No one has used it for an extended period of time. You don't get a headache right away, but after a while, you feel it.
I think unless Apple has really added some sort of magic, it will be an issue for most people to use Vision Pro for anything but passive activities, or with a physical trackpad.
Compare with a smartphone, I can move to tap the 'back' button in Safari without moving my eyes to the back button. Looking "at" the phone generally is enough to see where my finger is, and say clicking on links I can look at the link and move my hand to it and move my eyes away while my hand is moving.
Having to coordinate looking and clicking - while I haven't tried it - I can imagine that feels more load-bearing, more effortful, more constraining, more annoying.