Computer vision syndrome and ergonomic practices among undergraduate university students

Assessing the role of visual dysfunctions in the association between visual symptomatology and the use of digital devices

PURPOSE

To evaluate the association between visual symptoms and use of digital devices considering the presence of visual dysfunctions.

METHODS

An optometric examination was conducted in a clinical sample of 346 patients to diagnose any type of visual anomaly. Visual symptoms were collected using the validated SQVD questionnaire. A threshold of 6 hours per day was used to quantify the effects of digital device usage and patients were divided into two groups: under and above of 35 years old. A multivariate logistic regression was employed to investigate the association between digital device use and symptoms, with visual dysfunctions considered as a confounding variable. Crude and the adjusted odds ratio (OR) were calculated for each variable.

RESULTS

57.02 % of the subjects reported visual symptoms, and 65.02% exhibited some form of visual dysfunction. For patients under 35 years old, an association was found between having visual symptoms and digital device use (OR = 2.10, p = 0.01). However, after adjusting for visual dysfunctions, this association disappeared (OR = 1.44, p = 0.27) and the association was instead between symptoms and refractive dysfunction (OR = 6.52, p < 0.001), accommodative (OR = 10.47, p < 0.001), binocular (OR = 6.68, p < 0.001) and accommodative plus binocular dysfunctions (OR = 46.84, p < 0.001). Among patients over 35 years old, no association was found between symptoms and the use of digital devices (OR = 1.27, p = 0.49) but there was an association between symptoms and refractive dysfunction (OR = 3.54, p = 0.001).

CONCLUSIONS

Visual symptoms are not dependent on the duration of digital device use but rather on the presence of any type of visual dysfunction: refractive, accommodative and/or binocular one, which should be diagnosed.

Effect of an online posture exercise program during the COVID-19 pandemic on students' musculoskeletal pain and quality of life

BACKGROUND

Prolonged sitting and poor posture can contribute to musculoskeletal pain and have a negative effect on health-related quality of life (HRQoL) among young adults. Any prolonged posture leads to static loading of soft tissues and causes discomfort. Seated posture leads to inactivity causing an accumulation of metabolites, accelerating disk degeneration and musculoskeletal pain. Regular exercise has major contributions to the prevention and treatment of some health problems such as musculoskeletal disorders.

OBJECTIVE

This study aimed to assess the impact of online posture exercises on musculoskeletal pain and health related quality of life among university students receiving distance education during the COVID-19 pandemic.

METHODS

This randomized controlled trial involved 72 students divided into intervention (n= 35) and control (n= 37) groups. The intervention group followed an 8-week online stretching and posture exercise program. Baseline and 8-week results were measured using the SF-36 QoL Questionnaire and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ).

RESULTS

Students spent an average of 5.4 ± 2.5 hours daily at computers. While there was no difference between the scores of any region in the CMDQ in the control group, there was a decrease in the neck, right shoulder, left shoulder, waist, left upper leg, right lower leg, and left lower leg discomfort scores in the intervention group (p< 0.05). There was a significant difference between the intervention and control groups in the total score of SF-36 and the sub-dimensions of vitality and mental health (p< 0.05).

CONCLUSION

The online posture exercise program led to notable reductions in musculoskeletal pain and improvements in QoL among university students. Examining the effectiveness of online exercise programs in different age groups is important for health benefits during quarantines.

Prevalence of computer vision syndrome: A systematic review and meta-analysis

PURPOSE

This review aimed to estimate the prevalence of computer vision syndrome (CVS) in the general population and subgroups.

METHODS

A search was conducted in the following the databases: PubMed, SCOPUS, EMBASE, and Web of Science until February 13, 2023. We included studies that assessed the prevalence of CVS in any population. The Joanna Briggs Institute's critical appraisal tool was used to evaluate the methodological quality. A meta-analysis of the prevalence of CVS was done using a random-effects model, assessing the sources of heterogeneity using subgroup and meta-regression analyses.

RESULTS

A total of 103 cross-sectional studies with 66 577 participants were included. The prevalence of CVS was 69.0% (95% CI: 62.3 to 75.3; I2: 99.7%), ranging from 12.1 to 97.3% across studies. Point prevalence was higher in women than in men (71.4 vs. 61.8%), university students (76.1%), Africa (71.2%), Asia (69.9%), contact lens wearers (73.1% vs. 63.8%) in studies conducted before the COVID-19 pandemic (72.8%), and in those that did not use the CVS-Q questionnaire (75.4%). In meta-regression, using the CVS-Q scale was associated with a lower prevalence of CVS.

CONCLUSION

Seven out of ten people suffer from CVS. Preventive strategies and interventions are needed to decrease the prevalence of this condition which can affect productivity and quality of life. Future studies should standardize a definition of CVS.

Computer vision syndrome and associated factors in university students and teachers in Nampula, Mozambique

BACKGROUND

Computer Vision Syndrome (CVS) is a complex of eye and visual problems that arise while using a computer or other Video Display Terminal (DVT). With the advent of the COVID-19 pandemic, the use of these DVTs has become indispensable in the lives of students and teachers. This study aims to identify the prevalence of CVS and associated factors in students and teachers at Lúrio University, in Nampula, during the pandemic period.

METHODS

This is a cross-sectional study, carried out between November 2020 and March 2021. The validated CVS questionnaire (CVS-Q) and another semi-structured questionnaire on ergonomic risk factors were applied. Odds ratios (OR) and adjusted odds ratios (aOR) were calculated to measure the association between CVS and computer use conditions.

RESULTS

The prevalence of CVS was 76.6%, and the female gender, age ≤ 20 years, levels I, II, III of course, lack of knowledge about ergonomics, use the computer to study, use more than 6 hours daily, absence of anti-reflex treatment, use of other devices and sitting in an inappropriate chair were risk factors for the occurrence of CVS, while being a teacher was a protective factor.

CONCLUSION

The prevalence of CVS found in this study was high, due to several factors, especially not using ergonomic principles when using computers and other DVTs. There is a need to adopt intervention strategies focused on the most vulnerable groups such as women, age group ≤20 years and students, especially at the first year level, right after entering the University.

Ocular nociception and neuropathic pain initiated by blue light stress in C57BL/6J mice

To elucidate the physiological, cellular, and molecular mechanisms responsible for initiating and sustaining ocular neuropathic pain, we created a blue-light-exposure model in C57BL/6 mice. Mice were exposed to 12 h of blue or white light followed by 12 h of darkness. Before blue light exposure, baseline tear secretion, stability, and ocular hyperalgesia were assessed by measuring hyper- or hypo-osmotic solution-induced eye wiping, wind-induced eye closing, and cold-induced eye blinking. At 1 day post-blue light exposure, alterations in hypotonic/hypertonic-induced eye-wiping, and tear film abnormalities were observed. Eye-wiping behaviors were abolished by topical anesthesia. The cold-stimulated eye-blinking and wind-stimulated eye-closing behaviors began after day 3 and their frequency further increased after day 9. Blue-light exposure reduced the density of nerve endings, and increased their tortuosity, the number of beadlike structures, and the branching of stromal nerve fibers, as assessed by whole-mount confocal microscopy. Blue-light exposure also increased TRPV1, but not TRPV4 staining intensity of corneal-projecting neurons in the trigeminal ganglia, as detected by Fluorogold retrograde labeling and immunohistochemistry. TRPV1 and substance P expression was increased, whereas CGRP expression deceased at the mRNA level in isolated corneal projecting neurons. Hence, our blue-light exposure B6 mouse model for assessing tearing and ocular hyperalgesia is useful for studying ocular pain and its underlying mechanisms. Blue-light-induced alterations in tearing and ocular hyperalgesia may be related to the elevated expression of TRPV1, SP, and/or the suppressed expression of CGRP at the ocular surface.

Computer Vision Syndrome Among Medical Students at the University of Khartoum, Sudan: Prevalence and Associated Factors

Background and aims Regular continuous uninterrupted use of electronic devices, such as smartphones, tablets, and computers, can result in a spectrum of vision-related symptoms known as computer vision syndrome. Students today can readily access information and books on their smartphones and computers, which reduces their reliance on printed texts. Numerous muscle-related and ocular complaints could arise from this. The primary objective of this study was to estimate the prevalence of computer vision syndrome symptoms among medical students at the University of Khartoum and to identify its contributing factors. The secondary objective was to evaluate practices and knowledge related to computer vision syndrome prevention. Methods This study is a facility-based cross-sectional observation aimed at describing medical students' characteristics at the University of Khartoum. The sampling strategy employed was stratified random sampling, and a structured online questionnaire was used to collect the data. A total of 149 students completed the self-administered questionnaire. The questionnaire included questions on sociodemographic data, validated symptoms of computer vision syndrome, and factors associated with the syndrome's development. Data were analyzed using SPSS Statistics (Armonk, NY: IBM Corp.), simple descriptive statistics were calculated, and odds ratios and Pearson's chi-square test were employed to examine and quantify the association between variables. Results Of the 149 participants, 58.4% were female, while males made up 41.6% of the study sample. The prevalence of computer vision syndrome has been found to be 94%, and 72.4% of the students reported experiencing at least three symptoms of computer vision syndrome. Neck and shoulder pain was the most commonly reported symptom (78.5%), followed by headache (70.5%), while the least reported symptom was eye redness (36.2%). The majority of students (81.2%) used electronic devices for five or more hours a day, and the most common posture while using electronic devices was lying down, as reported by 54.4% of the students. A total of 68% of the medical students in this study reported keeping a distance that was shorter than the suggested 40 centimeters from the screen, and only 18.1% were aware of the 20-20-20 rule (every 20 minutes look at an object 20 feet away for 20 seconds). The seating position has been found to be significantly associated with the number of symptoms experienced (p=0.012); sitting with a bent back was 4.6 times more likely to cause more than three symptoms when compared to sitting upright with a straight back (OR=4.643; 95% CI: 1.63-13.21; p=0.004). Conclusion There was a very high prevalence of computer vision syndrome among medical students at the University of Khartoum. Most students had poor awareness and bad practices regarding the safe use of electronic devices. Awareness campaigns to encourage good practices and enable the safe use of computers and other digital devices are strongly recommended.

Computer vision syndrome-related symptoms in presbyopic computer workers

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.

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).

Spotlight on Digital Eye Strain

Digital Eye Strain (DES) is a clinical syndrome manifested with visual disturbances and/or ophthalmic dysfunction related to the usage of screen-enabled digital equipment. This term is gradually replacing the older term computer vision syndrome (CVS) that focused on the same symptoms found on personal computer users. DES is encountered more frequently during the past years due to the explosive increase in the usage of digital devices and subsequent increase in time in front of any screens. It presents with a series of atypical symptoms and signs stemming from asthenopia, dry eye syndrome, preexisting untreated vision issues and poor screen ergonomics. This review summarizes research data to date to determine whether the concept of DES has been conclusively defined and demarcated as a separate entity and if sufficient guidance is offered on professionals and the lay public. The maturity of the field, grouping of symptoms, examination techniques, treatment and prevention modalities are summarily presented.

Improving Visual Comfort during Computer Gaming with Preservative-Free Hyaluronic Acid Artificial Tears Added to Ergophthalmological Measures

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.

Assessment of risk factors on eye dryness in young adults using visual display device in both contact lens wearers and non-wearers

PURPOSE

Researchers are interested in examining the impact of visual display devices (VDDs) on the development of dry eye illness because their use is becoming more common among college students. The goal of this study was to see if there was a link between certain risk factors and the development of eye dryness in VDDs using young adults who wore contact lenses and those who did not.

METHODS

The self-administrated survey was hosted in Google Forms, sent via e-mail to the participants. It consisted of two parts of assessing different risk factors (i.e., environmental conditions, angle of gaze, and years of VDD use) with contact lens use and Ocular Surface Disease Index (OSDI) questionnaire. The OSDI scores of the entire sample who suffer from dry eye and the subgroup using contact lenses were calculated. The relationship between different risk factors with the OSDI scores was also assessed.

RESULTS

A total of 274 young adults from college students and academic staff (216 female, 58 male) were suffering from eye dryness. Eighty-eight of the 274 participants wore contact lenses. The mean OSDI scores of the 274 young adults were 32.92. Mean OSDI scores in contact lens wearers and non-wearers were 34.36 and 32.24, respectively (p < 0.01). There was a statistically significant relationship between OSDI score and indoor environmental conditions in computer using VDD group. Using a computer in a dark environment and above the line of sight resulted in a higher OSDI scores. Females who wore contact lenses while using a computer for more than three years had significantly higher OSDI scores than non-wearer females. Tablet type VDD use increased the mean ODSI scores of the contact lens wearers significantly.

CONCLUSIONS

Dry eye symptoms were shown to be increased in the contact lens wearer group with the increased duration of computer VDD use, decreased indoor environmental brightness conditions, and above the line of sight.

Computer Vision Syndrome in Undergraduate and Medical Students During the COVID-19 Pandemic

Purpose

The purpose of this study was to evaluate Computer Vision Syndrome (CVS) in undergraduate and medical students since transitioning to online learning during the COVID-19 pandemic.

Patients and Methods

This was a cross-sectional single center survey-based study using a validated CVS questionnaire (CVS-Q). The survey was distributed to 20,080 undergraduate students and 680 medical students at the University of Illinois at Chicago. The primary outcome measures were prevalence of CVS (based on CVS severity score of 6 or more), frequency of CVS and intensity of CVS symptoms.

Results

The survey was completed by 2300 undergraduate students (11.4% response rate) and 154 medical students (22.6% response rate). The prevalence of CVS was 77.1% in undergraduate students and 69.1% in medical students. CVS-Q severity scores were highest for headaches and eye dryness, with over half of students reporting worsening of symptoms since March 2020. Increased time spent on online learning (undergraduate: P <0.001, medical: P = 0.018), blue light glasses usage (undergraduate: P <0.001, medical: P = 0.0015), and increased number of device usage were associated with higher CVS severity scores (undergraduate: P <0.001, medical: P = 0.0032).

Conclusion

CVS among undergraduate and medical students has increased since the start of the COVID-19 pandemic. More focus should be placed on the management of CVS for students in higher education. Physicians should be cognizant of the consequences of online learning and be proactive about providing advice regarding preventative measures.

Computer vision syndrome and its determinants: A systematic review and meta-analysis

Objective:

Computer vision syndromes are becoming a major public health concern. Inconsistent findings existed on computer vision syndrome. This systematic review and meta-analysis aimed to estimate the pooled prevalence of computer vision syndrome and identify its determinants.

Methods:

In this study, the review was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Online electronic databases, including PubMed/Medline, CINAHL, and Google Scholar, were used to retrieve studies from 1 December to 9 April 2022. Quality assessment of the studies was performed using the JBI-MAStARI. RevMan and STATA 14 software were used for statistical analysis.

Result:

A total of 725 studies were retrieved, and 49 studies were included. The pooled prevalence of computer vision syndrome was 66% (95%, Confidence interval: 59, 74). Being female (Odd Ratio = 1.74, 95% Confidence interval [1.2, 2.53]), improper body posturing while using electronic devices (Odd Ratio = 2.65, 95% Confidence interval [1.7, 4.12]), use of electronic devices out of work (Odd Ratio = 1.66, 95% CI [1.15, 2.39]), no habit of taking breaks (Odd Ratio = 2.24, 95% Confidence interval [1.13, 4.44]), long duration of visual display terminal use (Odd Ratio = 2.02, 95% Confidence interval [1.08, 3.77]), short distance screen (Odd Ratio = 4.24, 95% Confidence interval [2.33, 7.71]), and general ergonomic practice (Odd Ratio = 3.87, 95% Confidence interval [2.18, 6.86]) were associated with increased odds of computer vision syndrome. However, good knowledge (Odd Ratio = 4.04, 95% Confidence interval [2.75, 5.94]) of computer vision syndrome was associated with decreased odds of computer vision syndrome.

Conclusion:

Nearly two in three participants had computer vision syndrome. Being female, improper body posturing, use of electronics devices out of work, no habit of taking a break, long-hour duration of visual display terminal use, short-distance screen, and general ergonomic practice were associated with increased odds of computer vision syndrome.

Video display terminal use and dry eye: preventive measures and future perspectives

BACKGROUND

Dry eye disease (DED) is a common cause of ocular pain and discomfort. Dry eye disease (DED) stems from a loss-of-tear film homeostasis and is frequently seen in video display terminal (VDT) users. Video display terminal (VDT) use reduces blink rates and increases incomplete blinks, leading to tear film instability and ocular inflammation, promoting DED.

PURPOSE

To assess and evaluate the methods for preventing VDT-associated DED and ocular discomfort.

METHODS

Studies were found using PubMed and Embase with the search terms: (digital visual terminal* OR computer use OR screen use OR smartphone OR display OR visual display terminal* OR computer vision syndrome OR tablet OR phone OR screen time) AND (dry eye OR DED).

RESULTS

Thirty-one relevant articles were found. Ten described single-visit studies, whereas 21 had a prolonged follow-up. Most preventive measures of VDT-associated DED aimed to increase blink rate or directly prevent tear film instability, ocular inflammation, mucin loss or ocular surface damage. Using an adjustable chair and ergonomic training, blink animations and omega-3 supplementation improved signs and symptoms of VDT-associated DED. Taking frequent breaks was associated with fewer symptoms, but no study assessed the commonly suggested 20-20-20 rule.

CONCLUSION

Preventive measures, such as blink animation programmes, oral intake of omega-3 fatty acids and improved ergonomics act on different parts of the vicious cycle of dry eye and could supplement each other. A comparison of the efficacy of the different interventions as well as more evidence of the effect of increased humidity, VDT filters and ergonomic practices, are required.

Self-Reported Student Awareness and Prevalence of Computer Vision Syndrome During COVID-19 Pandemic at Al-Baha University

BACKGROUND

The rapid increase increased, in using of video display terminals during the COVID-19 pandemic predisposes users to a variety of health problems restricted to visual problems and including various musculoskeletal problems, collectively known as computer vision syndrome (CVS) or computer vision syndrome.

AIM

This study aims to ascertain university students' awareness of computer vision syndrome at Al-Baha University, including the nature, sources, accuracy, and completeness of information, as well as the attitudes towards CVS, and mitigative practices.

METHODS

This study used a descriptive cross-sectional design and a convenient sample of 310 (80.0% male) students drawn from Al Baha University campuses. Data were collected using self-administered questionnaires.

RESULTS

The mean age of the participants was 23.51 years (SD=5.42). The results show that 78.7%, 66.1%, and 11.6% received CVS information from social media, mass media, and family, respectfully. Despite 70% of respondents being aware of CVS manifestations, between 42% to 67% of those sampled had accurate and complete information about the meaning, causes, prevention, and management of the syndrome. More than a third of the participants had either a good (62.9%) or average (29%) total knowledge of CVS. Less than 15% had incorrect information. On average, 62.5% of respondents engaged in preventive or mitigative behaviours/activities as opposed to 37.5% who did not, but only 44% believed CVS was a serious health threat. 65.2% of the studied students had a satisfactory total practice score. The regression analysis showed that the coefficients of marital status and faculty were a statistically significant association with the total knowledge score.

CONCLUSION

CVS awareness is acceptably high, but there is a low preventive/mitigative behaviors as well as a low realization of CVS' long-term health problems. This is why increasing CVS awareness and implementing interventions such as the 20-20-20 rule could be effective at Al Baha University.

Tweenager Computer Visual Syndrome Due to Tablets and Laptops during the Postlockdown COVID-19 Pandemic and the Influence on the Binocular and Accommodative System

The aim of our study was to compare computer visual syndrome (CVS) in a tweenager student population who use tablets and laptops only to play versus CVS in tweenagers who use these digital devices at school to study, in addition to playing. The tests performed were a validated survey for children for the detection of CVS and accommodative and vergence tests. The CVS item questionnaire was divided into four main groups based on questions concerning the following: (I) the digital device usage time, (II) musculoskeletal and ergonomic nature, (III) visual symptoms, and (IV) ocular surface symptoms. The high-demand digital device group showed worse punctuation in all item groups. From the optometric perspective, when the subjects were classified according to the CVS, high-demand participants presented a clear tendency to exophoria with statistically significant differences in distance vision (−1.94 ± 4.48 Δ) and near vision (−5.78 ± 8.62 Δ) (p < 0.01). Our results establish a relationship between the increased use of electronic devices and computer vision syndrome in the preadolescent population. In addition, this situation is related to the presence of visual, accommodative, and binocular dysfunctions that could affect the efficiency of the visual system.

Visual ergonomics, performance and the mediating role of eye discomfort: A structural equation modelling approach

The purpose of this study was to model the visual ergonomic factors affecting the performance in human computer interaction. A cross-sectional study using structural equation modelling was performed with a sample of 200 participants. The measuring instruments included Office Lighting Survey Questionnaire, performance assessment questionnaires, visual ergonomics assessment, and an eye discomfort assessment. The hypothetical model evaluated workplace lighting status and visual ergonomics as precursors, performance as the output, and eye discomfort as a mediator. The results showed that eye discomfort directly affected performance. Visual ergonomics also had a significant direct effect on eye discomfort. The final model suggested a significant new path between the quality of lighting and visual ergonomics. Also, the quality of lighting had an indirect effect on eye discomfort and performance, and the effect of visual ergonomics on performance was the same. Improving the lighting quality and visual ergonomics can reduce eye discomfort and increase performance.

Computer Visual Syndrome in Medical Students From a Private University in Paraguay: A Survey Study

Purpose

To determine the prevalence and factors associated with computer vision syndrome in medical students at a private university in Paraguay.

Methods

A survey study was conducted in 2021 in a sample of 228 medical students from the Universidad del Pacífico, Paraguay. The dependent variable was CVS, measured with the Computer Visual Syndrome Questionnaire (CVS-Q). Its association with covariates (hours of daily use of notebook, smartphone, tablet and PC, taking breaks when using equipment, use of preventive visual measures, use of glasses, etc.) was examined.

Results

The mean age was 22.3 years and 71.5% were women. CVS was present in 82.5% of participants. Higher prevalence of CVS was associated with wearing a framed lens (PR = 1.11, 95% CI: 1.03–1.20). In contrast, taking a break when using electronic equipment at least every 20 min and every 1 h reduced 7% (PR = 0.93, 95% CI: 0.87–0.99) and 6% (PR = 0.94, 95% CI: 0.89–0.99) the prevalence of CVS, respectively.

Conclusion

Eight out of 10 students experienced CVS during the COVID-19 pandemic. The use of framed lenses increased the presence of CVS, while taking breaks when using electronic equipment at least every 20 min and every 1 h reduced CVS.

Improving office workers’ workspace using a self-adjusting computer screen

With the rapid evolution of technology, computers and their users’ workspaces have become an essential part of our life in general. Today, many people use computers both for work and for personal needs, spending long hours sitting at a desk in front of a computer screen, changing their pose slightly from time to time. This phenomenon impacts people’s health negatively, adversely affecting their musculoskeletal and ocular systems. To mitigate these risks, several different ergonomic solutions have been suggested. This study proposes, demonstrates, and evaluates a technological solution that automatically adjusts the computer screen position and orientation to its user’s current pose, using a simple RGB camera and robotic arm. The automatic adjustment will reduce the physical load on users and better fit their changing poses. The user’s pose is extracted from images continuously acquired by the system’s camera. The most suitable screen position is calculated according to the user’s pose and ergonomic guidelines. Thereafter, the robotic arm adjusts the screen accordingly. The evaluation was done through a user study with 35 users who rated both the idea and the prototype system itself highly.

The Effect of Lockdown Due to the COVID-19 Pandemic on Digital Eye Strain Symptoms Among the General Population: A Cross-Sectional Survey

Repetitive prolonged use of digital devices without regular breaks has detrimental effects on ocular health and quality of vision. Individuals with chronic eye problems and refractive errors are at higher risk of developing digital eye strain (DES). Correction of refractive errors, adopting healthy practices will reduce its risk. The survey examined the effect of prolonged lockdown on the development and increased severity of digital eye strain (DES) symptoms among the general population. An online survey was conducted in March 2020 on social media platforms in Jordan. Data from 1,460 responders were analyzed. About half of the respondents were between 30–49 years, 28.4% were retired, 21% had chronic systemic illness, and 23% reported chronic eye problems. A rise in the use of digital devices during lockdown was reported by 957 participants, with 33% of them used digital devices more than 4 h a day. The most common symptoms before and during lockdown were headache and neck / shoulder pain have the highest associations (X² = 280.0, 271.3, df = 4, p < 0.001 respectively). Female gender, existence of chronic eye problems and systemic diseases, and duration of using digital devices were found to be statistically significant factors associated with increasing severity of eye symptoms during lockdown. Not taking enough regular breaks from digital devices showed significant association with blurred vision at distance and near (X² = 13.03, 10.74, df = 4, P = 0.011, 0.03, respectively). People with chronic eye problems and increased time using devices during lockdown developed new eye complaints three times more than before the lockdown and males were two times more likely than females to have more severe eye symptoms.

Online e-learning during the COVID-19 lockdown in Trinidad and Tobago: prevalence and associated factors with ocular complaints among schoolchildren aged 11-19 years

Background

The increase in online learning during the pandemic has been linked to various ocular complaints. This study determined the prevalence and factors associated with ocular complaints among schoolchildren aged 12-19 years during the COVID-19 lockdown in Trinidad and Tobago (T&T).

Methods

A cross-sectional study was conducted between January and May 2021, during the COVID-19 lockdown in T&T among secondary school students studying remotely. A two-stage cluster sampling method was employed. A modified web-based Computer Vision Syndrome questionnaire was administered to students. Data on demography, duration of digital device use, and ocular complaints were collected, and multilevel logistic regression was used to determine factors associated with ocular complaints among school children, 12-19 years of age in T&T.

Results

A total of 435 schoolchildren (mean age, standard deviation, 15.2 ± 1.9 years range 12-19 years) responded to the questionnaire. The prevalence of self-reported symptoms of headache, blurred vision, dry eyes, itchy eyes, and double vision were 75.0%, 65.1%; 56.8%; 46.4%; and 33.5%, respectively. Schoolchildren aged 18-19 years, those that used spectacles for correction of their refractive errors, and spent more than 6 h on average on digital devices, reported a high prevalence of any ocular complaints. Analysis also revealed that age (14-15 years) was associated with dry eyes, blurred vision, and headaches, while gender (more prevalently females) was associated with blurred vision and headache. Those that had an eye examination in the last year and schoolchildren that took action to resolve ocular complaints were more likely to experience nearly all ocular complaints.

Conclusions

During the COVID-19 lockdown, over three in four students in T&T reported ocular complaints from digital devices for online learning. Tailored interventional messages to reduce all forms of ocular complaints should target older students, particularly females, those who laid down when learning online via their devices and people who regularly examine their eyes.

The association between visual display terminal use and dry eye: a review

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.

Investigation and Analysis of Eye Discomfort Caused by Video Display Terminal Use Among Medical Students Studying at High-Altitude Regions

Objective

To investigate the use of video display terminal (VDT) in high-altitude regions by medical students and the resulted risk factors of eye discomfort.

Methods

A cross-sectional study was conducted in 686 medical students randomly selected from high-altitude regions, Kunming, Yunnan Province. The prevalence of video display terminal syndrome (VDTs) and related risk factors in medical students were analyzed by instructing students to fill in the eye discomfort symptom questionnaire [Ocular Surface Disease Index (OSDI) scale].

Results

There were 686 participants in this study, including 213 males (31.0%) and 473 females (69.0%). The results of questionnaire survey showed that 184 patients (26.8%) didn't have eye discomfort symptoms and 502 patients (73.2%) had eye discomfort symptoms. The comparison of demographic and ocular characteristics of eye discomfort symptoms group and no eye discomfort symptoms group showed that medical students in the group with ocular discomfort symptoms had longer total duration of video terminal use, longer duration of each VDT use, higher total scores of ocular discomfort symptom scores, and a higher percentage of the ocular discomfort severity group, all with statistically significant differences. There was no significant difference in the remaining parameters between the two groups of participants. The results of multivariate logistic regression model analysis showed that the relationship between total sleep time, total duration of VDT use and eye discomfort symptom score was statistically significant (P < 0.05). Besides, ordinal logistic regression was applied further to investigate related factors of the severity of eye discomfort. The model demonstrated that total sleep duration and total VDT using duration were significantly associated with the severity of eye discomfort symptom (P < 0.05).The severity of eye discomfort symptom was significantly negatively related to the increased total sleep duration and it was significantly positively related to the increased VDT use duration.

Conclusion

The prevalence of VDTs is high in medical students at high-altitude regions. The longer total duration of daily use of VDT and shorter sleep duration are risk factors associated with VDTs. The severity of eye discomfort symptom was significantly negatively related to the increased total sleep duration and it was significantly positively related to the increased total VDT using duration.

Self-Reported Computer Vision Syndrome among Thai University Students in Virtual Classrooms during the COVID-19 Pandemic: Prevalence and Associated Factors

During the COVID-19 pandemic, computer vision syndrome (CVS) related to online classrooms were unavoidable. This cross-sectional study aimed to explore the prevalence, characteristics and associated factors of CVS. A total of 527 students who were currently studying in a virtual classroom (70.40% female, mean (standard deviation; SD) age of 20.04 (2.17) years) were included. The prevalence of CVS assessed by an online CVS-Questionnaire was 81.0% (427/527). Comparing with those in the period before the online study, an increase in screen time (interquartile range) in students with and without CVS was 3 (0−3) and 2 (1−5) h, respectively. Overall, 516 students (97.9%) experienced at least one symptom. The most frequent symptom in CVS subjects was eye pain (96.5%). The most intense symptoms were the feeling of worsening eyesight (15.9%). The factors associated with CVS were female (p < 0.001), age (p = 0.010), atopic diseases (p = 0.020), prior ocular symptoms (p < 0.001), astigmatism (p = 0.033), distance from display <20 cm (p = 0.023), presence of glare or reflection on screen (p < 0.001), low screen brightness (p = 0.045), sleep duration (p = 0.030), inadequate break time between classes (p < 0.001) and increased screen time usage during online study (p < 0.001). Recommendations to prevent CVS based on the adjustable factors might reduce the burden of online study.

Prevalence rate of attention deficit hyperactivity disorder (ADHD) and computer vision syndrome (CVS) symptoms predisposition among digital device users of Bangladesh

Background

Around 5.29% of the world population is suffering from ADHD, and 60 million people are suffering from CVS, with an increasing rate of prevalence of these disorders. This study aimed to determine the prevalence rate of ADHD and CVS symptoms among the Bangladeshi population.

Results

To assess the aim of the study, a cross-sectional survey was conducted online through stratified sampling, and 197 responses were collected from the participants. Our survey method follows these criteria where the ARSV1.1 standard questionnaire was followed for the ADHD questionnaire, and a self-administered questionnaire was established based on the symptoms of CVS. The male age ranges from 18–24 have the highest value of ADHD (34%) coincided with > 6 h digital device usage (51%), and the Stroop effect is significantly correlated with the ADHD score (0.498, p < 0.01). The Stroop effect value is also higher among the males aged 18–24, digital device users for > 6 h (48%).

Conclusions

With the advent of science, it is impossible to avoid digital devices as necessary. Notwithstanding, safe and appropriate use of digital media is a must for healthy living.

Validation of the Digital Eye Strain Questionnaire and pilot application to online gaming addicts

INTRODUCTION

'Digital eye strain' (DES) is a clinical syndrome with eyesight symptoms related to continuous engagement in front of a screen-enabled digital device. With use of these devices constantly on the rise, the related symptoms have become prominent, even in younger ages. This study describes the process of validating the Digital Eye Strain Questionnaire (DESQ), a thirteen-item self-report scale in a yes-no format designed to offer a measure of complaints related to digital eye strain syndrome (DES).

METHODS

The validation process included 150 outpatients with no long-standing eye disease who were examined for various eye complaints and 50 outpatients who were diagnosed with gaming addiction according to WHO ICD-11 clinical criteria. All participants filled in a demographics questionnaire, the DESQ, the Computer Vision Syndrome Questionnaire (CVS-Q) and the Problematic Internet Use Questionnaire-9 (PIUQ-9).

RESULTS

Principal component analysis of categorical variables confirmed the proposed three-factor DES structure with a total of 61.02% of explained variance and Cronbach's alpha equal to.94. Concurrent validity was assessed by comparing the results of the DESQ to the CVS-Q while convergent validity was assessed by examining correlations of the DESQ with results from the PIUQ-9 questionnaire. In all cases the DESQ demonstrated excellent reliability and validity.

CONCLUSIONS

Results indicate that the DESQ questionnaire can be employed to reliably measure the symptomatology of digital eye strain in clinical populations who present either with eye issues or with excessive use of the gaming and screen-enabled devices in general.

Association between Psychological Stress and Neck Pain among College Students during the Coronavirus Disease of 2019 Pandemic: A Questionnaire-Based Cross-Sectional Study

The coronavirus disease of 2019 (COVID-19) greatly affected people’s lifestyles. We used an online, cross-sectional survey during a COVID-19-related lockdown in Israel, with the aim of investigating the effects of such lockdowns on students’ self-perceived stress and neck pain (NP). College students (N = 295) completed questions on sociodemographic characteristics, the Neck Disability Index (NDI), the Perceived Stress Scale, the Visual Analogue Scale (VAS), and NP frequency (four-point scale). Logistic regression models were calculated with the NDI as the dependent variable. In total, 35.6% of students experienced at least moderate NP-related disability (NDI ≥ 15), more during than before the lockdown. NP increased gradually, from a lifetime mean of 1.80 to a lockdown mean of 3.07 (χ² = 316.72; p < 0.001). Students’ self-perceived stress was moderate, and 59.3% reported experiencing study-related stress. Higher levels of self-perceived stress, study-related stress, sitting >3 h/day, and a higher VAS score were associated with a higher risk of an NDI ≥ 15 (Nagelkerke’s R² = 0.513, p < 0.001). The transition from on-campus to online learning seems to have exacerbated students’ NP, which was correlated to their study stress and lifestyles. These findings advocate for the need to promote the physical and mental health of students via e.g., mental health services and occupational and ergonomic consulting services.

Computer visual syndrome in graduate students of a private university in Lima, Perú

BACKGROUND

In recent decades, several studies have found a strong association between prolonged use of video display terminals and ophthalmological symptoms encompassed in the so-called computer visual syndrome (CVS). Few studies have addressed this syndrome in graduate students.

METHODS

Observational, cross-sectional descriptive study. A total of 106 postgraduate students were surveyed without ophthalmological pathologies. The diagnosis of CVS was made by means of the questionnaire of Seguí et al. validated in Spanish, which evaluates the frequency and intensity of 16 ocular symptoms.

RESULTS

The prevalence of CVS among graduate university students was 62.3% (95% CI: 52.3-71.5). It was found that the highest proportion of students with the syndrome was in the group of older than 40 years old (88.2%) and in the group 21-30 years old (70.0%), showing statistically significant differences (p = 0.004). According to the device and its time of use, students who used the mobile phone for 7-10 h a day showed a higher prevalence of CVS compared to those who used the device for less time (p = 0.030). The business School had the highest prevalence (75.0%).

CONCLUSION

Three out of every five graduate students presented CVS with this prevalence being like reported in other populations. There is a need to investigate possible interventions that can help reduce this entity.

Computer Vision Syndrome Prevalence and Ocular Sequelae among Medical Students: A University-Wide Study on a Marginalized Visual Security Issue

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.

Prevalence of Self-Reported Symptoms of Computer Vision Syndrome and Associated Risk Factors among School Students in China during the COVID-19 Pandemic

PURPOSE

To determine the prevalence and risk factors of self-reported symptoms of Computer Vision Syndrome (CVS) in school students during COVID-19 pandemic.

METHODS

In this cross-sectional study in Nanjing, China, students (grades 1-12) from six randomly selected schools self-administered the online survey questionnaire about hours on electronic devices, outdoor activities, frequency and intensity of 17 CVS symptoms during virtual learning period of COVID-19 pandemic.

RESULTS

Among 2363 invited students, 2005 (84.8%) completed the survey. Mean (SD) age was 12 (3.0) years, 51% were male, 53% wore glasses, 56% did not know the 20-20-20 rule (take a 20 second break every 20 min of close work and gaze at objects at least 20 feet away) and 6.5% knew but never followed the 20-20-20 rule. Mean (SD) hours/day was 4.6 (3.4) for screen time and 1.2 (1.0) for outdoor activities. Total of 1543 (77.0%) students reported at least one CVS symptom (median = 4) with eye dryness and itching the most common (48%). In multivariable analysis, CVS score 4 or more was independently associated with older age (adjusted odds ratio (aOR) = 1.05 for per-year increase, p = 0.02), children with myopia not wearing glasses (aOR = 2.12, p = 0.0003), astigmatism (aOR = 1.37, p = 0.04), other ocular diseases (aOR = 1.59, p = 0.005), not complying 20-20-20 rule (aOR = 2.13, p = 0.04), more screen time (aOR = 1.53 for >6 vs. ≤2 hours, p = 0.0001) and less outdoor activities (aOR = 1.37 for ≤0.6 vs. ≥1.9 hours, p = 0.005).

CONCLUSIONS

During COVID-19 pandemic, self-reported CVS symptoms occurred in more than three-quarters of students. Besides pre-existing ocular diseases, children with myopia not wearing glasses, excessive time on screens, non-compliance of the 20-20-20 rule and reduced outdoor activities were associated with higher risk of CVS.

One Year of COVID-19 Pandemic in Italy: Effect of Sedentary Behavior on Physical Activity Levels and Musculoskeletal Pain among University Students

The COVID-19 outbreak forced Italian students to reduce their daily activities, inducing a seden-tary attitude that was worsened by distanced learning. This study aimed to survey the physical activity levels that were maintained before and during the social restrictions following the pan-demic, their correlation to musculoskeletal pain, as well as analyzing the impact of these COVID-19 restrictions on pain and fatigue that affects daily life activities. A total of 2044 students completed the online questionnaire, of which the results of 1654 participants were eligible. Before the pandemic, the levels of physical activity were distributed as: 19.9% no activity, 30.1% light ac-tivity, 21.5% moderate activity, and 28.5% high activity. After one year of the pandemic, 30.6% of the participants were inactive, 48.1%, 10.9%, and 10.5% stated as maintaining, respectively, light, moderate and high levels of physical activity. Furthermore, 43.5% reported neck pain and 33.5% stated to experience low back pain. Physical activity levels lower than 150 min/week may have predisposed students to suffer from neck pain (1.95 OR at 95% CI, 1.44-2.64) and low back pain (1.79 OR at 95% CI, 1.29-2.49). A positive correlation between physical activity levels, Verbal Descriptive Scale (VDS), and pain frequency have been observed for neck and low back pain (p-value < 0.05). Finally, low physical activity levels were associated with musculoskeletal pain onset and pain worsening.

Chronic Back Condition and the Level of Physical Activity as Well as Internet Addiction among Physiotherapy Students during the COVID-19 Pandemic in Poland

Objectives: The aim of this study was to assess back pain and its relation to physical activity as well as Internet addiction among Polish university students during the COVID-19 pandemic. Methods: The research was conducted via the Internet in student groups of three universities in Poland (141 people). Back pain was examined by ODI—The Oswestry Disability Index and NDI—Neck Disability Index. The Polish-language International Physical Activity Questionnaire (IPAQ) was used to assess physical activity and the level of Internet addiction was tested using the Kimberly Young Questionnaire. Results: The respondents mostly suffered from pain originating in the cervical spine. In the study group, only every fifth person had a high level of physical activity. Sex differentiates the level of the measures considered. Sitting in front of the computer affects the pain in the spine. Conclusions: Research results suggest that the pandemic is negatively affecting students. Frequent occurrence of back pain is observed with a simultaneous low level of physical activity. Maintaining regular activity during a pandemic, at least at home, is an indispensable preventive measure for physical health.

Computer vision syndrome in presbyopic digital device workers and progressive lens design

PURPOSE

To estimate the prevalence of computer vision syndrome (CVS) in presbyopic digital device workers using two ophthalmic progressive lens designs during the working day, and to analyse the association of CVS with sociodemographic, occupational, digital device exposure and refractive factors.

METHODS

This time series, quasi-experimental design study included 69 presbyopic digital device workers (age range: 46-69 years; mean ± SD = 54.7 ± 5.0). All used desktop computers at their workplace. Progressive addition lenses (PALs) and occupational lenses were used for three months each. CVS was measured with the CVS-Q^© questionnaire before intervention (baseline) and at 1 week, 1 month and 3 months after wearing the lenses. A multivariate logistic regression model was used to identify the factors that were associated with an improved CVS-Q^© score.

RESULTS

37.7% of the subjects were female and 78.3% were ametropes; 65.2% had advanced presbyopia. 56.2% used digital devices at work >6 h day^-1 . The prevalence of CVS at baseline, after wearing PALs for three months and after three months of occupational lens wear was 68.1%, 33.3% and 18.8%, respectively. The mean CVS-Q^© score was lower with occupational lenses than with PALs (p = 0.001). 40.6% of the digital device workers improved their CVS-Q^© score ≥2 points with the occupational lenses. Ametropes were less likely than emmetropes to improve with occupational lenses (OR = 0.27, p = 0.05). 89.8% of the sample workers were satisfied or very satisfied with the occupational lenses and 71% were similarly satisfied with the PALs. 73.9% chose the occupational lenses as their first choice of lens for digital device use, compared with 17.4% for PALs.

CONCLUSIONS

Computer vision syndrome is reduced in presbyopic desktop computer workers wearing occupational lenses compared with PALs, especially in emmetropes.

Visual Sequelae of Computer Vision Syndrome: A Cross-Sectional Case-Control Study

Purpose

To assess the visual, ocular, extraocular, and multifocal electroretinography (mfERG) outcomes of computer vision syndrome (CVS) among medical students.

Methods

This study was designed as a cross-sectional case-control study that included 733 medical students. All students completed a specially designed and validated CVS questionnaire survey (CVS-F3). Students from the control (No-CVS) and CVS groups underwent comprehensive ophthalmic examinations including the mfERG examinations. Our main outcome measures included uncorrected and corrected distance visual acuity (UDVA and CDVA, resp.) measurements, subjective and cycloplegic refractions, slit-lamp examination, intraocular pressure measurement, pupillary reflexes tests, ocular movements' tests, dry eye disease tests, and fundus and mfERG examinations.

Results

The CVS-F3 identified that 87.9% of students had complaints that might be related to CVS. We documented a 76% prevalence rate in students undergoing an ophthalmologic exam. The most common ocular and extraocular complaints included visual blur and headache (40.9% and 46.8%, resp.). Statistical logistic and linear regression analyses showed that refractive errors, prolonged screen-hours, close eye-screen distance, improper gaze angle, poor screen-resolution, and screen-glare were risk factors for developing CVS and influencing its severity. In the mfERG subgroup, 42.5% demonstrated reduced amplitudes of mfERG rings and quadrants, indicating reduced foveal responses.

Conclusion

Surveys cannot yield an accurate CVS prevalence. However, they help to identify subjects at risk who should be comprehensively assessed to confirm or exclude CVS diagnosis. Smartphone misuse primarily caused CVS among users. Our mfERG findings might be a sign of potential CVS visual sequelae; however, future studies are warranted. Clinicians need to understand these sequelae to appropriately identify and treat CVS.

Computer vision syndrome prevalence according to individual and video display terminal exposure characteristics in Spanish university students

AIM

To estimate the prevalence of computer vision syndrome (CVS) in university students and its relationship with sociodemographic and optical correction factors and exposure to video display terminal (VDT).

METHODS

This cross-sectional study included 244 Spanish university students who responded to an anamnesis, a VDT exposure questionnaire and the Computer Vision Syndrome Questionnaire (CVS-Q^© ). A descriptive analysis was performed and the prevalence of CVS was calculated. Logistic regression models were used to measure the association between CVS and the variables studied.

RESULTS

The mean age was 20.7 years (SD = 2.1), 57% were women, 78.3% used VDTs ≥ 2 hours/day to study. The prevalence of CVS was 76.6%, and the most frequent symptoms were headache and itching. In the crude analysis, being a woman, using glasses daily and to study, and a longer VDT use to study and in total were associated with a higher prevalence of CVS; while in the older group, the prevalence was lower. In the multivariate model, VDT use to study was associated with a greater probability of CVS (aOR: 3.43; 95%CI: 1.03-11.42), and being between 22 and 29 years was associated with a lower probability of it (aOR: 0.36; 95%CI: 0.15-0.89).

CONCLUSION

CVS has a high prevalence amongst Spanish university students. The most affected are the younger ones and those who use VDTs for longer hours to study. It is essential to continue investigating the influence of the type of tasks conducted with VDTs on CVS and thus to establish the preventive measures to reduce this syndrome.

Computer visual syndrome in graduate students of a private university in Lima, Perú

BACKGROUND

In recent decades, several studies have found a strong association between prolonged use of video display terminals and ophthalmological symptoms encompassed in the so-called computer visual syndrome (CVS). Few studies have addressed this syndrome in graduate students.

METHODS

Observational, cross-sectional descriptive study. A total of 106 postgraduate students were surveyed without ophthalmological pathologies. The diagnosis of CVS was made by means of the questionnaire of Seguí et al. validated in Spanish, which evaluates the frequency and intensity of 16 ocular symptoms.

RESULTS

The prevalence of CVS among graduate university students was 62.3% (95% CI: 52.3-71.5). It was found that the highest proportion of students with the syndrome was in the group of older than 40 years old (88.2%) and in the group 21-30 years old (70.0%), showing statistically significant differences (p=0.004). According to the device and its time of use, students who used the mobile phone for 7 to 10hours a day showed a higher prevalence of CVS compared to those who used the device for less time (p=0.030). The business School had the highest prevalence (75.0%).

CONCLUSION

Three out of every five graduate students presented CVS with this prevalence being like reported in other populations. There is a need to investigate possible interventions that can help reduce this entity.

Accommodative and binocular disorders in preteens with computer vision syndrome: a cross-sectional study

To assess computer vision syndrome (CVS) in a preteen population through an adult-validated CVS questionnaire and to evaluate how digital devices affect accommodative and binocular vision, we enrolled 309 preteens in this cross-sectional study. An adult-validated CVS questionnaire adapted to preteens was used for all subjects. Visual acuity testing, unilateral and alternate cover tests, and tests for accommodative and vergence responses were performed for all preteens. The mean age was 10.75 ± 0.67 (10-12) years. Subjects were divided into two groups: the mild CVS group with a mean CVS score ≤2 and the severe CVS group with a mean CVS score >2. Between the mild and severe CVS groups, statistically significant differences were found in near point of convergence break and recovery (P = 0.03 and P = 0.02, respectively) and distance negative fusional vergence break and recovery (P = 0.02 and P < 0.01, respectively). More children with severe CVS developed vergence disorders than those with mild CVS. Optometric clinical screening assessments could reduce ocular symptomatology and prevent long-term effects. However, poor optometric findings might have occurred first, and the poor convergence skills resulted in the symptoms reported while using devices.

Impact of an educational intervention using the 20/20/20 rule on Computer Vision Syndrome

Background: Global estimates suggest that nearly 60 million people suffer from Computer Vision Syndrome (CVS).Aim: The goal of this research was to evaluate the effectiveness of an educational intervention using the 20/20/20 rule to reduce CVS symptoms.Setting: The study was conducted in the Qassim University eye clinic.Methods: An experiential intervention study was conducted amongst 40 patients with CVS, with their age ranging from 21 to 38 years. The sample was divided into two groups: (1) intervention patients (n = 20), who were given a structured advice booklet about how to reduce CVS symptoms using the 20/20/20 rule, and (2) control (n = 20) with CVS, who were given advice to simply drink more water. Both groups completed two questionnaires, namely, the CVS-Q and Dry Eye Questionnaire-5 (DEQ-5). Dry eye clinical tests were performed. The same procedures were repeated after 20 days to compare the outcomes before and after intervention.Results: The study findings revealed that patients complaining from dry eye symptoms showed significant changes after the educational intervention (pre-intervention: 9.05 ± 4.32; post-intervention: 7.10 ± 3.61) (p = 0.04). The symptoms of CVS were slightly reduced after educational intervention, from 9.00 ± 3.03 to 8.35 ± 1.89 (p = 0.38). However, TBUT showed a significant increase after the educational intervention (pre-intervention: 6.20 ± 2.02 s; post-intervention: 8.55 ± 2.84 s) (p = 0.005).Conclusion: The educational intervention of the 20/20/20 rule induces significant changes in dry eye symptoms and tear film and some limited changes for ocular surface integrity.

A novel botanical formula improves eye fatigue and dry eye: a randomized, double-blind, placebo-controlled study

BACKGROUND

With the frequent use of video display units, eye fatigue is becoming more common globally. An alternative nutritional strategy is needed to prevent the aggravation of eye fatigue symptoms.

OBJECTIVES

The objective was to evaluate the protective effect of a novel botanical combination of lutein ester, zeaxanthin, and extracts of blackcurrant, chrysanthemum, and goji berry on adults with eye fatigue in a randomized, double-blind, placebo-controlled clinical trial.

METHODS

We randomly allocated 360 participants into 4 groups to receive placebo and 3 doses of our formula (chewable tablets, containing 6 mg, 10 mg, or 14 mg of lutein) once daily for 90 d. Each participant had 3 visits at baseline (V1), 45 d (V2), and 90 d (V3) during the study.

RESULTS

Intervention with the formula improved individual scores of eye fatigue symptoms, including eye soreness, blurred vision, dry eye, foreign body sensation, and tearing. Compared with placebo, the formula at all 3 doses significantly decreased the total score of eye fatigue symptoms and increased the visuognosis persistence time at both V2 and V3. According to the Schirmer test, both 10-mg and 14-mg lutein formula groups had improved tear secretion at V3 compared with the placebo. The keratography results indicated that the first tear break-up time, average tear break-up time, and tear meniscus height were significantly increased after formula intervention. The formula at all 3 doses significantly increased the macular pigment optical density at V2 and V3 compared with the placebo, whereas optical coherence tomography showed no significant difference in retinal thickness and retinal volume across all groups at both visits.

CONCLUSIONS

Our botanical formula improves eye fatigue, dry eye, and macular function without changing the retinal structure, and thus it could serve as an effective nutritional strategy in improving eye fatigue without causing serious side effects.Clinical Trial Registry: chictr.org.cn (ChiCTR1800018987).

A Novel Botanical Combination Attenuates Light-Induced Retinal Damage through Antioxidant and Prosurvival Mechanisms

The prevalence of light-induced eye fatigue is increasing globally. Efficient regimen for mitigating light-induced retinal damage is becoming a compelling need for modern society. We investigated the effects of a novel combination of lutein ester, zeaxanthin, chrysanthemum, goji berry, and black currant extracts against retinal damage. In the current work, both in vitro and in vivo light-induced retinal damage models were employed. Animal study showed that under strong light exposure (15000 lx for 2 hours), the a-wave and b-wave from electroretinogram were significantly decreased. Treatment with the combination significantly restored the decrease for b-wave under high- and low-stimulus intensity. Histological analysis reported a substantial decrease in the outer nuclear layer (ONL) thickness in the model group, while the supplementation with the combination significantly improved the ONL thickness. To further explore the underlying mechanism of the protective effects, we utilized ARPE-19 retinal pigment epithelial cell line and found that strong light stimulation (2900 lx for 30 minutes) significantly increased phosphorylation of p38 and JNK and decreased HIF expression. Intriguingly, chrysanthemum, black currant extracts, lutein ester, and zeaxanthin significantly decreased the phosphorylation of p38 and JNK, while chrysanthemum, goji berry, black currant extracts, and lutein ester restored HIF expression. The botanical combination can alleviate light-induced retina damage, potentially through antioxidant and prosurvival mechanisms.

The Impact of Internet and Videogaming Addiction on Adolescent Vision: A Review of the Literature

During the past decade, vision problems that were attributed to the use of electronic screens have gradually shifted from being a workplace health issue to a wider public health issue. “Computer vision syndrome” originally related to the few professionals exposed to long hours of work in front of a computer screen. The widespread use of digital screens in devices used throughout the day have led to the emergence of “digital eye strain” as a new clinical syndrome that affects every individual who spends a large period of time fixated on multiple screens, for work or leisure. A new subcategory, “video game vision” has been proposed to specifically address vision issues related to large periods of continuous use of screen enabled devices in order to play video games. With gaming disorder being included in the next version of the WHO classification of diseases (ICD-11), it is becoming increasingly important to have a clear idea of the impact of this disorder in general health and functioning. At the same time, a number of research studies have reported positive impact of videogame playing on the players vision. This article reviews the latest research studies on the impact of digital screen enabled devices on adolescent vision in light of the increasing reports of internet addiction and gaming disorder while referencing positive findings of videogaming on vision in order to provide a balanced approach and assist with classification, diagnosis and treatment, while providing directions for future research.

Nonstrabismic binocular dysfunctions and cervical complaints: The possibility of a cross-dysfunction

The aim of this study is to establish a relationship between non-strabismic binocular dysfunction and neck pain. One hundred twelve participants underwent binocular vision assessment by evaluating horizontal heterophoria, horizontal and vertical fusional vergence ranges and vergence facility. The subjects were classified into two groups: binocular anomalies and normal binocular function. Neck complaints were measured with the Neck Disability Index, visual analogue scale, cervical range of motion, deep-flexor muscle activation score (AS) and performance index (PI). Our results showed that participants with low AS had significantly altered values of lateral phoria (near) (mean = -6.99 SD ± 6.96 PD) and PFV (near) blur (mean = 9.49 SD ± 5.45 PD) against those who presented normal AS (lateral phoria (near) mean = -3.64 SD ± 6.37 PD; PFV (near) blur mean = 12.84 SD ± 6.20 PD). In addition, participants with NFV (near) recovery outside the norm had a significantly lower right side-bending (mean = 35.63 SD ± 8.35 PD) than those within the standard (mean = 39.64 SD ± 9 PD). The subjects with binocular vision impairment showed a diminished response to the deep cervical musculature, with low AS and PI, as well as a tendency to suffer from cervicalgia of more than three months’ evolution and a lower range of motion.

Eyeing computer vision syndrome: Awareness, knowledge, and its impact on sleep quality among medical students

BACKGROUND

Computer vision syndrome (CVS) encompasses a constellation of ocular and extraocular symptoms in computer users who either habitually or compulsively use computers for long periods of time. Electronic devices such as computers, smart phones, and tablets emit blue light (400-490 nm) from their light-emitting diodes and produce electromagnetic fields, both of which interfere with the circadian rhythm.

AIM

This study aims to assess the awareness, knowledge, and impact on sleep quality of CVS among medical students.

MATERIALS AND METHODS

This study included 500 medical students. All participants anonymously filled up a pro forma including sociodemographic details and three questionnaires that (a) tested for awareness and knowledge about CVS, (b) tested for CVS, and (c) the Pittsburgh sleep quality index (PSQI), respectively. Data from 463 complete questionnaires were analyzed.

RESULTS

The mean (±standard deviation) age of the 463 individuals was 19.55 (±1.04) years. The prevalence of CVS was 77.5%. The prevalence was higher in boys (80.23%) compared to girls (75.87%), but the difference was not statistically significant. Only 34.1% of the medical students were aware of CVS. Good knowledge regarding various aspects of CVS was observed in 22.46% individuals, while 53.99% and 23.56% had average and poor knowledge, respectively. Poor sleep quality was present in 75.49% of individuals with CVS compared to 50.96% of students without CVS; the difference was statistically significant (odd's ratio [95% confidence interval]: 0.338 [0.214-0.531]). All the components of PSQI score, except components 1 and 6, had statistically significantly (P < 0.05) higher values in individuals with CVS as compared to individuals without CVS.

CONCLUSIONS

There is high prevalence but low level of awareness and knowledge about CVS among medical students. CVS is significantly associated with poor sleep quality in medical students.

Prevalence of self-reported computer vision syndrome symptoms and its associated factors among university students

Purpose:

To determine the prevalence of symptoms of computer vision syndrome and to identify its associated factors. The secondary objective was to assess knowledge and practices related to preventing computer vision syndrome symptoms.

Methods:

The data for this cross-sectional study were collected through a self-administered questionnaire distributed to 713 female undergraduates studying business and medicine in Saudi Arabia. The questionnaire included computer vision syndrome validated symptoms and factors associated with computer vision syndrome development.

Results:

The most common symptom due to prolonged computer use was neck or shoulder pain, reported by 82.2% of the subjects. Overall, 66.5% of the subjects suffered from headache and 51.5% from dry eyes, in mild, moderate, or severe form. Business students were 1.6 times as likely as medical students to suffer from computer vision syndrome (odds ratio = 1.65; 95% confidence interval: 1.22, 2.24). The use of electronic devices for more than 5 h (odds ratio = 1.52; 95% confidence interval: 1.07, 2.16) was also associated with experiencing computer vision syndrome symptoms. Regarding computer vision syndrome prevention, factors such as hours of use, screen distance, screen brightness, and room illumination showed statistically significant difference between the two groups (p < 0.0001).

Conclusion:

The prevalence of computer vision syndrome symptoms was significantly higher among business students, who reported lower awareness and poor practice measures of computer use recommendations. Relevant awareness campaigns focusing on the appropriate use of computers are highly recommended.