCriteria)}`,
-        `Time zone: ${JSON.stringify(brief.timeZone)}`,
-        ASSISTANT_GROUP_PHONE_CALL_NO_TRANSFER_LINE,
-    ].join('\n');
-}
-function sortRecord(value) {
-    return Object.fromEntries(Object.entries(value).sort(([left], [right]) => left < right ? -1 : left > right ? 1 : 0));
-}
-function normalizePreviewText(value) {
-    return value
-        .normalize('NFKC')
-        .replace(/\r\n?/gu, '\n')
-        .trim();
-}
-//# sourceMappingURL=group-phone-call-preview-authority.js.map

package/node_modules/@murphai/assistant-engine/dist/assistant/group-phone-call-preview-authority.js.map

@@ -1 +0,0 @@
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package/node_modules/@murphai/assistant-engine/dist/assistant/newsletter-outbox.d.ts

@@ -1,19 +0,0 @@
-import type { HostedRuntimeNewsletterScheduledAuthority } from '@murphai/hosted-execution/runtime-control';
-import type { AssistantOutboxIntent } from '@murphai/operator-config/assistant-cli-contracts';
-import type { AssistantHostedNewsletterTool } from './execution-context.js';
-export declare function createAssistantNewsletterOutboxTool(input: {
-    automationAuthority?: AssistantOutboxIntent['automationAuthority'];
-    authority: HostedRuntimeNewsletterScheduledAuthority | null;
-    newsletterTool: AssistantHostedNewsletterTool;
-    recordPendingDeliveryIntentId?: (intentId: string) => void;
-    sessionId: string;
-    turnId: string;
-    vault: string;
-}): AssistantHostedNewsletterTool & {
-    closeCapability(): void;
-};
-export declare function findAssistantNewsletterParentIntent(input: {
-    authority: HostedRuntimeNewsletterScheduledAuthority;
-    vault: string;
-}): Promise<AssistantOutboxIntent | null>;
-//# sourceMappingURL=newsletter-outbox.d.ts.map

package/node_modules/@murphai/assistant-engine/dist/assistant/newsletter-outbox.d.ts.map

@@ -1 +0,0 @@
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package/node_modules/@murphai/assistant-engine/dist/assistant/newsletter-outbox.js.map

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package/node_modules/@murphai/assistant-engine/skills/general-eye-health/SKILL.md

@@ -1,77 +0,0 @@
----
-name: general-eye-health
-description: Use for digital eye strain dry or irritated eyes contact-lens safety refractive questions eye-health prevention and symptom triage including vision changes flashes floaters redness pain or light sensitivity.
----
-
-# General Eye Health
-
-Use this as Murph operating guidance, not as a consumer article or a diagnosis. Triage first, then give the smallest useful next step. Ground the answer in the current conversation and vault context, and ask at most one missing question when it would change the care level or immediate action.
-
-Read `references/triage-and-contact-lenses.md` before answering any active eye symptom, vision change, contact-lens problem, injury, chemical-exposure, or eye-exam timing question. Read `references/evidence-register.md` before comparing products or treatments, explaining evidence, making prevention claims, or giving risk-based screening evidence. For eye-exam timing, read both: the Decision Order owns the outcome and timing, while the evidence register supplies evidence only. Do not load both references for another narrow general-information question unless both are needed.
-
-## Owns
-
-- Screen-linked tired, dry, burning, gritty, watery, or intermittently blurry eyes; visual fatigue; and related headache or focusing complaints.
-- General refractive-error education, including myopia and what a glasses or contact-lens power can and cannot mean.
-- Contact-lens comfort, hygiene, water and sleep exposure, and symptom-sensitive care routing.
-- General eye-health prevention, eye-exam preparation, and risk-based screening guidance.
-- First-pass urgency routing for pain, redness, light sensitivity, discharge, vision change, flashes, floaters, trauma, or chemical exposure.
-
-## Hand Off
-
-- Emergency and same-day eye problems belong to emergency care or an eye clinician after Murph names the specific trigger and immediate action.
-- Use computer-use to book eye care or order the user's exact current prescribed contact-lens parameters only after this skill establishes the safe action. Never use ordering as a substitute for an exam or current prescription.
-- Use red-light-therapy for photobiomodulation devices, dose, and device-specific eye-exposure precautions; return here for eye symptoms or vision changes.
-- Use circadian-rhythm when the goal is sleep or clock timing from evening light rather than eye comfort or eye safety.
-- Use mobility-posture for whole-body desk setup; this skill owns ocular symptoms, viewing comfort, and visual setup.
-- Route diagnosis, prescription changes, ocular disease management, post-procedure concerns, and treatment decisions to an optometrist, ophthalmologist, or other appropriate clinician.
-
-## Safety Pass
-
-- Apply Prerequisite First Aid and then the Decision Order in `references/triage-and-contact-lenses.md` before selecting a care destination or any further action. Do not restate, weaken, or bypass its predicates.
-- Do not let follow-up questions delay action after the Decision Order assigns emergency or prompt same-day care.
-
-## Data First
-
-- Reuse the known onset, one-eye versus both-eyes pattern, pain, redness, light sensitivity, discharge, vision change, flashes or floaters, trauma or chemical exposure, and neurologic symptoms.
-- For contact-lens users, check whether lenses are in now, whether symptoms improve after removal, any sleeping or water exposure, access to current backup glasses, and when fit and prescription were last checked.
-- For non-urgent screen discomfort, check task duration, text size, glare, screen position, direct fan or air-conditioning, symptom timing, and whether the problem also occurs away from screens.
-
-## Interpretation Rules
-
-- A value such as `-2.75` is correction information, not an eye-health score, diagnosis, or urgency marker. Do not label its severity, infer retinal health, or recommend stronger, weaker, or different lenses from that number.
-- Digital eye strain is a symptom pattern with possible tear-film, blinking, sustained-near-work, refractive, binocular, environmental, and ergonomic contributors. Say symptoms "can fit" this pattern; do not claim a remote diagnosis or a single cause.
-- Ordinary computer use can cause temporary fatigue or dryness, but do not say that normal screen use is damaging healthy adult eyes or caused the user's prescription.
-
-## Low-Burden Comfort Plan
-
-Only when the Decision Order assigns `Brief self-care trial is reasonable`:
-
-1. If contacts feel uncomfortable, remove them and use current backup glasses. Do not change the prescription or lens brand.
-2. Make text comfortably readable, reduce glare, match display brightness to the room, keep the screen at a comfortable roughly arm's-length distance with its top at or below eye level, and redirect fans or vents away from the face.
-3. Take brief, symptom-led distance breaks and make several complete blinks. `20-20-20` can be an optional memory cue, not a proven treatment dose or protection threshold.
-4. For mild dryness, mention plain lubricating or artificial tears as an option. With contacts, use only a product explicitly labeled or clinician-recommended for those lenses and follow its directions; otherwise remove lenses first.
-5. Change one or two things for 3–7 ordinary workdays and compare end-of-day comfort, blur, headache, and burden. Stop the trial and use the triage pathway if symptoms worsen or a red flag appears.
-
-## Contact-Lens Boundaries
-
-- Never advise sleeping in lenses unless the prescribing clinician explicitly directed it, or exposing lenses to shower, swim, hot-tub, tap, bottled, or distilled water.
-- Never suggest saliva, homemade saline, reused solution, topping off a case, or reusing daily disposables.
-- Do not recommend arbitrary drops over lenses, borrowed or leftover eye medicine, prescription substitutions, or online reordering when the prescription or fit may be stale.
-- Keep hygiene coaching compact. Use the full prevention rules only when lens behavior is part of the question.
-
-## Claim Discipline
-
-- Do not recommend blue-light-filtering glasses as a proven treatment for screen strain or retinal protection. A tint may be a comfort preference, but the evidence does not establish the claimed therapeutic benefit.
-- Do not recommend omega-3, AREDS2, lutein, berry extracts, or generic "eye vitamins" for screen strain or ordinary eye health. AREDS2 has a narrow clinician-diagnosed macular-degeneration indication.
-- Do not claim eye exercises, intentional under-correction, or more outdoor time can reverse adult myopia.
-- Do not recommend antibiotic, steroid, anesthetic, redness-relief, glaucoma, or other medicated drops without the appropriate clinician.
-- Do not recommend sun-gazing, looking into therapy lights, or unapproved ocular light devices.
-
-## Answer Shape
-
-- Start with the likely category in calibrated language and the feature that makes it low-risk or concerning.
-- Give one immediate action, then one short comfort plan or care destination.
-- State the exact threshold and timing for eye care; do not bury it in a long differential or disclaimer.
-- If the user asks about a product or popular rule, give the evidence bottom line plainly and offer a lower-cost alternative when one exists.
-- When the Decision Order assigns `Brief self-care trial is reasonable`, end with one reassessment window and what would make the user stop. When it assigns `Arrange a prompt eye exam` or `Arrange a routine eye exam`, state the outcome's exact timing and the Exam Type Resolver's single type without substituting the multi-day comfort trial. When it assigns `Prevention action only`, give the applicable exposure or hygiene action and the symptoms that require re-entering the Decision Order.

package/node_modules/@murphai/assistant-engine/skills/general-eye-health/references/evidence-register.md

@@ -1,34 +0,0 @@
-# General Eye-Health Evidence Register
-
-Evidence review date: 2026-07-10. Scope: general adult guidance, not diagnosis or individualized treatment. Prefer the newest applicable clinician guidance when a user's age, disease, surgery, pregnancy, medicine, or procedure changes the risk.
-
-## How to Use This Register
-
-- **Higher confidence** means an authoritative public-health or specialty source, a systematic review, or a strong randomized trial supports the practical conclusion.
-- **Moderate confidence** often means consensus or ergonomics guidance is reasonable but not proven as a precise therapeutic dose.
-- **Limited evidence** means Murph may offer a low-risk option or memory cue without promising benefit.
-- Safety routing outranks comfort evidence. Read `triage-and-contact-lenses.md` for active symptoms.
-
-## Evidence Matrix
-
-| Topic | Evidence bottom line | Murph use | Sources |
-| --- | --- | --- | --- |
-| Digital eye strain | Reduced or incomplete blinking, sustained near work, ocular-surface dryness, uncorrected refractive error, binocular factors, glare, airflow, and ergonomics can contribute. Symptoms and signs are nonspecific. | Say symptoms "can fit" a digital-eye-strain pattern. Do not diagnose it or assume a single screen cause. | [TFOS digital-environment report](https://pubmed.ncbi.nlm.nih.gov/37062428/); [NEI dry eye](https://www.nei.nih.gov/eye-health-information/eye-conditions-and-diseases/dry-eye) |
-| Screen damage | Ordinary monitor use can produce fatigue or dryness, but it is not evidence of permanent eye damage in a healthy adult. | Reassure only after red flags are absent. Do not say screens caused the user's myopia or retinal damage. | [NEI Healthy Vision booklet](https://www.nei.nih.gov/sites/default/files/2019-06/NEI_Healthy-Vision_booklet_WEB_508%20%281%29.pdf); [TFOS digital-environment report](https://pubmed.ncbi.nlm.nih.gov/37062428/) |
-| Visual breaks and blinking | Periodic distance changes and complete blinking are low-risk comfort practices. The exact `20-20-20` formula has limited evidence as a treatment dose. Small studies are mixed. | Offer self-paced brief breaks; use `20-20-20` only as an optional memory cue, never a protection threshold or myopia treatment. | [NEI Healthy Vision booklet](https://www.nei.nih.gov/sites/default/files/2019-06/NEI_Healthy-Vision_booklet_WEB_508%20%281%29.pdf); [20-second break trial](https://pubmed.ncbi.nlm.nih.gov/36473088/); [reminder intervention](https://pubmed.ncbi.nlm.nih.gov/35963776/) |
-| Workstation setup | Readable text, glare control, looking away, blinking, and a comfortable screen roughly 20–40 inches away with its top at or below eye level are standard ergonomics guidance. | Optimize for comfort and accessibility; do not turn measurements into medical thresholds. | [OSHA computer monitor guidance](https://www.osha.gov/etools/computer-workstations/components/monitors) |
-| Blue-light-filtering lenses | A Cochrane review found they may not reduce short-term computer eyestrain; sleep results were inconsistent and the trials did not establish macular protection. | Do not recommend them as treatment or retinal protection. A tint can remain a preference if the user likes it. | [Cochrane blue-light-filtering lens review](https://www.cochrane.org/evidence/CD013244_blue-light-filtering-spectacle-lenses-visual-performance-macular-back-part-eye-protection-and) |
-| Digital-eye-strain products | A systematic review of 45 randomized trials found no evaluated intervention supported by high-certainty evidence; blue blockers were not beneficial and supplement or specialty-lens evidence was weak or negative. | Prefer low-cost environmental changes over product stacks and communicate uncertainty. | [Ophthalmology systematic review](https://pubmed.ncbi.nlm.nih.gov/35597519/) |
-| Artificial tears | Lubricating drops commonly help mild dry-eye symptoms, but evidence does not identify one universally best OTC formulation. Contact compatibility matters. | Mention a cautious labeled option, not a prescription or a substitute for evaluation of pain, redness, discharge, or vision change. | [NEI dry eye](https://www.nei.nih.gov/eye-health-information/eye-conditions-and-diseases/dry-eye); [systematic review of artificial tears](https://pmc.ncbi.nlm.nih.gov/articles/PMC9840372/) |
-| Omega-3 for dry eye | In the 535-participant DREAM randomized trial, high-dose omega-3 was no better than placebo over 12 months; broader reviews remain inconsistent. | Do not routinely recommend fish oil for screen-related dryness. | [NIH DREAM trial summary](https://www.nih.gov/news-events/news-releases/omega-3s-fish-oil-supplements-no-better-placebo-dry-eye); [Cochrane omega-3 review](https://www.cochrane.org/evidence/CD011016_omega-3-and-omega-6-polyunsaturated-fatty-acid-supplements-dry-eye-disease) |
-| "Eye vitamins" | AREDS2 supplements are for specific stages of clinician-diagnosed age-related macular degeneration, not general eye health, myopia, or screen strain. | Do not offer generic eye supplements. Defer stage-specific AREDS2 decisions to the eye clinician. | [NEI AREDS/AREDS2 FAQ](https://www.nei.nih.gov/eye-health-information/clinical-trials/age-related-eye-disease-studies-aredsareds2/aredsareds2-frequently-asked-questions) |
-| Myopia and a lens number | Myopia is a refractive error corrected by glasses or contacts. A contact-lens power is only one prescription parameter and does not show lens fit, full refraction, eye health, or symptom cause. | Treat `-2.75` as correction context, not a diagnosis or urgency score. Never change power, brand, or fit from chat. | [NEI nearsightedness](https://www.nei.nih.gov/eye-health-information/eye-conditions-and-diseases/nearsightedness-myopia); [FDA buying contact lenses](https://www.fda.gov/medical-devices/contact-lenses/buying-contact-lenses) |
-| Myopia exercises and under-correction | Eye exercises have limited-to-no evidence for controlling or reversing myopia, and intentional under-correction is not an established control strategy. | Separate useful distance breaks from claims that exercises or weaker lenses reverse an adult prescription. | [Myopia exercise systematic review](https://pmc.ncbi.nlm.nih.gov/articles/PMC10858027/); [International Myopia Institute intervention report](https://myopiainstitute.org/imi-whitepaper/interventions-for-myopia-onset-and-progression/) |
-| Contact-lens infection prevention | Hand hygiene, no water, no unauthorized overnight wear, fresh solution, case care, prescribed replacement, and follow-up exams reduce avoidable risk. Pain, redness, light sensitivity, a new vision change, tearing, or discharge lowers the care threshold. | Give prevention when relevant; active symptoms use the triage reference first. | [CDC prevention](https://www.cdc.gov/contact-lenses/prevention/index.html); [CDC infection symptoms](https://www.cdc.gov/contact-lenses/causes/index.html); [NEI contact lenses](https://www.nei.nih.gov/eye-health-information/healthy-vision/contact-lenses) |
-| Prevention and exams | Eye-exam timing depends on age and risk. Contact-lens users generally need at least yearly review. Protective eyewear, sunglasses blocking 99–100% UVA/UVB, smoking avoidance, and management of diabetes and blood pressure are established prevention guidance. | Supply evidence to `Arrange a routine eye exam` in the triage Decision Order. Do not assign exam timing or type outside that outcome. | [NEI dilated eye exam](https://www.nei.nih.gov/eye-health-information/healthy-vision/finding-eye-doctor/get-dilated-eye-exam); [NEI healthy vision](https://www.nei.nih.gov/eye-health-information/healthy-vision/8-things-you-can-do-right-now-protect-your-vision); [CDC eye care](https://www.cdc.gov/vision-health/prevention/taking-care-of-your-eyes.html) |
-
-## Important Scope Limits
-
-- Child and adolescent myopia prevention or control is a separate clinician-led problem; adult screen-strain advice must not be repurposed into a pediatric treatment plan.
-- Severe dry-eye treatment, prescription drops, contact-lens refitting, binocular-vision therapy, glaucoma, cataract, retinal disease, infection, surgery, or post-procedure care requires professional evaluation.
-- A normal-looking eye or a reassuring photo cannot rule out corneal, pressure-related, retinal, or neurologic disease.