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Wang MTM, Power B, Xue AL, Craig JP. Discriminative performance of ocular surface staining and lid wiper epitheliopathy in dry eye disease: An investigator-masked, prospective registry-based, diagnostic accuracy study. Ocul Surf 2024; 34:165-172. [PMID: 39038751 DOI: 10.1016/j.jtos.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/16/2024] [Accepted: 07/19/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE To evaluate the diagnostic performance of corneal and conjunctival staining, and lid wiper epitheliopathy (LWE) in detecting dry eye disease, as defined by the global consensus Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II) criteria. METHODS A total of 2066 community residents (1285 females; mean ± SD age, 40 ± 19 years) were recruited in an investigator-masked, prospective registry-based, diagnostic accuracy study. Dry eye symptomology and ocular surface parameters were assessed in a single clinical session. The Sjögren's International Collaborative Clinical Alliance (SICCA) corneal and conjunctival staining scoring and Korb lid wiper epitheliopathy (LWE) grading were evaluated by an independent masked assessor. RESULTS Overall, 807 (39 %) participants fulfilled the TFOS DEWS II criteria for dry eye disease, of which 178 (9 %) participants were classified as moderate-to-severe disease. The discriminative abilities of superior and inferior LWE (C-statistics, 0.724 and 0.712, respectively) were greater than corneal and conjunctival staining (C-statistics, 0.573 and 0.627, respectively). The Youden-optimal diagnostic cut-offs for the SICCA corneal and conjunctival staining scores were both ≥1, and the optimal thresholds for the Korb superior and inferior LWE grades were both ≥1. LWE was more commonly detected in both mild-to-moderate and moderate-to-severe dry eye disease, and demonstrated more consistent correlation with other ocular surface parameters across a broader range of disease severity. CONCLUSIONS LWE demonstrates superior diagnostic performance relative to corneal and conjunctival staining. These findings would support the routine incorporation of LWE evaluation as part of the diagnostic workup of dry eye disease.
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Affiliation(s)
- Michael T M Wang
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Barry Power
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, New Zealand; Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Ally L Xue
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Jennifer P Craig
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, New Zealand.
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2
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Ji H, Yang Y, Lu Y, Kong X, Yang G, Liu J, Yang Y, Wang X, Ma X. Prevalence of dry eye during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS One 2023; 18:e0288523. [PMID: 38091282 PMCID: PMC10718424 DOI: 10.1371/journal.pone.0288523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/28/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE During the COVID-19 pandemic, many people devoted longer time to screen viewing due to the need for study, work, and online social activities, instead of outdoor activities, which may have led to an increase in dry eye symptoms. This study aimed to evaluate the prevalence of dry eye during the COVID-19 pandemic. METHODS PubMed, Cochrane Library, Embase, and Web of Science were searched from January 1, 2020 to October 20, 2022. Cross-sectional surveys on dry eye prevalence conducted after January 1, 2020 were included. Two review authors independently performed data extraction and assessed study quality. The random-effects model was used to analyze the prevalence of dry eye, and the odds ratio was used to assess the strength of the association between variables. Subgroup analysis was performed to detect heterogeneity, the leave-one-out method for sensitivity analysis, and the Egger test for publication bias. RESULTS A total of eleven studies with 15692 individuals met the eligibility criteria. The prevalence of dry eye during the COVID-19 pandemic was 61.0% (95%CI: 51.8%-70.2%) globally and 56.7% (95%CI: 45.3%-68.1%) in Asia. The prevalence of dry eye had significant differences in sex and visual display time, with higher prevalence among females and visual display time of more than 4 hours per day. Subgroup analysis was performed based on diagnostic tools, study population, and average age. A significant difference was found in diagnostic tools, but no significant change in heterogeneity (P<0.05). The leave-one-out method showed stable results, and the Egger test identified no significant publication bias. CONCLUSION The prevalence of dry eye during the COVID-19 pandemic is significantly higher than before, and a higher prevalence is found among females and those having a visual display time of more than 4 hours per day.
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Affiliation(s)
- Haiyang Ji
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yun Yang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yunqiong Lu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiehe Kong
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Guang Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Jie Liu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Yanting Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Xuejun Wang
- Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xiaopeng Ma
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
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Srivastav S, Basu S, Singh S. Tear film changes in symptomatic versus asymptomatic video display terminal users following computer challenge test. Ocul Surf 2023; 30:53-56. [PMID: 37595798 DOI: 10.1016/j.jtos.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/27/2023] [Accepted: 08/15/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To assess the real-time changes in the tear film and ocular surface of symptomatic video display terminal (VDT) versus asymptomatic users. METHODS A total of 35 symptomatic (29 ± 5.6 years; Group 1, mild dry eye disease) and 35 asymptomatic (24.1 ± 4.6 years; Group 2) VDT users with a mean OSDI of 28 ± 11 and 0.86 ± 2.1, respectively, had tear film examination (Oculus Keratograph 5 M and Tearlab Osmolarity System) at baseline and after 1 h of watching a movie on the laptop inside a controlled environment chamber along with blink rate calculation. RESULTS The mean VDT use was 11.4 ± 3.2 h/day in Group 1 and 2.3 ± 2.3 h/day in Group 2. In Group 1, the mean pre- and post-VDT task values for NIBUT and bulbar congestion were 10.7 ± 3.7s and 6.7 ± 3.1s (P = 0.007), and 0.8 ± 0.4 and 1.1 ± 0.5 (P = 0.01), respectively. There were no significant changes in tear meniscus height (P = 0.77), Schirmer I (P =0.14), corneal staining score (P = 1.0), and tear osmolarity (P > 0.05). Group 2 showed insignificant change in all parameters. Only 16.2% individuals in Group 1 met modified TFOS-DEWS II diagnostic criteria at baseline that increased to 67.6% following VDT task. The blink rate reduced significantly during the last 15 min (6.8 ± 3.4 vs. 9.3 ± 4.5; P = 0.006) compared to the first 15 min of the task in Group 1, whereas no significant change occurred in Group 2. CONCLUSION Tear film instability and increased bulbar congestion are observed in symptomatic VDT users after computer work despite baseline stable tear film. The changes are significantly altered in symptomatic VDT users compared to asymptomatic users.
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Affiliation(s)
- Saumya Srivastav
- Centre for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sayan Basu
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swati Singh
- Centre for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India; Ophthalmic Plastic Surgery Services, L V Prasad Eye Institute, Hyderabad, Telangana, India.
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Sharma D, Shrestha S. Dry Eyes among Visual Display Terminal Users Visiting the Outpatient Department of Ophthalmology of a Tertiary Care Centre. JNMA J Nepal Med Assoc 2023; 61:803-806. [PMID: 38289769 PMCID: PMC10579771 DOI: 10.31729/jnma.8307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Visual display terminal usage has increased substantially in recent years across all age groups and is considered one of the major risk factors for dry eye disease. Early assesment of dry eyes and prevention is important. The aim of this study is to find the prevalence of dry eyes among visual display terminal users visiting the Outpatient Department of Ophthalmology of a tertiary care centre. Methods A descriptive cross-sectional study was conducted among patients visiting the Department of Ophthalmology in a tertiary care centre after receiving ethical approval from the Institutional Review Committee. Data was collected from 1 October 2021 to 31 March 2022. Convenience sampling method was used. The point estimate was calculated at a 90% Confidence Interval. Results Among 94 visual display terminal users, the prevalence of dry eyes was 55 (58.51%) (50.18-66.84, 90% Confidence Interval). Conclusions The prevalence of dry eyes among visual display terminal users visiting the Outpatient Department of Ophthalmology was similar to other studies done in similar settings. Keywords dry eyes; health; prevalence.
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Affiliation(s)
- Dikchhya Sharma
- Department of Ophthalmology, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - Sabina Shrestha
- Department of Ophthalmology, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
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Galindo-Romero C, Rodríguez-Zamora CL, García-Ayuso D, Di Pierdomenico J, Valiente-Soriano FJ. Computer vision syndrome-related symptoms in presbyopic computer workers. Int Ophthalmol 2023:10.1007/s10792-023-02724-z. [PMID: 37103757 PMCID: PMC10133911 DOI: 10.1007/s10792-023-02724-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 04/09/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE To evaluate the prevalence of computer vision syndrome (CVS)-related symptoms in a presbyopic population using the computer as the main work tool, as well as the relationship of CVS with the electronic device use habits and the ergonomic factors. METHODS A sample of 198 presbyopic participants (aged 45-65 years) who regularly work with a computer completed a customised questionnaire divided into: general demographics, optical correction commonly used and for work, habits of electronic devices use, ergonomic conditions during the working hours and CVS-related symptoms during work performance. A total of 10 CVS-related symptoms were questioned indicating the severity with which they occurred (0-4) and the median total symptom score (MTSS) was calculated as the sum of the symptoms. RESULTS The MTSS in this presbyopic population is 7 ± 5 symptoms. The most common symptoms reported by participants are dry eyes, tired eyes and difficulties in refocusing. MTSS is higher in women (p < 0.05), in laptop computer users (p < 0.05) and in teleworkers compared to office workers (p < 0.05). Regarding ergonomic conditions, MTSS is higher in participants who do not take breaks while working (p < 0.05), who have an inadequately lighting in the workspace (p < 0.05) and in the participants reporting neck (p < 0.01) or back pain (p < 0.001). CONCLUSION There is a relationship between CVS-related symptoms, the use of electronic devices and the ergonomic factors, which indicates the importance of adapting workplaces, especially for home-based teleworkers, and following basic visual ergonomics rules.
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Affiliation(s)
- Caridad Galindo-Romero
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Pascual Parrilla (IMIB-Pascual Parrilla), Murcia, Spain.
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain.
- Grupo de Oftalmología Experimental, Instituto Murciano de Investigación Biosanitaria-Pascual Parrilla, Edificio LAIB Planta 5ª, Carretera Buenavista s/n, El Palmar, 30120, Murcia, Spain.
| | | | - Diego García-Ayuso
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Pascual Parrilla (IMIB-Pascual Parrilla), Murcia, Spain
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
| | - Johnny Di Pierdomenico
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Pascual Parrilla (IMIB-Pascual Parrilla), Murcia, Spain
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
| | - Francisco J Valiente-Soriano
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Pascual Parrilla (IMIB-Pascual Parrilla), Murcia, Spain.
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain.
- Grupo de Oftalmología Experimental, Instituto Murciano de Investigación Biosanitaria-Pascual Parrilla, Edificio LAIB Planta 5ª, Carretera Buenavista s/n, El Palmar, 30120, Murcia, Spain.
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Pavel IA, Bogdanici CM, Donica VC, Anton N, Savu B, Chiriac CP, Pavel CD, Salavastru SC. Computer Vision Syndrome: An Ophthalmic Pathology of the Modern Era. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020412. [PMID: 36837613 PMCID: PMC9961559 DOI: 10.3390/medicina59020412] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/08/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
Digital device usage has increased significantly in last decade among all age groups, both for educational and recreational purposes. Computer vision syndrome (CVS), also known as digital eye strain (DES), represents a range of ocular, musculoskeletal, and behavioral conditions caused by prolonged use of devices with digital screens. This paper reviews the principal environmental, ocular, and musculoskeletal causes for this condition. Due to the high prevalence of DES and frequent usage of digital devices, it is important that eye care practitioners be able to provide advice and management options based on quality research evidence.
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Affiliation(s)
- Irina Andreea Pavel
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
| | - Camelia Margareta Bogdanici
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
- Correspondence: (C.M.B.); (V.C.D.)
| | - Vlad Constantin Donica
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
- Correspondence: (C.M.B.); (V.C.D.)
| | - Nicoleta Anton
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
| | - Bogdan Savu
- Department of Pediatrics, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
| | | | - Cristian Dan Pavel
- Department of Histology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
| | - Silvia Cristina Salavastru
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No.16, 700115 Iasi, Romania
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Improving Visual Comfort during Computer Gaming with Preservative-Free Hyaluronic Acid Artificial Tears Added to Ergophthalmological Measures. VISION (BASEL, SWITZERLAND) 2023; 7:vision7010005. [PMID: 36649052 PMCID: PMC9844297 DOI: 10.3390/vision7010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023]
Abstract
Digital asthenopia (DA) or Computer Vision Syndrome can occur after prolonged use of digital devices and is usually managed with ergophthalmological measures and the use of artificial tears. This prospective, controlled study evaluated the use of hyaluronic acid artificial tears on the signs and symptoms of DA in participants of a videogame convention. Subjects (n = 56) were randomized into a control group (CG, n = 26), which followed ergophthalmological measures, and a study group (SG, n = 30), which followed ergophthalmological measures and instilled 1 drop of artificial tears with hyaluronic acid 0.15% four times a day. Subjects were evaluated before and after playing for three consecutive days for eye dryness (SPEED questionnaire), conjunctival hyperemia, corneal fluorescein staining, conjunctival lissamine green staining, tear breakup time, Schirmer I test, near convergence and accommodation, and using questionnaires for DA symptoms. After 3 days of intense videogaming, the SPEED score of CG increased significantly (p = 0.0320), while for the SG it was unchanged. Similarly, the CG presented significant increases in ocular fatigue (p = 0.0173) and dryness (p = 0.0463), while these parameters decreased significantly in the SG (p = 0.0149 and p = 0.00427, respectively). This study confirms the protective effect of hyaluronic acid artificial tears against DA symptoms associated with prolonged visual display terminal use.
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Tonkerdmongkol D, Poyomtip T, Poolsanam C, Watcharapalakorn A, Tawonkasiwattanakun P. Prevalence and associated factors for self-reported symptoms of dry eye among Thai school children during the COVID-19 outbreak. PLoS One 2023; 18:e0284928. [PMID: 37093868 PMCID: PMC10124893 DOI: 10.1371/journal.pone.0284928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 04/11/2023] [Indexed: 04/25/2023] Open
Abstract
PURPOSE COVID-19 pandemic caused an increase in digital screen time, which seemed to increase the prevalence of dry eye symptoms among the population with abnormally high digital screen usage hours. However, there are no reports of dry eye symptoms in school children with high digital usage hours. Therefore, the present study aimed to assess the prevalence of dry eye symptoms and evaluate the associated factors among school children aged 12 to 18 years during the COVID-19 outbreak. METHODS Multistage cluster sampling was applied, and six sections of online questionnaires were distributed to selected respondents in November 2021. The odds ratio (OR) with confidence intervals (CIs) for the factors was calculated using binary logistic regression. All statistical significance was determined at p < 0.05. RESULTS The findings revealed that 62.5% of 603 students showed symptoms of dry eye (DEQ-5 score ≥ 6). Significant associated factors included being female (adjusted OR (aOR) 1.54; 95% CIs 1.05-2.25), higher-grade student (aOR 1.77; 95% CIs 1.23-2.57), digital screen time use (6 to < 12 hours: aOR 2.00; 95% CIs 1.12-3.57, ≥12 hours: aOR 2.54; 95% CIs 1.39-4.76), and perceived stress (aOR 1.12; 95% CIs 1.08-1.16). The Thai-Perceived Stress Scale-10 scores were positively correlated with the scores on the 5-item dry eye questionnaire (Spearman's r = 0.38, p-value < 0.01). CONCLUSION A high prevalence of dry eye symptoms might be common among school children during the COVID-19 outbreak. Significant risk factors include being female, being a higher-grade level student, prolonged use of digital screens, and perceived stress. However, contact lens use, smoking, and the most common digital device usage patterns were not found to be contributing factors.
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Affiliation(s)
| | - Teera Poyomtip
- Faculty of Optometry, Ramkhamhaeng University, Bangkok, Thailand
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9
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Prolonged Computer Use by Office Workers Induces Ocular Symptoms Associated With Tear Film Alterations and Overexpression of Mucin 5 AC and Catalase. J Occup Environ Med 2023; 65:34-38. [PMID: 35914288 DOI: 10.1097/jom.0000000000002653] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate office workers for symptoms of computer vision syndrome (CVS) and alterations in the tear film relate to the hours of daily computer use. METHODS Sixty-seven volunteers were divided into 2 groups: 2 to 6 and 7 to 12 hours of daily computer use. Computer vision syndrome symptoms, tear film stability by tear film break-up time test, and composition of mucin 5 AC, catalase, and IL-6 was assessed by relative gene expression of conjunctival impression cytology samples were examined. RESULTS All participants exhibited moderate symptoms of CVS, whereas 90% showed reduced tear film stability. For the 7- to 12-hour (vs 2- to 6-hour) group, these effects were more pronounced and overexpression of mucin 5 AC and catalase was detected. CONCLUSIONS Prolonged computer use induced an overexpression of mucin 5 AC and catalase and instability of the tear film, associated with ocular symptoms.
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Fjærvoll K, Fjærvoll H, Magno M, Nøland ST, Dartt DA, Vehof J, Utheim TP. Review on the possible pathophysiological mechanisms underlying visual display terminal-associated dry eye disease. Acta Ophthalmol 2022; 100:861-877. [PMID: 35441459 PMCID: PMC9790214 DOI: 10.1111/aos.15150] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 03/13/2022] [Accepted: 03/23/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Visual display terminal (VDT) use is a key risk factor for dry eye disease (DED). Visual display terminal (VDT) use reduces the blink rate and increases the number of incomplete blinks. However, the exact mechanisms causing DED development from VDT use have yet to be clearly described. PURPOSE The purpose of the study was to conduct a review on pathophysiological mechanisms promoting VDT-associated DED. METHODS A PubMed search of the literature investigating the relationship between dry eye and VDT was performed, and relevance to pathophysiology of DED was evaluated. FINDINGS Fifty-five articles met the inclusion criteria. Several pathophysiological mechanisms were examined, and multiple hypotheses were extracted from the articles. Visual display terminal (VDT) use causes DED mainly through impaired blinking patterns. Changes in parasympathetic signalling and increased exposure to blue light, which could disrupt ocular homeostasis, were proposed in some studies but lack sufficient scientific support. Together, these changes may lead to a reduced function of the tear film, lacrimal gland, goblet cells and meibomian glands, all contributing to DED development. CONCLUSION Visual display terminal (VDT) use appears to induce DED through both direct and indirect routes. Decreased blink rates and increased incomplete blinks increase the exposed ocular evaporative area and inhibit lipid distribution from meibomian glands. Although not adequately investigated, changes in parasympathetic signalling may impair lacrimal gland and goblet cell function, promoting tear film instability. More studies are needed to better target and improve the treatment and prevention of VDT-associated DED.
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Affiliation(s)
- Ketil Fjærvoll
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway
| | - Haakon Fjærvoll
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway
| | - Morten Magno
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of Ophthalmology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | | | - Darlene A. Dartt
- Schepens Eye Research Institute of Massachusetts Eye and EarHarvard Medical SchoolBostonMassachusettsUSA
| | - Jelle Vehof
- Department of Ophthalmology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands,Department of Twin Research & Genetic EpidemiologyKing's College LondonSt Thomas' HospitalLondonUK,Department of Epidemiology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Tor P. Utheim
- Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of OphthalmologyOslo University HospitalOsloNorway,Department of OphthalmologySørlandet Hospital ArendalArendalNorway,Department of Quality and Health Technology, The Faculty of Health SciencesUniversity of StavangerStavangerNorway,Department of OphthalmologyStavanger University HospitalStavangerNorway,Department of Computer ScienceOslo Metropolitan UniversityOsloNorway,Department of Clinical Medicine, Faculty of MedicineUniversity of BergenBergenNorway
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Identified risk factors for dry eye syndrome: A systematic review and meta-analysis. PLoS One 2022; 17:e0271267. [PMID: 35984830 PMCID: PMC9390932 DOI: 10.1371/journal.pone.0271267] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 06/28/2022] [Indexed: 01/04/2023] Open
Abstract
A meta-analytic approach was used to identify potential risk factors for dry eye syndrome. PubMed, Embase, and the Cochrane library were systematically searched for studies investigated the risk factors for dry eye syndrome from their inception until September 2021. The odds ratio (OR) with 95% confidence interval (CI) was calculated using the random-effects model. Forty-eight studies comprising 493,630 individuals were included. Older age (OR: 1.82; P<0.001), female sex (OR: 1.56; P<0.001), other race (OR: 1.27; P<0.001), visual display terminal use (OR: 1.32; P<0.001), cataract surgery (OR: 1.80; P<0.001), contact lens wear (OR: 1.74; P<0.001), pterygium (OR: 1.85; P = 0.014), glaucoma (OR: 1.77; P = 0.007), eye surgery (OR: 1.65; P<0.001), depression (OR: 1.83; P<0.001), post-traumatic stress disorder (OR: 1.65; P<0.001), sleep apnea (OR: 1.57; P = 0.003), asthma (OR: 1.43; P<0.001), allergy (OR: 1.38; P<0.001), hypertension (OR: 1.12; P = 0.004), diabetes mellitus (OR: 1.15; P = 0.019), cardiovascular disease (OR: 1.20; P<0.001), stroke (OR: 1.32; P<0.001), rosacea (OR: 1.99; P = 0.001), thyroid disease (OR: 1.60; P<0.001), gout (OR: 1.40; P<0.001), migraines (OR: 1.53; P<0.001), arthritis (OR: 1.76; P<0.001), osteoporosis (OR: 1.36; P = 0.030), tumor (OR: 1.46; P<0.001), eczema (OR: 1.30; P<0.001), and systemic disease (OR: 1.45; P = 0.007) were associated with an increased risk of dry eye syndrome. This study reported risk factors for dry eye syndrome, and identified patients at high risk for dry eye syndrome.
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Cortés-Albornoz MC, Ramírez-Guerrero S, Rojas-Carabali W, de-la-Torre A, Talero-Gutiérrez C. Effects of remote learning during the COVID-19 lockdown on children's visual health: a systematic review. BMJ Open 2022; 12:e062388. [PMID: 35922104 PMCID: PMC9352565 DOI: 10.1136/bmjopen-2022-062388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Increased exposure to digital devices as part of online classes increases susceptibility to visual impairments, particularly among school students taught using e-learning strategies. This study aimed to identify the impact of remote learning during the COVID-19 lockdown on children's visual health. DESIGN Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES Scopus, PubMed and ScienceDirect databases from the year 2020 onwards. ELIGIBILITY CRITERIA We included cross-sectional, case-control, cohort studies, case series and case reports, published in English, Spanish or French, that approached the effects of remote learning during the COVID-19 lockdown on visual health in neurotypical children. DATA EXTRACTION AND SYNTHESIS We included a total of 21 articles with previous quality assessments using the Joanna Briggs checklist. Risk of bias assessment was applied using the National Institutes of Health quality assessment tool for before-and-after studies with no control group; the tool developed by Hoy et al to assess cross-sectional studies; the Murad et al tool to evaluate the methodological quality of case reports and case series; and the Newcastle-Ottawa Scale for cohort studies. RESULTS All but one study reported a deleterious impact of the COVID-19 lockdown on visual health in children. Overall, the most frequently identified ocular effects were refractive errors, accommodation disturbances and visual symptoms such as dry eye and asthenopia. CONCLUSIONS Increased dependence on digital devices for online classes has either induced or exacerbated visual disturbances, such as rapid progression of myopia, dry eye and visual fatigue symptoms, and vergence and accommodation disturbances, in children who engaged in remote learning during the COVID-19 lockdown. PROSPERO REGISTRATION NUMBER CRD42022307107.
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Affiliation(s)
- María Camila Cortés-Albornoz
- Neuroscience Research Group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogota D.C, Colombia
| | - Sofía Ramírez-Guerrero
- Neuroscience Research Group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogota D.C, Colombia
| | - William Rojas-Carabali
- Neuroscience Research Group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogota D.C, Colombia
| | - Alejandra de-la-Torre
- Neuroscience Research Group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogota D.C, Colombia
| | - Claudia Talero-Gutiérrez
- Neuroscience Research Group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogota D.C, Colombia
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Diurnal changes of noninvasive parameters of ocular surface in healthy subjects before and after continuous face mask wearing during the COVID-19 pandemic. Sci Rep 2022; 12:12998. [PMID: 35906320 PMCID: PMC9334741 DOI: 10.1038/s41598-022-17486-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
To investigate whether diurnal changes in noninvasive ocular surface parameters and subjective symptoms occur in healthy subjects wearing face mask who were analyzed before and after 8 h of continuous use. In this prospective cross-sectional study, healthy volunteers attending the same workplace environment underwent a noninvasive ocular surface workup by means of Keratograph 5 M (Oculus, Wetzlar, Germany) in the same day at 2 different time points: (i) in the early morning before wearing face mask (T0); (ii) after 8 h of continuous face mask use (T1). Noninvasive break-up time (NIBUT), tear meniscus height (TMH), ocular redness and meibomian gland dropout were measured. All subjects were asked to complete the Ocular Surface Disease Index (OSDI) questionnaire before and after 8 h of face mask wearing. Data from 20 healthy subjects (10 males and 10 females, mean age 25.1 ± 3.9 years) were included. Mean value of TMH decreased significantly from 0.29 ± 0.07 at T0 to 0.23 ± 0.07 mm at T1 (P < 0.001); conversely, mean values of NIBUT, redness score and meibomian gland dropout did not change significantly after continuous face mask wearing (always P > 0.532). Concerning ocular discomfort symptoms, mean value of OSDI score worsened significantly at T1 compared to T0 (from 12.9 ± 12.6 to 19.4 ± 12.0; P = 0.017). Continuous face mask wearing for 8 h led to decreased TMH associated with the onset of ocular discomfort symptoms in young healthy subjects.
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14
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Kasetsuwan N, Suwan-Apichon O, Lekhanont K, Chuckpaiwong V, Reinprayoon U, Chantra S, Puangsricharern V, Pariyakanok L, Prabhasawat P, Tesavibul N, Chaidaroon W, Tananuvat N, Hirunpat C, Prakairungthong N, Sansanayudh W, Chirapapaisan C, Phrueksaudomchai P. Assessing the Risk Factors For Diagnosed Symptomatic Dry Eye Using a Smartphone App: Cross-sectional Study. JMIR Mhealth Uhealth 2022; 10:e31011. [PMID: 35731569 PMCID: PMC9260529 DOI: 10.2196/31011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/10/2021] [Accepted: 05/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background Dry eye (DE) is a chronic inflammatory disease of the ocular surface of the eye that affects millions of people throughout the world. Smartphone use as an effective health care tool has grown exponentially. The “Dry eye or not?” app was created to evaluate the prevalence of symptomatic DE, screen for its occurrence, and provide feedback to users with symptomatic DE throughout Thailand. Objective The purpose of this study was to compare the prevalence of symptomatic dry eye (DE), blink rate, maximum blink interval (MBI), and best spectacle-corrected visual acuity (BSCVA) between people with and without symptomatic DE and to identify risk factors for symptomatic DE in Thailand. Methods This cross-sectional study sourced data from the “Dry eye or not?” smartphone app between November 2019 and July 2020. This app collected demographic data, Ocular Surface Disease Index (OSDI) score, blink rate, MBI, BSCVA, and visual display terminal (VDT) use data. The criterion for symptomatic DE was OSDI score ≥13. Results The prevalence of symptomatic DE among individuals using this smartphone app in Thailand was 85.8% (8131/9482), with the Northeastern region of Thailand having the highest prevalence, followed by the Northern region. Worse BSCVA (median 0.20, IQR 0.40; P=.02), increased blink rate (median 18, IQR 16; P<.001), reduced MBI (median 8.90, IQR 10.80; P<.001), female sex (adjusted OR 1.83; 95% CI 1.59-2.09; P<.001), more than 6 hours of VDT use (adjusted OR 1.59; 95% CI 1.15-2.19; P=.004), and lower than bachelor’s degree (adjusted OR 1.30; 95% CI 1.03-1.64; P=.02) were significantly associated with symptomatic DE. An age over 50 years (adjusted OR 0.77; 95% CI 0.60-0.99) was significantly less associated with symptomatic DE (P=.04). Conclusions This smartphone DE app showed that the prevalence of symptomatic DE in Thailand was 85.8%. Signs and risk factors could be also evaluated with this smartphone DE app. Screening for DE by this app may allow for the development of strategic plans for health care systems in Thailand.
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Affiliation(s)
- Ngamjit Kasetsuwan
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center of Cornea and Limbal Stem Cell Transplantation, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Olan Suwan-Apichon
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kaevalin Lekhanont
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Varintorn Chuckpaiwong
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Usanee Reinprayoon
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center of Cornea and Limbal Stem Cell Transplantation, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Somporn Chantra
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Rajavithi Hospital, Bangkok, Thailand
| | - Vilavun Puangsricharern
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center of Cornea and Limbal Stem Cell Transplantation, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Lalida Pariyakanok
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Thai Red Cross Eye Bank, Bangkok, Thailand
| | - Pinnita Prabhasawat
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nattaporn Tesavibul
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Winai Chaidaroon
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Napaporn Tananuvat
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chakree Hirunpat
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand
| | - Nauljira Prakairungthong
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Mettapracharak Hospital, Nakhon Pathom, Thailand
| | - Wiwan Sansanayudh
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Chareenun Chirapapaisan
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pakornkit Phrueksaudomchai
- Cornea and Refractive Surgery Society of Thailand, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
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Wei J, Wei Q, Li T, Xie Z, Xu X, Bian X, Wu Y. Acupuncture for patients with type 2 diabetes mellitus with dry eye: protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e057289. [PMID: 35701049 PMCID: PMC9198793 DOI: 10.1136/bmjopen-2021-057289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 05/18/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The global incidence of patients with type 2 diabetes mellitus (T2DM) with dry eye is increasing annually, which imposes additional healthcare costs and financial burden on families and societies. In clinical practice, artificial tears are often used for symptomatic treatment, but these can only relieve the symptoms of discomfort. Acupuncture is a widely used alternative therapy. Indeed, randomised trials have found that acupuncture confers a definite therapeutic effect on patients with T2DM with dry eye. However, systematic reviews on the effectiveness and safety of acupuncture are lacking, therefore this systematic review aims to evaluate the effectiveness and safety of acupuncture for T2DM with dry eye. METHODS AND ANALYSIS Four English databases (PubMed, Cochrane Library, Embase and Ovid), three Chinese databases (China National Knowledge Infrastructure, Wanfang, Chonqing VIP Information), three Japanese databases (Japan Science, Technology Agency and Japan Medical Abstracts Society) and three Korean databases (Korean Medical database, Oriental Medicine Advanced Searching Integrated System and Research Information Service System) will be searched for reports published between 1 January 2007 and 1 October 2021. Only randomised controlled trials will be included, and language or publication dates will not be restricted. Two researchers will independently extract, manage and analyse data. The primary outcomes will include Schirmer's I test, breakup time, corneal fluorescein staining and ocular surface disease index scores. Secondary results will include visual analogue scale scores for ocular symptoms and any adverse events related to acupuncture. We will use Review Manager V.5.4 for the meta-analysis. The risk of bias will be independently assessed using Cochrane's 'risk of bias' tool. ETHICS AND DISSEMINATION Ethical approval will not be required since raw data will not be collected or generated. Our findings will be disseminated through peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021271891.
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Affiliation(s)
- Juan Wei
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Qingbo Wei
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Ting Li
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Zhouyu Xie
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xin Xu
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xiangyu Bian
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yunchuan Wu
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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16
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Fjærvoll H, Fjærvoll K, Magno M, Moschowits E, Vehof J, Dartt DA, Utheim TP. The association between visual display terminal use and dry eye: a review. Acta Ophthalmol 2022; 100:357-375. [PMID: 34697901 DOI: 10.1111/aos.15049] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/06/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Dry eye disease (DED) is a multifactorial disease of the tear film and ocular surface. It causes ocular symptoms, reduced quality of life and a considerable economic burden on society. Prolonged use of visual display terminals (VDTs) has been suggested as an important risk factor for DED. PURPOSE This review aims to study the association between DED and VDT use with an emphasis on the prevalence of DED among VDT users and harmful daily duration of VDT use. METHODS A PubMed search was conducted and yielded 57 relevant articles based on a set of inclusion and exclusion criteria. The studies were subclassified according to study design. RESULTS The far majority of the studies showed an association between VDT use and DED or DED-related signs and symptoms. The prevalence of definite or probable DED in VDT and office workers ranged from 26% to 70%, with as few as 1-2 hr of VDT exposure per day being associated with DED. CONCLUSION VDT use is strongly associated with DED. VDT-associated DED is prevalent, but the exact prevalence needs to be further elucidated using standardized DED diagnosis criteria. Furthermore, a safe lower limit of daily VDT use has yet to be established. More research is needed on the effect of digitalization and digital transformation, which are particularly high during the time of the COVID-19 pandemic.
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Affiliation(s)
- Haakon Fjærvoll
- Department of Plastic and Reconstructive Surgery Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Ketil Fjærvoll
- Department of Plastic and Reconstructive Surgery Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Morten Magno
- Department of Plastic and Reconstructive Surgery Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Medical Biochemistry Oslo University Hospital Oslo Norway
- Department of Ophthalmology University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Emily Moschowits
- Department of Medical Biochemistry Oslo University Hospital Oslo Norway
| | - Jelle Vehof
- Department of Ophthalmology University Medical Center Groningen University of Groningen Groningen The Netherlands
- Section of Academic Ophthalmology Faculty of Life Sciences and Medicine (FoLSM) School of Life Course Sciences King's College London St Thomas' Hospital London UK
- Department of Epidemiology University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Darlene A. Dartt
- Schepens Eye Research Institute of Massachusetts Eye and Ear Harvard Medical School Boston MA USA
| | - Tor P. Utheim
- Department of Plastic and Reconstructive Surgery Oslo University Hospital Oslo Norway
- Department of Medical Biochemistry Oslo University Hospital Oslo Norway
- Department of Ophthalmology Drammen Hospital Vestre Viken Trust Drammen Norway
- Department of Ophthalmology Sørlandet Hospital Arendal Arendal Norway
- Department of Computer Science Oslo Metropolitan University Oslo Norway
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Wang C, Yuan K, Mou Y, Wu Y, Wang X, Hu R, Min J, Huang X, Jin X. High-Intensity Use of Smartphone Can Significantly Increase the Diagnostic Rate and Severity of Dry Eye. Front Med (Lausanne) 2022; 9:829271. [PMID: 35559345 PMCID: PMC9086534 DOI: 10.3389/fmed.2022.829271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To investigate the effects of high-intensity use of smartphones on ocular surface homeostasis and to explore whether high-intensity use of handheld digital devices can cause false increase of dry eye diagnostic rate. Methods In this prospective self-control study, 60 subjects (120 eyes) were recruited and asked to read on smartphones provided by the same manufacturer for two consecutive hours. This study was conducted during 8:00 – 10:00 AM to eliminate the influence of digital equipment used the previous day. Ophthalmological examinations [non-invasive tear breakup time (NIBUT), fluorescein breakup time (FBUT), Schirmer I test, corneal fluorescein staining (CFS), bulbar conjunctival redness and meibomian gland (MG) assessment] and a questionnaire survey were conducted before and after the reading test. Based on the collected data, the changes in ocular surface damage and subjective symptoms of the subjects were evaluated, and the differences in the diagnostic rate of dry eye before and after high-intensity use of smartphones were compared. Results The diagnostic rate of dry eye was sharply increased (61.7% vs. 74.2%). The severity of dry eye also changed significantly, and the moderate and severe degree increased after reading (10% vs. 15%; 5% vs. 10.8%). The aggravated severity subjects had lower MG expressibility and more evident bulbar conjunctival redness compared to the non-aggravated severity subjects. After 2 h of continuous reading, NIBUT-First, NIBUT-Average and FBUT-Average were significantly decreased, while the proportion of BUT ≤ 5 s increased significantly. Non-invasive keratograph tear meniscus height(NIKTMH) decreased significantly compared to the baseline level, while the proportion of NIKTMH<0.20 mm increased significantly. No significant difference was observed in the Schirmer I test and CFS score between the two groups. Compared to the baseline, evident aggravation was observed in bulbar conjunctival redness. The Ocular Surface Disease Index (OSDI) was significantly higher than the baseline after the reading test. Conclusion Diagnostic indicators related to dry eye are rapidly deteriorating after high-intensity smartphone use, especially those with lower MG expressibility and ocular redness. High-intensity smartphone use can increase the false positive rate of dry eye diagnosis by disturbing ocular surface homeostasis.
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18
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Wearing face masks and possibility for dry eye during the COVID-19 pandemic. Sci Rep 2022; 12:6214. [PMID: 35418586 PMCID: PMC9007396 DOI: 10.1038/s41598-022-07724-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/23/2022] [Indexed: 01/08/2023] Open
Abstract
This population-based observational, cross-sectional, and descriptive survey was to investigate the relationship of increased face mask usage in the coronavirus disease (COVID-19) era with mask-associated dry eye (MADE). Participants aged 6–79 years old with formal school education were selected. All participants finished the 19-item questionnaire online, distributed through different social media platforms. From 6925 participants who submitted eligible questionnaires, MADE was reported in 547 participants, which included 419 participants who developed new dry eye symptoms after wearing face masks and 128 participants whose pre-existing dry eye symptoms worsened with mask wearing. Longer time of face mask wearing, nonstandard wearing of face masks, reduced outdoor time, decreased daily reading time, shortened visual display terminals time, and dry environment were positively associated with MADE. There were significant associations between perceived MADE and age, female sex, education, use of glasses and contact lenses, and pre-existing dry eye. MADE was more common in adults aged > 20 years than those aged ≤ 20 years or juveniles. MADE incidence increased. Standard wearing of face masks was suggested as a protective factor for MADE. Awareness about the possible risk of MADE should also be created and the clinical dry eye signs should be verified. Clinical trial registration number: NCT04744805.
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19
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The 17-Item Computer Vision Symptom Scale Questionnaire (CVSS17): Translation, Validation and Reliability of the Italian Version. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052517. [PMID: 35270207 PMCID: PMC8909352 DOI: 10.3390/ijerph19052517] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 02/01/2023]
Abstract
Background. To validate the 17-item Computer Vision Symptom Scale questionnaire (CVSS17) in Italian. Methods. Cross-sectional validation study on video terminal (VDT) users and a reference sample of subjects not working at a VDT (control group), cognitively able to respond to a health status interview. The Italian self-administered version of the CVSS17 questionnaire was administered to all participants. The reliability and validity of the Italian translation of the CVSS17 were tested using standard statistical methods for questionnaire validation. The Rasch analysis was performed as well. Results. A total of 216 subjects were enrolled. Concerning the reliability, the Cronbach’s alpha coefficient was 0.925 (from 0.917 to 0.924), and the test−retest stability was 0.91 (<0.001). Concerning the validity, the control group had significantly better scores, and there were good correlations between responses to the CVSS17 and analogous domains of the GSS. Conclusion. The Italian version of the CVSS17 has shown psychometric properties comparable to those of the Spanish version, having good validity, discriminatory power, internal consistency and reliability. The questionnaire is a specific measure of vision-related quality of life in Italian-speaking VDT workers and can be used both in clinical practice and for research purposes.
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Artime-Ríos E, Suárez-Sánchez A, Sánchez-Lasheras F, Seguí-Crespo M. Computer vision syndrome in healthcare workers using video display terminals: an exploration of the risk factors. J Adv Nurs 2022; 78:2095-2110. [PMID: 35112736 DOI: 10.1111/jan.15140] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/18/2021] [Accepted: 12/09/2021] [Indexed: 02/03/2023]
Abstract
AIMS To estimate the prevalence of computer vision syndrome (CVS) in healthcare workers and its relationship to video display terminal (VDT) exposure, sociodemographic, optical correction and work characteristics, and to analyse whether there are differences among occupational groups. DESIGN Cross-sectional study. METHODS A sample of 1179 physicians and surgeons, nurses, and nursing assistants from two hospitals in Spain between January 2017 and February 2018 were invited to participate in this study. Of these, 622 workers from both hospitals were finally included. CVS was measured using a questionnaire, the CVS-Q© . Logistic regression was used to identify the factors associated with CVS. All the results were stratified by occupational group. RESULTS The prevalence of CVS was 56.75% with nurses being the most affected occupational group (61.75%). It was associated significantly with female sex (aOR = 2.57; 95% CI 1.36-4.88) and morning shifts plus on-call (aOR = 2.33; 95% CI 1.11-4.88) in the physicians and surgeons group. Among the nurses, it was associated with female sex (aOR = 2.35; 95% CI 1.03-5.37), seniority between 10 and 20 years (aOR = 2.17; 95% CI 1.03-4.59), VDT exposure at work of 2-4 h/day (aOR = 6.14; 95% CI 1.08-35.02), VDT exposure at work >4 h/day (aOR = 7.14; 95% CI 1.29-39.62) and self-perception that using the software application was not easy (aOR = 2.49; 95% CI 1.23-5.01). CONCLUSIONS A high prevalence of CVS among healthcare workers was observed. The risk factors that increased the likelihood of suffering from this syndrome depended on the occupation. IMPACT The findings may be used as a reference for occupational health services to implement specific preventive measures to reduce CVS for each occupational group. Such measures should consider both individual factors and the working conditions.
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Affiliation(s)
- Eva Artime-Ríos
- Occupational Health Service, Healthcare Area IV, Public Health Service of the Principality of Asturias (SESPA), Oviedo, Spain.,Doctoral Programme in Health Sciences, University of Alicante, Alicante, Spain
| | - Ana Suárez-Sánchez
- Department of Business Administration, University of Oviedo, Oviedo, Spain
| | | | - Mar Seguí-Crespo
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Public Health Research Group, University of Alicante, Alicante, Spain
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Mou Y, Shen X, Yuan K, Wang X, Fan F, Wu Y, Wang C, Jin X. Comparison of the influence of light between circularly polarized and linearly polarized smartphones on dry eye symptoms and asthenopia. Clin Transl Sci 2021; 15:994-1002. [PMID: 34962062 PMCID: PMC9010255 DOI: 10.1111/cts.13218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 11/28/2022] Open
Abstract
This paper aims to investigate the efficacy of circularly polarized light smartphones in affecting dry eye symptoms and asthenopia through a comparison with linearly polarized smartphones. One hundred twenty participants were randomly divided into four groups. Dry eye and asthenopia symptoms were evaluated using the Ocular Surface Disease Index (OSDI), Computer Vision Syndrome Scale 17 (CVSS17), Convergence Insufficiency Symptom Survey (CISS), and visual analogue scale (VAS). Objective ocular examinations were assessed by confusion flicker frequency (CFF), tear meniscus height (TMH), noninvasive break‐up time (NIBUT), conjunctiva redness, fluorescein tear break‐up time (FTBUT), corneal fluorescein staining, and the Schirmer I test. Tests were performed before and after a reading task. Subjective evaluations including the OSDI, CVSS17, and CISS were all significantly increased after reading on a linearly polarized smartphone, whereas no change was observed in the circular polarization groups in both light and dark environments. A significantly enlarged VAS was shown in all of the four groups, but a significant increase in ΔVAS only appeared in the linear polarization groups. There were significant decreases in TMH, NIBUT, conjunctiva redness, FTBUT, and CFF after reading on a linearly polarized smartphone but the circularly polarized smartphone had lesser effects on these parameters. Our study indicated that reading on linearly polarized smartphones may cause dry eye disorder, asthenopia, and ocular discomforts, whereas circularly polarized smartphones appears to minimize these adverse effects on eye dryness and visual fatigue in light and dark environments.
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Affiliation(s)
- Yujie Mou
- Eye Center, School of Medicine, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Xiao Shen
- Eye Center, School of Medicine, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China.,Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Kelan Yuan
- Eye Center, School of Medicine, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Xin Wang
- Eye Center, School of Medicine, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Fangli Fan
- First People's Hospital of Linping District, Hangzhou, China
| | - Yaying Wu
- Eye Center, School of Medicine, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Chunyang Wang
- Eye Center, School of Medicine, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Xiuming Jin
- Eye Center, School of Medicine, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
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22
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Provocation of dry eye disease symptoms during COVID-19 lockdown. Sci Rep 2021; 11:24434. [PMID: 34952901 PMCID: PMC8709849 DOI: 10.1038/s41598-021-03887-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/07/2021] [Indexed: 12/28/2022] Open
Abstract
To assess the impact of COVID-19 lockdown measures on dry-eye symptoms in a community-based population, a cross-sectional study was conducted during the first wave of the COVID-19 outbreak in Thailand. An online survey was distributed via social media between June and July 2020. The questionnaire elicited information on demographics, dry-eye symptoms, use of visual display terminals, and mental health status. There were 535 respondents. Thirty-seven percent reported having been diagnosed with dry-eye disease (DED). During the lockdown, the mean dry-eye symptom score (DESS) of overall participants dropped significantly from 81.6 ± 15.9 to 79.8 ± 17.4 (P < 0.001). The mean, daily, visual display terminal (VDT) usage increased from 10.55 ± 5.16 to 13.08 ± 5.65 h (P < 0.001). A negative correlation between age and VDT usage was observed in both the normal and lockdown situations. One-quarter of all participants had an abnormal mental health status. The female gender (OR 1.86; 95% CI 1.14–3.04) and increased VDT usage during the lockdown (OR 5.68; 95% CI 3.49–9.23) were independently associated with worsening dry-eye symptoms. The lockdown measures abruptly altered the behaviors and lifestyles of the overall population. Excessive exposure to VDTs were associated with deteriorated dry-eye symptoms, and it possibly contributed to the increased DED incidence in the surveyed population.
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23
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Symptoms of Dry Eye Disease in Hospitalized Patients with Coronavirus Disease 2019 (COVID-19). J Ophthalmol 2021; 2021:2678706. [PMID: 34912574 PMCID: PMC8668290 DOI: 10.1155/2021/2678706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/21/2021] [Accepted: 10/29/2021] [Indexed: 11/25/2022] Open
Abstract
Background We aimed to investigate the symptoms of the dry eye disease (DED) of hospitalized patients with coronavirus disease 2019 (COVID-19). Methods This cross-sectional, observational study analysis included 91 hospitalized patients with confirmed COVID-19 in Wuhan, China. The Ocular Surface Disease Index (OSDI) and the five-item Dry Eye Questionnaire (DEQ-5) were used to assess the severity of DED symptoms in the patients, and the analysis of variance was used to determine the factors associated with DED. Results A total of 42 patients consented to complete the investigation (response rate 46.15%). There were 26 (61.90%) patients who were diagnosed with DED symptoms by OSDI, and there were 28 (66.67%) patients with DED symptoms who were diagnosed by DEQ-5 score. For the biochemical tests, the patients with DED symptoms had lower aspartate aminotransferase (AST) levels compared to those with no DED symptoms (20.86 vs. 42.14, p=0.04). Further analysis showed that a previous history of cardiac or stroke disease (p=0.02) and typical symptoms of muscle soreness (p=0.03) were significantly different among the four DED symptoms groups on the basis of OSDI scores. The contributing factors of OSDI were mainly focused on visual function and environmental triggers. Conclusion The incidence of DED symptoms is higher in hospitalized patients with COVID-19. The serum AST levels, history of cardiac or stroke disease, and the typical symptoms of muscle soreness may be the main impact factors on DED symptoms. We also need to pay more attention to the visual function and environmental triggers of hospitalized patients with COVID-19.
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24
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Fan Q, Wang H, Kong W, Zhang W, Li Z, Wang Y. Online Learning-Related Visual Function Impairment During and After the COVID-19 Pandemic. Front Public Health 2021; 9:645971. [PMID: 34912766 PMCID: PMC8666689 DOI: 10.3389/fpubh.2021.645971] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 10/29/2021] [Indexed: 01/06/2023] Open
Abstract
This study aimed to review the consequences of increased online learning, which was precipitated by the coronavirus disease 2019 (COVID-19), on visual function, as well as the methods for preventing the associated visual impairment. The recent finding implies that a higher incidence of myopia may be observed during the pandemic than that before. The myopia prevalence was 59.35% in COVID-19, which was higher than that in the normal period. COVID-19-related influence of developing myopia among students should be addressed and under control. Online learning precipitated by COVID-19 is likely to increase the global burden of visual function impairment. This review highlighted useful measures to prevent online learning-related visual function impairments, including the following: (1) desktop illumination of no >300 lx, online learning time for primary, and middle-school students of no more than 20–30 min per session; (2) daily video time for preschool children not exceeding 1 h, and for school-age children and adolescents not exceeding 2 h; (3) after every 30–40 min of online learning, moving eyes away from the screen or closed for 10 min; (4) engaging in outdoor activities for ≥ 2 h a day; (5) suitable screen and learning environment settings and correct postures for reading and writing; (6) sufficient sleep and proper nutrition. Preventing online learning-related visual impairment during and after this unprecedented pandemic will facilitate future ophthalmic practice.
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Affiliation(s)
- Qian Fan
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital and Eye Institute, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
| | - Hongxia Wang
- Shanghai Guanghua Integrated Traditional Chinese and Western Medicine Hospital, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenjun Kong
- Beijing You'an Hosptial, Capital Medical University, Beijing, China
| | - Wei Zhang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital and Eye Institute, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
| | - Zhouyue Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yan Wang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital and Eye Institute, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
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25
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A Pilot, Phase II, Observational, Case-Control, 1-Month Study on Asthenopia in Video Terminal Operators without Dry Eye: Contrast Sensitivity and Quality of Life before and after the Oral Consumption of a Fixed Combination of Zinc, L-Carnitine, Extract of Elderberry, Currant and Extract of Eleutherococcus. Nutrients 2021; 13:nu13124449. [PMID: 34960000 PMCID: PMC8705792 DOI: 10.3390/nu13124449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 12/13/2022] Open
Abstract
The aims of the study were to investigate the ability and effectiveness of an oral intake of a fixed combination of zinc, L-carnitine, elderberry extract, black currant and Eleutherococcus extract in controlling the symptoms of eyestrain in videoterminal (VDT) users and to record its effects on contrast sensitivity. A single-center, phase II, observational, case-control, 1-month study in VDT workers without dry eye disease was carried out. Demographics and number of actual hours at VDT/day were taken into account. All subjects underwent a complete ophthalmic examination, including assessment of contrast sensitivity, and completed the computer vision symptom scale questionnaire at baseline and one month later. A total of 30 Caucasian subjects adhered to the required inclusion criteria and completed the study; 15 subjects were treated (T) and 15 were controls (C). All clinical data at baseline were similar in both groups (p > 0.05): after one month, all subjects had stable visual acuity, refractive defect and intraocular pressure (IOP); screen exposure time was unchanged. Regarding symptoms, at randomization, the groups had a similar score: 33.1 ± 3.3 in T and 32.8 ± 5.6 in C. One month later, the computer vision symptom scale (CVSS) questionnaire score decreased by −14.1 ± 3, 1 (p = 0.000) and −2.3 ± 1.8 (p = 0.568), respectively. Regarding contrast sensitivity, in group C the values of spatial frequencies remained unchanged, while they improved in almost all the cycles per degree stimuli in the treated group. Oral intake of a fixed combination of zinc, L-carnitine, elderberry extract, black currant and eleutherococcus extract can significantly improve contrast sensitivity and symptoms in VDT workers with no signs of dry eye disease.
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26
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Galindo-Romero C, Ruiz-Porras A, García-Ayuso D, Di Pierdomenico J, Sobrado-Calvo P, Valiente-Soriano FJ. Computer Vision Syndrome in the Spanish Population during the COVID-19 Lockdown. Optom Vis Sci 2021; 98:1255-1262. [PMID: 34510149 DOI: 10.1097/opx.0000000000001794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE After 6 to 8 weeks of mandatory lockdown due to coronavirus disease 2019 (COVID-19) in Spain, the encouraged change in daily habits resulted in a significant increase in electronic device use. Computer vision syndrome-related symptoms were reported more often in participants who used electronic device for more time and spent less time outdoors. PURPOSE The main purpose of this study was to evaluate computer vision syndrome-related eye symptoms due to the use of electronic devices during COVID-19 lockdown decreed in Spain in 2020. METHODS After 6 to 8 weeks of strict lockdown, a total of 730 participants (18 to 73 years old) filled in a customized questionnaire divided into three sections: (1) general demographics, (2) usage habits of electronic devices during this period, and (3) computer vision syndrome-related ocular and visual symptoms associated with their use and with ergonomic practices. RESULTS The daily duration of use of electronic devices increased an average of 3.1 ± 2.2 h/d during the lockdown, with computer use increasing the most. The main symptoms reported by the participants were headache (36.7%), dry eye (31.1%), irritation (24.1%), blurred vision (21.2%), and ocular pain (14.9%). There was a significant relationship between computer vision syndrome-related symptoms and age (greater in participants between 18 and 30 years old than in those older than 45 years, P < .001), primary activity (greater in studying from home and remote working, P < .001), and extended periods of electronic device use (greater when used more than 10 h/d, P = .05). Symptoms were also associated with time spent outdoors (greater in participants with <1 h/d, P = .02). CONCLUSIONS The lockdown due to COVID-19 showed an increase in the electronic device use. Participants who spent more time with electronic devices and less time outdoors reported more computer vision syndrome-related eye symptoms.
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Affiliation(s)
| | - Alberto Ruiz-Porras
- Máster en Optometría Aplicada, Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
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27
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Ashwini DL, Ve RS, Nosch D, Wilmot N. Efficacy of blink software in improving the blink rate and dry eye symptoms in visual display terminal users - A single-blinded randomized control trial. Indian J Ophthalmol 2021; 69:2643-2648. [PMID: 34571605 PMCID: PMC8597488 DOI: 10.4103/ijo.ijo_3405_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose: Dry eye disease (DED) is a multifactorial disease, more prevalent among visual display terminal users. Reduced blink rate is a risk factor to dry eye disorder, innovative means to remind to blink while using computers can be helpful. Methods: Single-blinded Randomized Control Trial enrolled computer users with dry eye. Allocation concealment was done using opaque envelope and principal investigator was blinded. After baseline examination, eligible participants were randomized to intervention group (appearance of bars is 8 times/min) and control group (appearance of bars is 1 time/min). Participants from both groups used the software for 15 days, came for first follow up, and did not use the software for next 15 days until second follow-up examination. During each visit, detailed eye examination was done including blink rate, tear film break up time, and Ocular Surface Disease Index score. Results: Forty-six participants (women n = 31; men n = 15) with a mean age of 28.02 (±6.295) years completed the study. Four participants were excluded from analysis because of early dropout. In the intervention group (n = 23) and control group (n = 23), participants were allocated. At the end of first phase, there was statistically significant difference in OSDI score (P = 0.021). Statistically significant difference was noticed in OSDI (P = 0.014) and blink rate (P = 0.049) as baseline, and final visit data were compared. Conclusion: “Blink–Blink” software with 8 reminders/min improved DED-related symptoms by increasing the blink rate. The carry-over effect after cessation of Blink-Blink software in improving blink rate was maintained even after 1 month. Trial Registration: Clinical Trials Registry-India (CTRI): CTRI/2018/08/015176
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Affiliation(s)
- D L Ashwini
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi; Sankara College of Optometry, Sankara Eye Hospital, Bengaluru, Karnataka, India
| | - Ramesh S Ve
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, India
| | - Daniela Nosch
- FHNW University of Applied Sciences and Northwestern Switzerland, School of Engineering, Riggenbachstrasse 16 CH-4600 Olten, Switzerland
| | - Natoya Wilmot
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, India
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28
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Iqbal M, Elzembely H, Elmassry A, Elgharieb M, Assaf A, Ibrahim O, Soliman A. Computer Vision Syndrome Prevalence and Ocular Sequelae among Medical Students: A University-Wide Study on a Marginalized Visual Security Issue. Open Ophthalmol J 2021. [DOI: 10.2174/1874364102115010156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
This study aimed to discover and document the potential of visual and ocular sequelae of computer vision syndrome (CVS) among medical students.
Methods:
This cross-sectional case-control study was conducted on medical students (n=4030) of five universities in Egypt. All students completed a specially designed and validated CVS questionnaire survey (CVS-F3). Students with ≥5 CVS symptoms constituted a risk group (n=352), while students with 1-4 CVS symptoms constituted a low-symptoms group (n=3067). Students from the control and risk groups were examined using objective methods, such as visual acuity, subjective refraction, dry eye disease tests, and anterior segment and fundus examinations. Students who complained of visual blur underwent multifocal electroretinography mfERG examinations (mfERG group).
Results:
The CVS-F3 indicated that 84.8% of students had complaints that might be related to CVS, however, our ophthalmic examination group revealed only a 56% CVS prevalence rate. The most common single screen type used by 70.4% of students was the smartphone, and the most common complaint was headache (50.2%). Multivariate logistic regression analysis revealed that CVS was significantly associated with increased screen-hours, including >2 screen-hours daily (odds ratio [OR], 2.48; P<0.0001), >2 screen-hours at night (OR, 1.79; P=0.003), and ≥3 screen-years (OR, 1.69; P=0.006). In the mfERG group, 37% demonstrated reduced amplitudes of mfERG rings and quadrants, indicating reduced foveal responses.
Conclusion:
CVS-questionnaires overestimate the true CVS prevalence and sequelae, which could be accurately detected by objective ophthalmic examination. Smartphones primarily caused CVS among students, with CVS severity increasing in correlation with shorter eye-to-screen distance and frequent use. Contact lens wearing doubled the risk of CVS development and augmented its severity. CVS might affect macular integrity with screen-induced foveal dysfunction.
Clinical Trials Registration:
PACTR201811618954630.
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29
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García-Ayuso D, Di Pierdomenico J, Moya-Rodríguez E, Valiente-Soriano FJ, Galindo-Romero C, Sobrado-Calvo P. Assessment of dry eye symptoms among university students during the COVID-19 pandemic. Clin Exp Optom 2021; 105:507-513. [PMID: 34279190 DOI: 10.1080/08164622.2021.1945411] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
CLINICAL RELEVANCE The synchronous hybrid learning environment is associated with increased time spent by students working with VDT and increased prevalence of dry eye symptoms in a university-based population. BACKGROUND To assess the prevalence of dry eye symptoms using the ocular surface disease index (OSDI) questionnaire in university students and to identify whether factors such as the synchronous hybrid learning environment as a preventive measure of COVID-19, video display terminal use, gender or contact lens wear influence dry eye symptomatology. METHODS This study was performed using a web-based questionnaire that was distributed to university students to assess questions related to class attendance, to the use of video display terminals, the need for optical correction and, finally, the OSDI questionnaire. RESULTS A total of 676 university students with an average age of 20.7 ± 2.9 years completed the questionnaire, of which 72.6% (491) were females and 27.4% (185) were males. Only 10.2% of the participants attended face to face classes. Of the participants, 35.5% were contact lens wearers. The mean OSDI score of the study population was 27.68 ± 20.09 and the prevalence of symptomatic dry eye disease (OSDI score above 22) was 51.8%. Female gender (X2(3) = 38.605, p < 0.001), online class attendance (X2(1) = 20.31; p < 0.001), increased hours of online class attendance (X2(2) = 26.84, p < 0.001) and contact lens wear (X2(2) = 15.264, p < 0.05) were associated with a higher incidence of symptomatic dry eye disease. CONCLUSION The synchronous hybrid learning environment increases the time students spend working with video display terminals and the prevalence of dry eye symptoms. Female gender and contact lens wear were also associated with a higher prevalence of dry eye symptoms. It should not be ignored that dry eye could also affect academic performance.
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Affiliation(s)
- Diego García-Ayuso
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-virgen de la Arrixaca), Murcia, Spain.,Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
| | - Johnny Di Pierdomenico
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-virgen de la Arrixaca), Murcia, Spain.,Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
| | | | - Francisco J Valiente-Soriano
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-virgen de la Arrixaca), Murcia, Spain.,Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
| | - Caridad Galindo-Romero
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-virgen de la Arrixaca), Murcia, Spain.,Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
| | - Paloma Sobrado-Calvo
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-virgen de la Arrixaca), Murcia, Spain.,Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
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30
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Schlatter A, Hirn C, Palkovits S, Werkmeister RM, Findl O, Garhöfer G, Schmidl D. Anwendungsmöglichkeiten der optischen Kohärenztomographie beim trockenen Auge. SPEKTRUM DER AUGENHEILKUNDE 2021. [DOI: 10.1007/s00717-021-00490-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
ZusammenfassungDurch die stetige Weiterentwicklung und Verbesserung der Technik hat die optische Kohärenztomographie (OCT) in den letzten Jahren neue Möglichkeiten zur Beurteilung der Strukturen des vorderen Augenabschnittes eröffnet. Aufgrund der Darstellung kleinster Strukturen, wie beispielsweise des Tränenfilms, nimmt die OCT in der Diagnostik und Verlaufsbeurteilung des trockenen Auges eine immer wichtigere Rolle ein. Der vorliegende Beitrag gibt einen Überblick über die derzeitigen Einsatzmöglichkeiten der OCT beim trockenen Auge.
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31
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Yuan K, Zhu H, Mou Y, Wu Y, He J, Huang X, Jin X. Effects on the Ocular Surface from Reading on Different Smartphone Screens: A Prospective Randomized Controlled Study. Clin Transl Sci 2021; 14:829-836. [PMID: 33202098 PMCID: PMC8212737 DOI: 10.1111/cts.12933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/30/2020] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to investigate the influence of smartphone reading on the ocular surface and to compare the various effects of different screens and light conditions on the ocular surface. One hundred nineteen volunteers were randomly divided into: light + organic light-emitting diode (OLED), light + electronic ink (eINK), dark + OLED, and dark + eINK. Ocular surface examinations, including noninvasive break-up time (NIBUT), noninvasive keratograph tear meniscus height (NIKTMH), ocular redness, fluorescein break-up time (FBUT), corneal fluorescein staining, meibomian gland assessment, Schirmer I Test, and blinking frequency, were performed before and after a reading task. Symptoms were evaluated using the Ocular Surface Disease Index (OSDI) and Computer Vision Syndrome Questionnaire (CVS-Q). NIBUT and FBUT were decreased statistically significantly after participants read on an OLED screen for 2 hours compared with the baseline in light and dark environments, whereas no statistically significant decrease was observed on an eINK screen. NIKTMH was statistically significantly decreased after reading on an OLED screen in light and dark settings, and the eINK screen had a lesser effect on NIKTMH. An obvious increase in the ocular redness, OSDI and CVS-Q scores was observed after reading on an OLED screen, whereas the eINK screen had a lesser effect on these indicators. Blink rate increased gradually in OLED subgroups during the reading task, whereas no statistically significant difference was observed in the eINK subgroups. Our research suggested that reading on an OLED screen can cause ocular surface disorder and obvious subjective discomfort, whereas reading on an eINK screen can minimize ocular surface disorder in both dark and light environments.
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Affiliation(s)
- Kelan Yuan
- Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Haiping Zhu
- Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yujie Mou
- Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yaying Wu
- Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jingliang He
- Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaodan Huang
- Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiuming Jin
- Eye Center, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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32
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Wei QB, Ding N, Wang JJ, Wang W, Gao WP. Acupoint selection for the treatment of dry eye: A systematic review and meta-analysis of randomized controlled trials. Exp Ther Med 2020; 19:2851-2860. [PMID: 32256769 PMCID: PMC7086192 DOI: 10.3892/etm.2020.8561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 10/28/2019] [Indexed: 01/22/2023] Open
Abstract
The effectiveness of acupuncture in the treatment of dry eye has been confirmed, but the association between acupoint selection and therapeutic effect has remained to be elucidated. In the present study, a systematic review and meta-analysis were performed to evaluate the effect of periocular acupoints and periocular acupoints plus body acupoints compared with AT for the treatment of dry eye disease (DED). The PubMed, Cochrane Library, Embase, Ovid, China National Knowledge Infrastructure and Chonqing VIP Information, Co., Ltd. databases were searched with entries until 10 July 2018 considered. Only randomized controlled trials (RCTs) were included. Meta-analyses were performed to compare the effects of acupuncture with those of conventional treatment (including AT or other non-acupuncture therapies). The primary outcomes, including tear break-up time (BUT), Schirmer's I test (SIT) result and Symptom scores were analyzed. Subgroup analysis was performed for periocular acupoints only and periocular acupoints plus body acupoints. A total of 12 studies comprising 900 participants were included. In the primary meta-analysis, a significant improvement in the BUT [n=1,209, weighted mean difference (WMD)=1.01, 95% CI: 0.56-1.84, P<0.00001], SIT result (n=1,107, WMD=1.98, 95% CI: 0.44-3.34, P<0.00001) and Symptom scores (n=402, WMD=-1.02, 95% CI: -1.33 to -0.72, P<0.00001) was obtained to evaluate the clinical efficacy of acupuncture and AT. Furthermore, periocular acupoints plus body acupoints were more effective in the treatment of DED. However, the total sample size of subjects with only periocular acupoints in the treatment of DED was too small to get any firm conclusions. Further large RCTs are warranted.
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Affiliation(s)
- Qing-Bo Wei
- Ophthalmology Department of Traditional Chinese Medicine, The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, P.R. China.,Ophthalmology Department, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China
| | - Ning Ding
- Ophthalmology Department of Traditional Chinese Medicine, The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, P.R. China.,Ophthalmology Department, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China
| | - Jiao-Jiao Wang
- Ophthalmology Department of Traditional Chinese Medicine, The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, P.R. China.,Ophthalmology Department, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China
| | - Wei Wang
- School of Healthcare Sciences, Cardiff University, Cardiff, CF10 3AT, UK
| | - Wei-Ping Gao
- Ophthalmology Department of Traditional Chinese Medicine, The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, P.R. China.,Ophthalmology Department, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China
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