Real-Time Non-Intrusive Assessment of Viewing Distance during Computer Use

Assessment of precision and reliability of a novel computerized heterophoria test

Purpose

To assess the precision and reliability of a novel computerized heterophoria test (CHT).

Methods

One hundred and three subjects aged 20 to 48 (27.37 ± 5.15) were recruited from Wenzhou Medical University. All subjects with corrected spectacles were examined with CHT and a prism-neutralized objective cover test (POCT) in a randomized order. They were then re-examined with CHT within 1 week. Their heterophoria was measured at three different distances (3 m, 0.77 m and 0.4 m); the average was recorded after three consecutive measurements. Inter-examiner repeatability, intra-examiner repeatability of CHT and agreement between CHT and POCT were evaluated.

Results

There was no significant difference among repeated measurements using CHT (all p > 0.05). The difference between POCT and CHT was statistically significant at three distances (all p < 0.001). However, the mean absolute difference was 1.20^△, 1.93^△, and 2.41^△, all of which were significantly smaller than the permissible range of error (4^△) at three different distances (all p < 0.001).

Conclusion

The CHT demonstrated excellent inter- and intra-examiner repeatability, as well as good correlation with POCT. The differences between CHT and POCT were within the permissible range of error, indicating that CHT could provide a precise and reliable measurement for clinical applications.

TFOS Lifestyle: Impact of the digital environment on the ocular surface

Eye strain when performing tasks reliant on a digital environment can cause discomfort, affecting productivity and quality of life. Digital eye strain (the preferred terminology) was defined as "the development or exacerbation of recurrent ocular symptoms and/or signs related specifically to digital device screen viewing". Digital eye strain prevalence of up to 97% has been reported, due to no previously agreed definition/diagnostic criteria and limitations of current questionnaires which fail to differentiate such symptoms from those arising from non-digital tasks. Objective signs such as blink rate or critical flicker frequency changes are not 'diagnostic' of digital eye strain nor validated as sensitive. The mechanisms attributed to ocular surface disease exacerbation are mainly reduced blink rate and completeness, partial/uncorrected refractive error and/or underlying binocular vision anomalies, together with the cognitive demand of the task and differences in position, size, brightness and glare compared to an equivalent non-digital task. In general, interventions are not well established; patients experiencing digital eye strain should be provided with a full refractive correction for the appropriate working distances. Improving blinking, optimizing the work environment and encouraging regular breaks may help. Based on current, best evidence, blue-light blocking interventions do not appear to be an effective management strategy. More and larger clinical trials are needed to assess artificial tear effectiveness for relieving digital eye strain, particularly comparing different constituents; a systematic review within the report identified use of secretagogues and warm compress/humidity goggles/ambient humidifiers as promising strategies, along with nutritional supplementation (such as omega-3 fatty acid supplementation and berry extracts).

Environment width robustly influences egocentric distance judgments

Past work has suggested that perception of object distances in natural scenes depends on the environmental surroundings, even when the physical object distance remains constant. The cue bases for such effects remain unclear and are difficult to study systematically in real-world settings, given the challenges in manipulating large environmental features reliably and efficiently. Here, we used rendered scenes and crowdsourced data collection to address these challenges. In 4 experiments involving 452 participants, we investigated the effect of room width and depth on egocentric distance judgments. Targets were placed at distances of 2–37 meters in rendered rooms that varied in width (1.5–40 meters) and depth (6–40 meters). We found large and reliable effects of room width: Average judgments for the farthest targets in a 40-meter-wide room were between 16–33% larger than for the same target distances seen in a 1.5-meter-wide hallway. Egocentric distance cues and focal length were constant across room widths, highlighting the role of environmental context in judging distances in natural scenes. Obscuring the fine-grained ground texture, per se, is not primarily responsible for the width effect, nor does linear perspective play a strong role. However, distance judgments tended to decrease when doors and/or walls obscured more distant regions of the scene. We discuss how environmental features may be used to calibrate relative distance cues for egocentric distance judgments.