My fuzzy graphics problems happen when I switch between windowed and fullscreen mode. The update before to the april 18th update seemed to be the culprit.
I also find I get much better performance in fullscreen mode and I have started using the "Adaptive v-sync options for Nvidia drivers,, i actually use the V-sync half option but that may not be needed for you. Also limit your maxfps (frames per second), there is an option in the STO video\troubleshooting area of the game, this can also be done manually in the console for a custom number, I like 36 myself as my monitor runs at 75hz.
- Toggle the half resolution button
- Toggle resolution mode up and down a resolution
- Use fullscreen mode
- Nvidia settings, adaptive vsync, then try adaptive half
- Monitor your frame rate by typing in game " /showfps 1 " in the chat area, no quotes
- Limit Maxfps, look at your average fps and put max around there, for me " /Maxfps 36 "
ps.. On my setup I selected PhysX to be on my second nvidia card , I did not do an fps check but it seemed to help * however in reading another STO forum post on physX this may not be doing what I think.