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Pucker AD, Kerr AM, Sanderson J, Lievens C. Digital Eye Strain: Updated Perspectives. CLINICAL OPTOMETRY 2024; 16:233-246. [PMID: 39308959 PMCID: PMC11416787 DOI: 10.2147/opto.s412382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 09/12/2024] [Indexed: 09/25/2024]
Abstract
Purpose Digital eye strain (DES) is a growing worldwide concern because digital devices are prevalent in both our work and home lives. The purpose of this review was to summarize clinically relevant and evolving key topics related to DES. Methods A PubMed.gov search was conducted on or before June 8, 2024. No date restrictions were used during the primary search. The search was aimed at detecting all articles related to DES; thus, the search terms only included "digital eye strain" or "computer vision syndrome". Results The two most used, validated DES questionnaires are the Computer Vision Syndrome Questionnaire (CVS-Q) and Computer Vision Symptom Scale (CVSS17). The world-wide prevalence of DES ranges from 8.2% to 100% depending upon the subjects evaluated and the method used to evaluate them. The most common DES symptoms include headache, eye strain, eye redness, eye itching, tearing, photophobia, burning sensation, blurred vision, eye pain, neck and shoulder pain, and eye dryness. Ocular surface symptoms in DES are integrally tied to decreased blink frequency, which causes ocular surface desiccation, increased osmolarity, and dry eye-like symptoms. The most studied DES-specific treatments are improving subjects' environment, artificial tears, blinking exercises, and near work breaks. Conclusion DES is a highly prevalent condition that should be regularly screened for in clinic with a validated diagnosis instrument. While there are several treatment options, the community's treatment approach is evolving and primarily focused on treating the visual and dry eye-like symptoms associated with the condition.
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Affiliation(s)
- Andrew D Pucker
- Clinical and Medical Sciences, Lexitas Pharma Services, Durham, NC, USA
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Seguí-Crespo M, Cantó-Sancho N, Sánchez-Brau M, Ronda-Pérez E. CVS-Q teen: an adapted, reliable and validated tool to assess computer vision syndrome in adolescents. Sci Rep 2024; 14:21576. [PMID: 39285189 PMCID: PMC11405871 DOI: 10.1038/s41598-024-70821-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 08/21/2024] [Indexed: 09/19/2024] Open
Abstract
Adolescents' extensive use of digital devices raises significant concerns about their visual health. This study aimed to adapt and validate the computer vision syndrome questionnaire (CVS-Q©) for adolescents aged 12-17 years. A mixed-method sequential design was used. First, a qualitative study was involved two nominal groups to assess the instrument's acceptability. A subsequent cross-sectional quantitative study with 277 randomly selected adolescents assessed reliability and validity. Participants completed the adapted CVS-Q©, an ad hoc questionnaire, and the ocular surface disease index (OSDI) questionnaire. Repeatability was tested in 54 adolescents after 7-14 days. The Rasch-Andrich rating scale model was used. Instructions and symptoms were modified to obtain the 14-item CVS-Q teen©. It showed unidimensionality, no local dependence between items, and respected monotonicity. Adequate internal consistency (person reliability = 0.69, item reliability = 0.98) and intraobserver reliability (intraclass correlation coefficient = 0.77, Cohen's Kappa = 0.49) were observed. A significant correlation (0.782, p < 0.001) between CVS-Q teen© and OSDI supported construct validity. A score of ≥ 6 points indicated computer vision syndrome (CVS) (sensitivity = 85.2%, specificity = 76.5%, and area under the curve = 0.879). In conclusion, CVS-Q teen© is a valid and reliable instrument for assessing CVS in adolescents using digital devices, applicable in research and clinical practice for early identification and recommendations for visual health.
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Affiliation(s)
- Mar Seguí-Crespo
- Public Health Research Group, University of Alicante, San Vicente del Raspeig, Spain
- Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig, Spain
| | - Natalia Cantó-Sancho
- Public Health Research Group, University of Alicante, San Vicente del Raspeig, Spain
| | - Mar Sánchez-Brau
- Public Health Research Group, University of Alicante, San Vicente del Raspeig, Spain.
| | - Elena Ronda-Pérez
- Public Health Research Group, University of Alicante, San Vicente del Raspeig, Spain
- Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Ouyang W, Yan D, Hu J, Liu Z. Multifaceted mitochondrial as a novel therapeutic target in dry eye: insights and interventions. Cell Death Discov 2024; 10:398. [PMID: 39242592 PMCID: PMC11379830 DOI: 10.1038/s41420-024-02159-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 08/20/2024] [Accepted: 08/22/2024] [Indexed: 09/09/2024] Open
Abstract
Dry eye, recognized as the most prevalent ocular surface disorder, has risen to prominence as a significant public health issue, adversely impacting the quality of life for individuals across the globe. Despite decades of extensive research into the chronic inflammation that characterizes dry eye, the intricate mechanisms fueling this persistent inflammatory state remain incompletely understood. Among the various cellular components under investigation, mitochondria-essential for cellular energy production and homeostasis-have attracted increasing attention for their role in dry eye pathogenesis. This involvement points to mechanisms such as oxidative stress, apoptosis, and sustained inflammation, which are central to the progression of the disease. This review aims to provide a thorough exploration of mitochondrial dysfunction in dry eye, shedding light on the critical roles played by mitochondrial oxidative stress, apoptosis, and mitochondrial DNA damage. It delves into the mechanisms through which diverse pathogenic factors may trigger mitochondrial dysfunction, thereby contributing to the onset and exacerbation of dry eye. Furthermore, it lays the groundwork for an overview of current therapeutic strategies that specifically target mitochondrial dysfunction, underscoring their potential in managing this complex condition. By spotlighting this burgeoning area of research, our review seeks to catalyze the development of innovative drug discovery and therapeutic approaches. The ultimate goal is to unlock promising avenues for the future management of dry eye, potentially revolutionizing treatment paradigms and improving patient outcomes. Through this comprehensive examination, we endeavor to enrich the scientific community's understanding of dry eye and inspire novel interventions that address the underlying mitochondrial dysfunctions contributing to this widespread disorder.
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Affiliation(s)
- Weijie Ouyang
- Xiamen University affiliated Xiamen Eye Center, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, Eye Institute of Xiamen University, School of Medicine of Xiamen University, Xiamen, Fujian, China; Department of Ophthalmology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Dan Yan
- Xiamen University affiliated Xiamen Eye Center, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, Eye Institute of Xiamen University, School of Medicine of Xiamen University, Xiamen, Fujian, China
| | - Jiaoyue Hu
- Xiamen University affiliated Xiamen Eye Center, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, Eye Institute of Xiamen University, School of Medicine of Xiamen University, Department of Ophthalmology of Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China.
| | - Zuguo Liu
- Xiamen University affiliated Xiamen Eye Center, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, Eye Institute of Xiamen University, School of Medicine of Xiamen University, Department of Ophthalmology of Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China; Department of Ophthalmology, the First Affiliated Hospital of University of South China, University of South China, Hengyang, Hunan, China.
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Muñoz-Villegas P, García-Sánchez G, Jauregui-Franco RO, Quirarte-Justo S, Sánchez-Ríos A, Olvera-Montaño O. Influence of Environmental Factors with Clinical Signs and Symptoms in the Management of Dry Eye Disease. Clin Ophthalmol 2024; 18:2439-2451. [PMID: 39233999 PMCID: PMC11372294 DOI: 10.2147/opth.s480223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 08/19/2024] [Indexed: 09/06/2024] Open
Abstract
Background This research aims to investigate the influence of environmental factors on the treatment efficacy of ocular lubricants in patients from urban areas with dry eye disease (DED). Methods A phase IV clinical trial, which included 173 patients from major cities in Mexico, was randomly assigned to use ocular lubricants four times a day for 30 days. Ocular Surface Disease Index (OSDI), noninvasive tear film break-up time (NIBUT), ocular staining, and conjunctival hyperemia (CH) among other factors like weather, and air pollution as covariates were analysed. Results After 30 days, OSDI score decreased by 14.8 points (p<0.001), and NIBUT increased by 2.9 seconds (p< 0.001), with longer values observed in patients recruited in autumn and winter (additional 1.8 seconds, p< 0.05) compared to those recruited in spring. Patients living in cities with cooler weather and high humidity, but low air quality had higher OSDI and conjunctival stain scores of up to 4.4 and 0.3 points, respectively, as compared to those living in cities with similar pollution and humidity levels but with higher temperatures (p-values= 0.019 and 0.050). Patients with moderate CH had an increase of up to 0.8 points in their corneal stain score (p< 0.010). We also found that ozone levels were related to the predicted changes in OSDI and NIBUT. Conclusion This study demonstrated the impact of environmental factors on the signs and symptoms of DED and suggests that patients residing in cities with inadequately controlled air pollution can benefit from using ocular lubricants to alleviate their symptoms. Trial Registration Trial is registered at clinicaltrials.gov (NCT04702776).
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Affiliation(s)
- Patricia Muñoz-Villegas
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Zapopan, Jalisco, Mexico
- Centro de Investigación en Matemáticas, A.C., Unidad Aguascalientes (CIMAT), Aguascalientes, Aguascalientes, Mexico
| | - Gisela García-Sánchez
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Zapopan, Jalisco, Mexico
| | | | - Sebastian Quirarte-Justo
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Zapopan, Jalisco, Mexico
| | - Alejandra Sánchez-Ríos
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Zapopan, Jalisco, Mexico
| | - Oscar Olvera-Montaño
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Zapopan, Jalisco, Mexico
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Sharma S, Singh A, Agrawal A, Kumari R, Kumar B. Association of smartphones use, ocular symptoms and binocular dysfunctions in adolescents: a hospital-based cross-sectional study. Strabismus 2024:1-8. [PMID: 39037013 DOI: 10.1080/09273972.2024.2382289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
PURPOSE Given the current scenario of increased smartphone use in youth, this study aims to evaluate the proportion of ocular symptoms and binocular dysfunction and their association with smartphone use in adolescents through a hospital-based cross-sectional study. METHODS The participants were asked to fill out questionnaires related to smartphone use and symptoms of eyestrain experienced (Balik et al. and Kucer). They were asked about the following seven symptoms: blurring of vision, redness, visual disturbance, secretion, inflammation, lacrimation, and dryness. Each symptom out of the 7, was scored on a scale of 0-1 and was used to calculate an Ocular Symptom Score (OSS) by summing the scores of each symptom.Depending upon the duration of smartphone usage, the participants were classified into four groups: <2 hours/day, 2-4 hours/day, 4-6 hours/day, and >6 hours/day. Binocular functions were assessed using near point of convergence (NPC), near point of accommodation (NPA), Accommodative convergence/Accommodation (AC/A) ratio, dissociated heterophoria, and binocular accommodative facility (BAF). RESULTS A total of 123 smartphone user adolescents, aged 10-19 years were included in this study. The mean age of the study population was 16.58 + 2.8 years, out of which 52.03% were males. Prevalence of ocular symptoms was higher in groups with greater duration of smartphone use (2 to 4, 4 to 6, and >6 hours/day as compared to <2 hours/day: 90.48%, 94.74%, 100% vs. 75% respectively). The mean of NPC was 8.51, it was highest in subjects using smartphones for >6 hours. (p-value = .001). The mean AC/A ratio was 2.83 + 1.03: 1. A low AC/A ratio was associated with a longer duration of smartphone usage (p-value = .0001). The mean of BAF was 7.4 + 3.18 cycles/min, only 30 (24.4%) participants had BAF beyond the normal range (<5 cycles/min). The mean of BAF was lowest in the group with >6 hours/day of smartphone use (p-value < .0001). No significant change was found in NPA and dissociated heterophoria with the duration of smartphone usage. CONCLUSION Higher duration of smartphone use (>2 hours/day) is associated with various ocular symptoms and binocular dysfunction. However, additional research is necessary to authenticate the results of the study.
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Affiliation(s)
- Srishti Sharma
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, India
| | - Anupam Singh
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, India
| | - Ajai Agrawal
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, India
| | - Ranjeeta Kumari
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Barun Kumar
- Department of Cardiology, All India Institute of Medical Sciences, Rishikesh, India
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Khezrzade S, Ehsaei A, Momeni-Moghaddam H, Wolffsohn JS, Oladi Abbas Abadi S. After-effect on tear film quality and quantity of reading on laptop computer screen versus hardcopy. Clin Exp Optom 2024; 107:499-503. [PMID: 37797942 DOI: 10.1080/08164622.2023.2241053] [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: 03/30/2023] [Accepted: 07/22/2023] [Indexed: 10/07/2023] Open
Abstract
CLINICAL RELEVANCE Electronic displays, including laptops, tablets, and smartphones, have dramatically altered the way information is accessed and become significant factors in human daily life. They interfere with the blink rate and increase dry eye symptoms, which lead to more discomfort compared to hard copy while reading. BACKGROUND Digital eye strain occurs when an individual suffers from symptoms, or they are exacerbated, while performing a task requiring digital screen viewing. This study assessed the tear film status immediately following reading on a laptop computer screen versus an identical hard copy. METHODS Thirty young adults with normal ocular health and reporting no significant symptoms of dry eye (ocular surface disease index (OSDI) score < 13 and non-invasive tear break-up time (NITBUT) > 10 seconds) read a text as hard copy and on a laptop computer screen for 30 min on separate days in a random sequence in a controlled reading experimental condition. The texts were matched in size and contrast and presented at a viewing distance of 40 cm. The NITBUT and strip meniscometry tube tests were administered at baseline and after reading in both conditions. RESULTS The median baseline NITBUT decreased from 13.0 s to 10.0 s (P < 0.001) after hardcopy reading and to 7.0 (P < 0.001) after reading from a laptop computer screen, with a significant difference between the task medium (P = 0.001). The baseline strip meniscometry tube results decreased from 6.7 mm to 5.0 mm (P < 0.001) after hardcopy reading and to 5.0 mm (P < 0.001) after reading from a laptop computer screen, but there was no significant difference with the task medium (P = 0.085). CONCLUSION Reading in both conditions led to tear film instability in terms of the tear film quality and quantity. Additionally, the computer screen has a greater impact on the TBUT compared to hardcopy reading, while these two reading mediums had a similar effect on the tear volume.
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Affiliation(s)
- Soraya Khezrzade
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asieh Ehsaei
- Refractive Error Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Momeni-Moghaddam
- Rehabilitation Sciences Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - James S Wolffsohn
- Optometry and Vision Sciences Research Group, Aston University, Health and Life Sciences, Birmingham, UK
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Jadeja JN, Shroff KV, Shah A, Pandey A, Dubey S. Association of digital device usage and dry eye disease in school children. Indian J Ophthalmol 2024; 72:1031-1036. [PMID: 38905463 PMCID: PMC11329823 DOI: 10.4103/ijo.ijo_703_23] [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: 03/12/2023] [Revised: 11/23/2023] [Accepted: 12/11/2023] [Indexed: 06/23/2024] Open
Abstract
PURPOSE To investigate the influence of digital device use (computers, laptops, tablets, smartphones) on dry eye disease (DED) in a pediatric population. SETTINGS AND DESIGN This was a cross-sectional study. School children studying in grades 5-9 at two private schools in the city of Ahmedabad, the capital city of Gujarat, India were invited to participate in the study. METHODS In this study, 462 children underwent ocular examination including tear film breakup time (TBUT) and Schirmer's test. Questionnaires were administered for collecting information on the type and duration of digital device usage separately for academic and leisure activities and the Ocular Surface Disease Index (OSDI) score. RESULTS The mean age of participants was 11.2 + 1.4 years, and 63% were boys. The mean OSDI score was 37.2 + 11.8, and 90.5% had symptoms of DED. Children with moderate to severe DED (n = 88, 19%) had longer daily duration of device use and lower Schirmer's test and TBUT values compared to children with mild DED (P = 0.001). A cumulative exposure time of more than 3-3.5 h per day had a significantly increased risk of DED. Multivariable logistic regression analysis showed that increment in computer usage (odds ratio [OR] 1.94 for every half an hour increase, 95% confidence interval [CI] = 1.2-3.1) and children studying in higher grades (OR 1.30, 95% CI = 1.1-1.6) had a higher risk of moderate to severe dry eye. CONCLUSION Cumulative device exposure time of more than 3-3.5 h per day had a significantly increased risk of pediatric DED. Children with an increment in computer usage by half an hour per day had a higher chance of experiencing moderate to severe dry eye. Policymakers should aim to restrict the screen time below 3 h on a daily basis.
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Affiliation(s)
- Jagruti N Jadeja
- Ophthalmology, M and J Institute of Ophthalmology, BJ Medical College, Ahmedabad, Gujarat, India
| | - Kruti V Shroff
- Ophthalmology, M and J Institute of Ophthalmology, BJ Medical College, Ahmedabad, Gujarat, India
| | - Ashka Shah
- Ophthalmology, M and J Institute of Ophthalmology, BJ Medical College, Ahmedabad, Gujarat, India
| | - Ashish Pandey
- Ophthalmology, PDU Government Medical College, Rajkot, Gujarat, India
| | - Shubhra Dubey
- Senior Resident, Government Medical College, Satna, Madhya Pradesh, India
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Moore PA, Wolffsohn JS, Sheppard AL. Digital eye strain and its impact on working adults in the UK and Ireland. Cont Lens Anterior Eye 2024:102176. [PMID: 38735811 DOI: 10.1016/j.clae.2024.102176] [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: 04/02/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/14/2024]
Abstract
CLINICAL RELEVANCE Digital eye strain (DES) is a condition encompassing visual and ocular symptoms that may arise due to the prolonged use of digital devices. The 2023 Tear Film Ocular Surface Lifestyle report defined DESas"the development or exacerbation of recurrent ocular symptoms and / or signs related specifically to digital device screen viewing". Studies vary as to the prevalence of DES with some reporting values as low as 10 % and some reporting values over 90 %, however no study has examined the prevalence of DES in the UK or Ireland (UK&I). PURPOSE To determine the prevalence of DES amongst adults who work with digital devices in UK&I, their symptoms and ameliorative approaches taken by those affected. METHODS A web-based survey of digital device users was conducted. Adults who used a device for at least 1 h per day for work purposes were eligible to participate. The questionnaire was designed to determine the prevalence of DES, daily device usage, musculoskeletal and ocular symptoms, how they manage their symptoms and eye care history. RESULTS Based on a Computer Vision Syndrome Questionnaire score ≥ 6, the occurrence of DES was high at 62.6 %. The mean number of hours devices were used for was 9.7 h. Musculoskeletal symptoms were reported by 94.3 % of users and ocular symptoms by 89.5 % with symptoms most likely to occur with those working from home. 8.1 % of respondents considered their symptoms significant enough to affect their work. CONCLUSION This study provides a valuable insight into DES in digital device users in UK&I and is the first of its kind to be completed. It shows, that while the level of DES is high in device users, at 62.6 %, the actual effect or consequences of it on many does not appear to be significant.
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Affiliation(s)
- Patrick A Moore
- Optometry and Vision Sciences Research Group, Aston University, Birmingham, UK.
| | - James S Wolffsohn
- Optometry and Vision Sciences Research Group, Aston University, Birmingham, UK
| | - Amy L Sheppard
- Optometry and Vision Sciences Research Group, Aston University, Birmingham, UK.
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Talens-Estarelles C, Talens-Estarelles C, García-Lázaro S. Ocular surface changes following computer use in post-LASIK patients. Ophthalmic Physiol Opt 2024; 44:554-563. [PMID: 38386250 DOI: 10.1111/opo.13297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE To assess the impact of computer use on the ocular surface of individuals after laser in situ keratomileusis (LASIK). METHODS The dry eye symptoms and ocular surface of 18 post-LASIK young individuals and 18 controls were evaluated before and after performing a 30-min task on a computer without (Visit 1) and with (Visit 2) initial instillation of artificial tears. Symptoms were assessed using the Ocular Surface Disease Index (OSDI), Symptom Assessment in Dry Eye questionnaire version two (SANDE II) and Computer Vision Syndrome Questionnaire (CVS-Q). The ocular surface was assessed by measuring corneal higher order aberrations, tear meniscus height (TMH), conjunctival redness, blink rate and incomplete blinking, lipid layer thickness (LLT) and non-invasive keratograph break-up time (NIKBUT). RESULTS SANDE II scores were >0 after the computer task in both groups (p ≤ 0.01). SANDE II and CVS-Q scores did not differ between LASIK and controls (p ≥ 0.43). Greater bulbar-temporal conjunctival redness, TMH and LLT and shorter NIKBUT were found after computer use in the LASIK group (p ≤ 0.04), whereas no changes were observed in the controls (p ≥ 0.20). Lower SANDE II and CVS-Q scores were reported at Visit 2 compared with Visit 1 in both groups (p ≤ 0.01). Likewise, no worsening of dry eye signs was observed at Visit 2 (p ≥ 0.11). CONCLUSIONS Ocular symptoms reported during computer use were comparable between the groups. However, a worsening of dry eye signs was mostly observed in post-LASIK individuals. The instillation of artificial tears was effective in preventing the effects of computer use on the ocular surface in post-LASIK patients.
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Affiliation(s)
| | | | - Santiago García-Lázaro
- Department of Optics & Optometry & Vision Science, University of Valencia, Valencia, Spain
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Maity M, Galor A, Basu S, Singh S. Tear Film Dynamics in Visual Display Terminal Users: A Review of Impact on Goblet Cells, Lacrimal and Meibomian Gland Function. Semin Ophthalmol 2024:1-14. [PMID: 38629642 PMCID: PMC7616525 DOI: 10.1080/08820538.2024.2332355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/13/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE The prevalence of dry eye disease (DED) is rising among visual display terminal (VDT) users, a trend that correlates with the growing use of digital devices. The prevalence of VDT-associated DED is reported based on dry eye questionnaires; however, VDT's impact on tear film parameters is less understood. METHODS A review of published literature on both the alterations in tear film observed in VDT users and the impact of various interventions on their tear film. RESULTS Most studies show reduction in tear stability as well as reduction in the blink rate. The role of lacrimal gland hypofunction in visual display terminal (VDT) users is a subject of ongoing debate. Schirmer test values typically exceed the 10 mm threshold, suggesting normal tear production, and tear osmolarity remains within normal ranges but VDT users consistently present with lower Schirmer values compared to non-VDT users. The effects on Meibomian glands and mucin levels need more research as the numbers studied are small. Very few studies have analysed mucin levels in VDT users with reports of normal or reduced values. Even asymptomatic users can have tear film instability; hence, the diagnostic criteria need to be formulated and validated. Different interventions such as neurostimulation, blink improving apps, eyelid warming devices, moist goggles, and lubricants have been explored in VDT users but without a control arm and in asymptomatic VDT users in most studies. CONCLUSION The alterations have been observed on aqueous, lipid and mucin components of the tear film, although the extent of the impact is variable across studies. There is urgent need of well-designed studies for studying the tear film changes and management options for the upcoming lifestyle epidemic in VDT users.
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Affiliation(s)
- Moumi Maity
- Center for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anat Galor
- Bascom Plamer Eye Institute, University of Miami, Miami, FL, USA
- Miami Veterans Administration Medical Center, Miami, FL, USA
| | - Sayan Basu
- Brien Holden Center for Eye Research (BHERC), L V Prasad Eye Institute, Hyderabad, Telangana, India
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swati Singh
- Brien Holden Center for Eye Research (BHERC), L V Prasad Eye Institute, Hyderabad, Telangana, India
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Bu J, Liu Y, Zhang R, Lin S, Zhuang J, Sun L, Zhang L, He H, Zong R, Wu Y, Li W. Potential New Target for Dry Eye Disease-Oxidative Stress. Antioxidants (Basel) 2024; 13:422. [PMID: 38671870 PMCID: PMC11047456 DOI: 10.3390/antiox13040422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Dry eye disease (DED) is a multifactorial condition affecting the ocular surface. It is characterized by loss of tear film homeostasis and accompanied by ocular symptoms that may potentially result in damage to the ocular surface and even vision loss. Unmodifiable risk factors for DED mainly include aging, hormonal changes, and lifestyle issues such as reduced sleep duration, increased screen exposure, smoking, and ethanol consumption. As its prevalence continues to rise, DED has garnered considerable attention, prompting the exploration of potential new therapeutic targets. Recent studies have found that when the production of ROS exceeds the capacity of the antioxidant defense system on the ocular surface, oxidative stress ensues, leading to cellular apoptosis and further oxidative damage. These events can exacerbate inflammation and cellular stress responses, further increasing ROS levels and promoting a vicious cycle of oxidative stress in DED. Therefore, given the central role of reactive oxygen species in the vicious cycle of inflammation in DED, strategies involving antioxidants have emerged as a novel approach for its treatment. This review aims to enhance our understanding of the intricate relationship between oxidative stress and DED, thereby providing directions to explore innovative therapeutic approaches for this complex ocular disorder.
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Affiliation(s)
- Jinghua Bu
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Yanbo Liu
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Rongrong Zhang
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Sijie Lin
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Jingbin Zhuang
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Le Sun
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Lingyu Zhang
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Hui He
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Rongrong Zong
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Yang Wu
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, China
| | - Wei Li
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361005, China
- Xiamen University Affiliated Xiamen Eye Center, Xiamen 361102, China
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Chidi-Egboka NC, Jalbert I, Wagner P, Golebiowski B. Blinking and normal ocular surface in school-aged children and the effects of age and screen time. Br J Ophthalmol 2023; 107:1613-1620. [PMID: 36002237 DOI: 10.1136/bjo-2022-321645] [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: 04/13/2022] [Accepted: 08/09/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Baseline ocular surface characteristics in children require investigation. This study characterised blinking and relationships with ocular symptoms, tear film and digital device use. METHODS 45 children aged 6-15 years (56% female) participated in a cross-sectional study. Ocular surface symptoms (Instant Ocular Symptoms Survey, Dry Eye Questionnaire 5, Symptoms Assessment in Dry Eye, Ocular Surface Disease Index, Ocular Comfort Index and Numerical Rating Scale) and clinical indices (lipid layer thickness, tear secretion and stability, meibomian gland) were assessed. Blink rate and interblink interval were measured in situ using a wearable eye-tracking headset (Pupil Labs GmbH, Germany). Associations between blinking, ocular surface, age, and digital device use (bivariate and partial correlations) and between automated and manually counted blink rate (Bland & Altman) were examined. RESULTS Mean blink rate and interblink interval were 20.5±10.5 blinks/min and 2.9±1.9 s during conversation. There was no difference between automated and manual blink rate (p=0.78) and no relationship between blinking and digital device use, age or sex. Mean group symptoms were within normal range and not associated with clinical measurements including blinking. Greater tear volume was associated with a faster blink rate (r=0.46, p=0.001) and shorter interblink interval (r=-0.36, p=0.02). Older age was associated with improved tear volume (r=0.37, p=0.01) and stability (r=0.38, p=0.01). CONCLUSIONS Blinking characterised in situ was not impacted by age or habitual digital device use. A faster blink rate was associated with greater tear volume but not symptoms. Improved tear function was found with age suggesting that the ocular surface continues to develop through childhood.
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Affiliation(s)
- Ngozi Charity Chidi-Egboka
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Isabelle Jalbert
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Peter Wagner
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Blanka Golebiowski
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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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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14
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Li X, Guo C, Zhang Y, Yu L, Ma F, Wang X, Zhang L, Li P. Contribution of Different Food Types to Vitamin A Intake in the Chinese Diet. Nutrients 2023; 15:4028. [PMID: 37764811 PMCID: PMC10535670 DOI: 10.3390/nu15184028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Vitamin A is a fat-soluble micronutrient that is essential for human health. In this study, the daily vitamin A intake of Chinese residents was evaluated by investigating the vitamin A content of various foods. The results show that the dietary intake of vitamin A in common foods was 460.56 ugRAE/day, which is significantly lower than the recommended dietary reference intake of vitamin A (800 ugRAE/day for adult men and 700 ugRAE/day for adult women). Vegetables contributed the most to daily vitamin A dietary intake, accounting for 54.94% of vitamin A intake (253.03 ugRAE/day), followed by eggs, milk, aquatic products, meat, fruit, legumes, coarse cereals, and potatoes. Therefore, an increase in the vitamin A content of vegetables and the fortification of vegetable oils with vitamin A are effective ways to increase vitamin A intake to meet the recommended dietary guidelines in China. The assessment results support the design of fortified foods.
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Affiliation(s)
- Xue Li
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Can Guo
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Yu Zhang
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Li Yu
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Fei Ma
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Xuefang Wang
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
| | - Liangxiao Zhang
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
- College of Food Science and Engineering, Collaborative Innovation Center for Modern Grain Circulation and Safety, Nanjing University of Finance and Economics, Nanjing 210023, China
- Hubei Hongshan Laboratory, Wuhan 430070, China
| | - Peiwu Li
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China (F.M.)
- Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China
- College of Food Science and Engineering, Collaborative Innovation Center for Modern Grain Circulation and Safety, Nanjing University of Finance and Economics, Nanjing 210023, China
- Hubei Hongshan Laboratory, Wuhan 430070, China
- Xianghu Laboratory, Hangzhou 311231, China
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15
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Jordi AS, Chávez Méndez MA. [Associated factors and types of eye injuries occurring in dentistry practice: systematic review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e169. [PMID: 38287994 PMCID: PMC10809966 DOI: 10.21142/2523-2754-1103-2023-169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/02/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction The dentist and auxiliary personnel are in constant risk of occupational diseases such as: allergies, infections, skin or eye injuries; that could affect patients. A problem of social interest are the ocular injuries that occur to dental personnel. The literature reveals the prevalence of eye injuries in dental practice that are associated with solid particles, fluid splashes. Our objective was, through a systematic review, to review the types of ocular injuries and their associated factors that occurred in dental practice. Material and Methods The relevant studies were searched in the databases: PubMed, Scopus, Ebsco, among others. The search included cross-sectional studies that evaluated the evidence on ocular injuries occurring in dental practice, excluding literature reviews, letters to the reader, and editorials. Results Eight studies were included to develop the systematic review; determining that the associated factors of ocular injuries occurred in dental practice are: a) occasional use of ocular protection b) age c) sex d) years of practice and the types of ocular injuries are the entry of liquids and foreign bodies. Conclusions Deficiency in compliance with eye or facial protection protocols in dental practice, cause eye injuries; Type of fluid entry, foreign bodies, splash of biological fluids or conjunctivitis. These eye injuries are generated from associated factors such as the occasional use of eye protection, age, sex, and others.
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Affiliation(s)
- Abanto Sheron Jordi
- Departamento de Ciencias de la Salud, Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. Universidad Científica del Sur Departamento de Ciencias de la Salud Carrera de Estomatología Universidad Científica del Sur Lima Peru
| | - Martín Andrés Chávez Méndez
- Departamento de Rehabilitación Oral, Carrera de Estomatología, Universidad Científica del Sur. Lima Perú. Universidad Científica del Sur Departamento de Rehabilitación Oral Carrera de Estomatología Universidad Científica del Sur Lima Peru
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Chatzistergiou V, Tzamalis A, Diafas A, Oustoglou E, Mataftsi A, Tsinopoulos I, Ziakas N. Repeatability of corneal pachymetry and epithelial thickness measurements with spectral-domain optical coherence tomography (SD-OCT) and correlation to ocular surface parameters. Int Ophthalmol 2023:10.1007/s10792-023-02713-2. [PMID: 37097425 DOI: 10.1007/s10792-023-02713-2] [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: 08/08/2022] [Accepted: 04/09/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE To assess the repeatability of corneal pachymetry and epithelial thickness measurements with spectral-domain optical coherence tomography (SD-OCT) and identify correlations between epithelial thickness and ocular surface parameters. METHODS Adults who happened to have prolonged computer use were recruited, excluding those with conditions interfering with corneal measurements or tear production. All subjects filled in the ocular surface disease index (OSDI) questionnaire. Three consecutive measurements of central and peripheral corneal and epithelial thickness were performed with SD-OCT (RTVue XR). Schirmer test I and tear film break-up time (TBUT) were performed. Repeatability was evaluated with intraclass correlation coefficient (ICC), coefficient of variation and repeatability limit. Spearman correlation was used for non-parametric variables. RESULTS 113 eyes of 63 subjects were included in the study. ICC was ≥ 0.989 for all corneal and ≥ 0.944 for all epithelial pachymetry segments. The best repeatability was found centrally and the worst superiorly both for corneal and epithelial measurements. Central epithelial thickness was weakly correlated with Schirmer test I (rho = 0.21), TBUT (rho = 0.02), OSDI symptoms and OSDI score (rho <|0.32|). OSDI symptoms and OSDI score were weakly correlated with Schirmer test I (rho <|0.3|) and TBUT (rho <|0.34|). CONCLUSION RTVue XR measurements of corneal and epithelial thickness are highly repeatable in all segments. The lack of correlation between epithelial thickness and ocular surface parameters could suggest the assessment of epithelial integrity with reliable methods such as SD-OCT.
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Affiliation(s)
- Vasileia Chatzistergiou
- 2nd Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Argyrios Tzamalis
- 2nd Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asterios Diafas
- 2nd Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eirini Oustoglou
- 2nd Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asimina Mataftsi
- 2nd Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Tsinopoulos
- 2nd Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Ziakas
- 2nd Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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17
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Talens-Estarelles C, Cerviño A, García-Lázaro S, Fogelton A, Sheppard A, Wolffsohn JS. The effects of breaks on digital eye strain, dry eye and binocular vision: Testing the 20-20-20 rule. Cont Lens Anterior Eye 2023; 46:101744. [PMID: 35963776 DOI: 10.1016/j.clae.2022.101744] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the benefits on the eyes of taking breaks based on the 20-20-20 rule. METHODS Bespoke computer software using the laptop webcam to assess user breaks, eye gaze and blinking, and emitting personalized reminders of breaks based on the 20-20-20 rule, was downloaded onto the laptops of 29 symptomatic computer users. Digital eye strain (DES), binocular vision and dry eye were assessed before and after two weeks of using the reminders and one week after the discontinuation of the strategy. Binocular measurements included visual acuity, accommodative posture, stereopsis, fixation disparity, ocular alignment, accommodative facility, positive/negative vergences and near point of convergence. Symptoms were evaluated using the computer vision syndrome questionnaire, ocular surface disease index (OSDI), and symptom assessment in dry eye questionnaire (SANDE) versions one and two. Dry eye signs were assessed by measuring tear meniscus height, conjunctival redness, blink rate and incomplete blinking, lipid layer thickness, non-invasive keratograph break-up time, corneal and conjunctival staining and lid wiper epitheliopathy. RESULTS A decrease in the duration of computer work and the duration of breaks, along with an increase in the number of breaks taken per day was observed as a result of the 20-20-20 rule reminders (p ≤ 0.015). No changes on any binocular parameter were observed after the management period (p ≥ 0.051), except for an increase in accommodative facility (p = 0.010). Dry eye symptoms and DES decreased with the rule reminders (p ≤ 0.045), although this improvement was not maintained one week after discontinuation (p > 0.05). No changes on any ocular surface and tear film parameter were observed with the rule reminders (p ≥ 0.089). CONCLUSIONS The 20-20-20 rule is an effective strategy for reducing DES and dry eye symptoms, although 2 weeks was not enough to considerably improve binocular vision or dry eye signs.
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Affiliation(s)
- Cristian Talens-Estarelles
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
| | - Alejandro Cerviño
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
| | - Santiago García-Lázaro
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain.
| | - Andrej Fogelton
- Vision and Graphics Group, Faculty of Informatics and Information Technologies, Slovak University of Technology in Bratislava, Ilkovičova 2, Bratislava 842 16, Slovakia
| | - Amy Sheppard
- Optometry and Vision Sciences, Aston University, Birmingham, UK
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18
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Wolffsohn JS, Lingham G, Downie LE, Huntjens B, Inomata T, Jivraj S, Kobia-Acquah E, Muntz A, Mohamed-Noriega K, Plainis S, Read M, Sayegh RR, Singh S, Utheim TP, Craig JP. TFOS Lifestyle: Impact of the digital environment on the ocular surface. Ocul Surf 2023; 28:213-252. [PMID: 37062428 DOI: 10.1016/j.jtos.2023.04.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
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).
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Affiliation(s)
- James S Wolffsohn
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.
| | - Gareth Lingham
- Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Byki Huntjens
- Division of Optometry and Visual Sciences, City, University of London, EC1V 0HB, UK
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Saleel Jivraj
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK
| | | | - Alex Muntz
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Karim Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL). Monterrey, 64460, Mexico
| | - Sotiris Plainis
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | - Michael Read
- Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Rony R Sayegh
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sumeer Singh
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Tor P Utheim
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Jennifer P Craig
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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Chu GCH, Chan LYL, Do CW, Tse ACY, Cheung T, Szeto GPY, So BCL, Lee RLT, Lee PH. Association between time spent on smartphones and digital eye strain: A 1-year prospective observational study among Hong Kong children and adolescents. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:58428-58435. [PMID: 36991204 PMCID: PMC10057686 DOI: 10.1007/s11356-023-26258-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/28/2023] [Indexed: 05/07/2023]
Abstract
Prolonged electronic screen use can cause digital eye strain. It can be difficult to rectify due to increasing smartphone reliance, potentially leading to serious public health problems. To investigate the association between time spent on smartphones and digital eye strain (DES) among Hong Kong Chinese school-aged children. Of a total of 1,508 students (748 males, 49.6%) from 8 to 14 years old (mean age = 10.91 years, SD = 2.01) who provided valid data on DES, the 1,298 (86%) who completed the DES questionnaire at 1-year follow-up were included in the analysis. DES was measured using a 10-item scale, and the sum of the 10 dichotomised scores was used as the DES total score. The most commonly reported symptoms were eye fatigue (n = 804, 53.3%), blurred vision (changing from reading to distance viewing) (n = 586, 38.9%), and irritated or burning eyes (n = 516, 34.2%). The DES total scores at baseline and 1-year follow-up were 2.91 (SD = 2.90) and 3.20 (SD = 3.19), respectively. Linear regression controlling for demographic and socio-economic confounders showed that participants with baseline smartphone usage of 241 + min/d had a significantly higher baseline total DES score than those with baseline smartphone usage of 0-60 min/d (2.44 vs 3.21, P < 0.001), and participants with baseline smartphone usage of 181-240 min/d had a significantly higher 1-year follow-up total DES score than those with baseline smartphone usage of 0-60 min/d (2.80 vs 3.50, P = 0.003).
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Affiliation(s)
- Geoffrey C H Chu
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Lily Y L Chan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Chi-Wai Do
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Andy C Y Tse
- Department of Health and Physical Education, Education University of Hong Kong, Hong Kong, Hong Kong
| | - Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Grace P Y Szeto
- School of Medical and Health Sciences, Tung Wah College, Hong Kong, Hong Kong
| | - Billy C L So
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Regina L T Lee
- Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Paul H Lee
- Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, Hampshire, UK.
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Şimşek OM, Kaya AB, Çevık O, Koçak O. How is the problematic smartphone use affected by social support? A research model supported by the mediation of Ikigai. CURRENT PSYCHOLOGY 2023; 43:1-16. [PMID: 36845209 PMCID: PMC9938517 DOI: 10.1007/s12144-023-04362-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 02/21/2023]
Abstract
Social support and ikigai (making life worthwhile) have positive effects on problematic smartphone use and are seen to be related to each other. However, what mediates these relationships has not been adequately analyzed. This study aims to examine how the effect between social support and problematic smartphone use occurs by suggesting the mediator role of ikigai. The study was designed as quantitative and cross-sectional, and 1189 university participants aged 18 and over were reached online. The multidimensional scale of perceived social support, ikigai-9 scale, smartphone application-based addiction scale and sociodemographic information form were used as data collection tools in the study. The data obtained were carried out using SPSS 24 and Amos 25 statistical programs. Established hypotheses were tested with correlation, multiple regression and mediation analyzes. The results confirmed that social support was positively associated with ikigai, and ikigai was negatively associated with problematic smartphone use. In addition, interaction analyzes found that ikigai had a mediating effect. These findings show the importance of implementing specific applications based on the meaning and purpose of life (ikigai), especially for vulnerable groups, to minimize the problems that may arise with the excessive use of smartphones.
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Affiliation(s)
| | - Aysel Basmaci Kaya
- Institute of Graduate Studies, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey
| | - Orhan Çevık
- Institute of Graduate Studies, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey
| | - Orhan Koçak
- Department of Social Work, Faculty of Health Sciences, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey
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Sánchez-Brau M, Seguí-Crespo M, Cantó-Sancho N, Tauste A, Ramada JM. What Are the Dry Eye Questionnaires Available in the Scientific Literature Used for? A Scoping Review. Am J Ophthalmol 2023; 246:174-191. [PMID: 36336073 DOI: 10.1016/j.ajo.2022.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Dry eye disease (DED) is a frequent chronic ophthalmic condition. Its diagnosis includes tests and patient reported outcomes (PRO) questionnaires. Although many PRO dry eye questionnaires (PRO-DEQs) are available, they differ greatly from each other and not all have been validated. The purpose of this study was to retrieve the PRO-DEQs present in the scientific literature by performing a descriptive analysis of them and identifying those with known validity and reliability characteristics and to perform a descriptive analysis of the geographic area, year of publication, and characteristics of the target population of the clinical studies that have used validated PRO-DEQs. DESIGN Scoping review of the literature. METHODS Searches were conducted in PubMed to retrieve PRO-DEQs published up to July 2018 and written in English, French, Italian or Spanish. RESULTS One thousand six hundred two records were identified and 973 were included in the final analysis. Of these, 56 provided information on the design and validation of PRO-DEQs and 49 PRO-DEQs were identified. Twenty-two PRO-DEQs were validated (17 original and 5 modified) and 27 had no associated design, validity, and reliability studies. Most of the validated PRO-DEQs were designed in English, the number of items varies from 1 to 57, the dimensions are generally not specified, and they are self-administered. The greatest use of validated PRO-DEQs in clinical studies has been in Asia since 2010, with the Ocular Surface Disease Index being the most used. These questionnaires have been used mostly in adults, retired professionals, and people with visual diseases to diagnose DED. CONCLUSIONS This study aims to encourage the use of validated PRO-DEQs to guarantee the quality of the results obtained and the comparability and replicability among studies.
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Affiliation(s)
- Mar Sánchez-Brau
- Doctoral Programme in Health Sciences (M.S-B., N.C-S.), University of Alicante, San Vicente del Raspeig, Spain
| | - Mar Seguí-Crespo
- Department of Optics, Pharmacology and Anatomy (M.S-C., N.C-S.), University of Alicante, San Vicente del Raspeig, Spain; Public Health Research Group (M.S-C.), University of Alicante, San Vicente del Raspeig, Spain.
| | - Natalia Cantó-Sancho
- Doctoral Programme in Health Sciences (M.S-B., N.C-S.), University of Alicante, San Vicente del Raspeig, Spain; Department of Optics, Pharmacology and Anatomy (M.S-C., N.C-S.), University of Alicante, San Vicente del Raspeig, Spain
| | - Ana Tauste
- Department of Optics, Optometry and Vision Sciences (A.T.), University of Valencia, Valencia, Spain
| | - José María Ramada
- Institut Hospital del Mar d'Investigacions Mèdiques (J.M.R.), Barcelona, Spain; CIBER of Epidemiology and Public Health (J.M.R.), Madrid, Spain
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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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Fjaervoll K, Fjaervoll 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 DOI: 10.1111/aos.15150aos15150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 03/13/2022] [Accepted: 03/23/2022] [Indexed: 05/25/2023]
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 Fjaervoll
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Haakon Fjaervoll
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Morten Magno
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sara Tellefsen Nøland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Darlene A Dartt
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Jelle Vehof
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Hospital, London, UK
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Tor P Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway
- Department of Quality and Health Technology, The Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway
- Department of Computer Science, Oslo Metropolitan University, Oslo, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
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Garcia-Queiruga J, Pena-Verdeal H, Sabucedo-Villamarin B, Giraldez MJ, Garcia-Resua C, Yebra-Pimentel E. A cross-sectional study of non-modifiable and modifiable risk factors of dry eye disease states. Cont Lens Anterior Eye 2022; 46:101800. [DOI: 10.1016/j.clae.2022.101800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/08/2022] [Accepted: 12/21/2022] [Indexed: 12/26/2022]
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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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Abstract
OBJECTIVES To evaluate dry eye-related lifestyle and demographic factors associated with digital eye strain (DES). METHODS An anonymous online survey was conducted in 851 university students. Participants were classified into DES (computer vision syndrome questionnaire [CVS-Q]≥6) or non-DES (CVS-Q<6). Respondents completed three dry eye questionnaires (Ocular Surface Disease Index [OSDI]; 5-item Dry Eye Questionnaire [DEQ-5]; 8-item Contact Lens Dry Eye Questionnaire) and were surveyed on dry eye risk factors contemplated by the Tear Film and Ocular Surface Society Dry Eye Workshop II. RESULTS Six hundred twenty-eight participants were classified into the group with DES and 222 into the group without DES. Participants with DES slept fewer hours, spent more hours indoors with air conditioning, drank more caffeinated beverages, used the computer for longer periods, reported poorer health quality, and obtained a higher score in all questionnaires (P<0.025). A higher proportion of the participants were female, had several health disorders, and took several medications associated with dry eye (P<0.029). Multivariate logistic regression analysis revealed that stress (P=0.035), contact lens wear (P=0.011), hours of computer use per day (P=0.010), migraine headaches (P=0.013), and a higher OSDI (P<0.001) and DEQ-5 score (P<0.001) were associated with DES. CONCLUSIONS Several dry eye-related risk factors and health conditions are associated with suffering from DES. Clinicians should acknowledge the relevance of triaging questions and dry eye disease risk factors when dealing with patients who view screens for extended periods.
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Determining the Best Management Strategy for Preventing Short-Term Effects of Digital Display Use on Dry Eyes. Eye Contact Lens 2022; 48:416-423. [PMID: 36155947 DOI: 10.1097/icl.0000000000000921] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To assess and compare the effectiveness of four main management strategies for preventing short-term effects of digital display use on dry eye signs and symptoms. METHODS The ocular surface, tear film, and visual fatigue of 47 healthy individuals were assessed before and after reading on a laptop computer for 20 min under five different experimental conditions: control, instillation of artificial tears, taking a brief break, using a blue light screen filter, and blink control. Measurements included the Ocular Surface Disease Index (OSDI) Questionnaire, 5-item Dry Eye Questionnaire (DEQ-5), tear meniscus height (TMH), noninvasive keratograph break-up time (NIKBUT), bulbar conjunctival redness, and pupil size. RESULTS Worse results were obtained after the control and blue light filter conditions in all variables (P≤0.037). A higher post-task DEQ-5 score (P=0.013) and TMH (P<0.0005) were obtained when taking a brief break compared with pretask, although the increase in symptoms was significantly smaller than that observed in the nonmanagement control condition (P≤0.036). Similarly, a smaller increase in OSDI and DEQ-5 was obtained with the use of artificial tears and blink control in comparison with the control condition (P≤0.008), whereas a greater increase in DEQ-5 and decrease in NIKBUT was obtained for the blue light filter condition in comparison with the instillation of artificial tears (P=0.017) or blink control (P=0.008), respectively. Finally, a significantly lower post-task pupil size was obtained for all the conditions (P≤0.027). CONCLUSIONS The instillation of artificial tears and blink control were the best management strategies for preventing short-term effects of digital display use on dry eyes. Conversely, using a blue light filter did not offer any benefits.
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Melatonin Type 2 Receptor Activation Regulates Blue Light Exposure-Induced Mouse Corneal Epithelial Damage by Modulating Impaired Autophagy and Apoptosis. Int J Mol Sci 2022; 23:ijms231911341. [PMID: 36232639 PMCID: PMC9569495 DOI: 10.3390/ijms231911341] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 12/02/2022] Open
Abstract
The MT1/2 receptors, members of the melatonin receptor, belong to G protein-coupled receptors and mainly regulate circadian rhythms and sleep in the brain. Previous studies have shown that in many other cells and tissues, such as HEK293T cells and the retina, MT1/2 receptors can be involved in mitochondrial homeostasis, antioxidant, and anti-inflammatory responses. In our study, we aimed to investigate the effects of blue light (BL) exposure on the expression of melatonin and its receptors in the mouse cornea and to evaluate their functional role in corneal epithelial damage. After exposing 8-week-old C57BL/6 mice to BL at 25 and 100 J/cm2 twice a day for 14 days, a significant increase in the expression of 4-HNE and MT2 was observed in the cornea. MT2 antagonist-treated mice exposed to BL showed an increased expression of p62 and decreased expression of BAX and cleaved caspase 3 compared with mice exposed only to BL. In addition, MT2 antagonist-treated mice showed more enhanced MDA and corneal damage. In conclusion, BL exposure can induce MT2 expression in the mouse cornea. MT2 activation can modulate impaired autophagy and apoptosis by increasing the expression of BAX, an apoptosis activator, thereby regulating the progression of corneal epithelial damage induced by BL exposure.
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Yue H, Yue X, Zhang X, Liu B, Bao H. Exploring the relationship between social exclusion and smartphone addiction: The mediating roles of loneliness and self-control. Front Psychol 2022; 13:945631. [PMID: 36046412 PMCID: PMC9421163 DOI: 10.3389/fpsyg.2022.945631] [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: 05/16/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Previous studies have identified many antecedents of smartphone addiction. However, social exclusion as a risk factor for smartphone addiction has not been widely studied, and little is known concerning the psychological mechanism underlying this association. The present study tested the influence of social exclusion on smartphone addiction as well as the mediating roles of loneliness and self-control in this relationship. An online survey was conducted, and the sample consisted of 573 university students (323 females). The results revealed that (1) social exclusion was a positive predictor of smartphone addiction; (2) loneliness and self-control separately mediated the association between social exclusion and smartphone addiction; and (3) loneliness and self-control sequentially mediated the relation between social exclusion and smartphone addiction. Possible explanations were discussed. The findings of the current study would contribute to understanding the relationships between these study variables as well as the psychological mechanisms underlying these associations.
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Affiliation(s)
- Heng Yue
- School of Psychology, Inner Mongolia Normal University, Hohhot, China
| | - Xiwen Yue
- Beidou College, Wuhan Qingchuan University, Wuhan, China
| | - Xuemin Zhang
- School of Psychology, Inner Mongolia Normal University, Hohhot, China
| | - Bo Liu
- School of Psychology, Inner Mongolia Normal University, Hohhot, China
| | - Hugejiletu Bao
- College of Physical Education, Inner Mongolia Normal University, Hohhot, China
- *Correspondence: Hugejiletu Bao,
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Changes in the tear film and meibomian gland morphology between preclinical dry eye and normal subjects represented by ocular surface disease index scores. Exp Eye Res 2022; 222:109188. [PMID: 35841949 DOI: 10.1016/j.exer.2022.109188] [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: 03/16/2022] [Revised: 06/15/2022] [Accepted: 07/05/2022] [Indexed: 11/22/2022]
Abstract
Tear film and MG morphology play an essential role in detecting dry eyes and Meibomian Gland Dysfunction (MGD). Previous studies have reported these changes in cases diagnosed with dry eyes. However, it is important to study these changes among subjects with symptoms of dry eyes without signs. Hence, this study evaluated the changes in the tear film and meibomian gland (MG) morphology among subjects with pre-clinical dry eye and compared it with the normals defined by the Ocular Surface Disease Index score. One hundred and fifty subjects were enrolled in this prospective cross-sectional study. All the subjects completed the Ocular Surface Disease Index (OSDI) questionnaire and the Computer Vision Syndrome Questionnaire (CVS-Q). Tear film tests such as non-invasive break-up time (NIBUT), tear meniscus height (TMH), lipid layer pattern, Schirmer's test, and corneal staining were performed. Images were captured from both the upper and the lower eyelids to study the MG morphology. TMH, MG length, thickness, loss, and tortuosity were measured using ImageJ software. Subjects were differentiated into two groups based on an OSDI threshold score of ≥13 as preclinical dry eye and normals. Among all the subjects, 43.6% of them were categorized as pre-clinical dry eye, and 56.4% as normals. In the pre-clinical dry eye group, a significant reduction in NIBUT (Z = -2.13, p = 0.03) and MG length of the lower lid (Z = -2.58, p = 0.01) was found when compared to normals. TMH, Schirmer's test, and MG width did not vary among both groups (p > 0.05). Similarly, MG loss and tortuosity score was higher in the pre-clinical dry eye group, but did not show any statistical significance (p > 0.05). The majority of the young individuals presenting for the regular eye examination may have pre-clinical dry eye based on their OSDI scores. Hence, it is important to administer the OSDI questionnaire and perform non-invasive tests such as NIBUT and IR imaging of MG as a part of the routine eye examination.
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Smartphone gaming induces dry eye symptoms and reduces blinking in school-aged children. Eye (Lond) 2022; 37:1342-1349. [PMID: 35668140 PMCID: PMC9169596 DOI: 10.1038/s41433-022-02122-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose Smartphone use by children is rising rapidly, but its ocular surface impact is unknown. This study examined the effect of smartphone use on blinking, symptoms, and tear function in children. Methods Prospective intervention study where 36 children aged 6–15years (14 M:22 F) played games on a smartphone continuously for one hour. Symptoms (SANDE, IOSS, NRS) and tear film (lipid layer thickness, tear secretion, stability) were assessed before and after gaming. Blink rate and interblink interval were measured in situ using an eye tracking headset, before (during conversation) and continuously throughout gaming. Symptoms and tear film changes were examined using paired t-tests. Changes in blinking throughout one hour were examined using repeated measures ANOVA, post-hoc comparisons with Bonferroni correction. Associations examined using Pearson bivariate correlation. Significance level was 0.05. Results Symptoms worsened following one hour smartphone gaming (SANDE + 8.2units, p = 0.01; IOSS + 1.3units, p < 0.001; NRS-average +6.3units, p = 0.03; NRS-comfort +7.6units, p = 0.04; NRS-tiredness +10.1units, p = 0.01), but tear film remained unchanged. Blink rate reduced from 20.8 blinks/min to 8.9 blinks/min (p < 0.001) and interblink interval increased from 2.9 s to 8.7 s (p = 0.002) within the first minute of gaming relative to baseline conversation, and this effect remained unchanged throughout one hour of gaming. Conclusions Smartphone use in children results in dry eye symptoms and immediate and sustained slowing of blinking, with no change in tear function evident up to one hour. Given the ubiquitous use of smartphones by children, future work should examine whether effects reported herein persist or get worse over a longer term causing cumulative damage to the ocular surface.
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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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Talens-Estarelles C, García-Marqués JV, Cerviño A, García-Lázaro S. Digital display use and contact lens wear: Effects on dry eye signs and symptoms. Ophthalmic Physiol Opt 2022; 42:797-806. [PMID: 35394083 DOI: 10.1111/opo.12987] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE To assess the potential additive effects of short-term display use and contact lens (CL) wear on the ocular surface and tear film. METHODS Thirty-four healthy volunteers (20.87 ± 2.33 years old) participated in this study. Participants' dry eye symptoms, ocular surface, tear film and pupil size were assessed before and after executing a 20-min reading task on a computer and a smartphone with and without CL wear, or with CL wear and artificial tear instillation. Measurements included the Ocular Surface Disease Index (OSDI) questionnaire; 5-item Dry Eye Questionnaire (DEQ-5); tear meniscus height (TMH); noninvasive keratograph break-up time (NIKBUT); bulbar conjunctival redness (BR) and pupil size. RESULTS Higher symptoms were reported after reading on both displays with and without CLs (p ≤ 0.001) for short periods. BR was higher and NIKBUT shorter after reading on the computer regardless of wearing CLs (p ≤ 0.02 and p ≤ 0.02, respectively), while TMH increased for all conditions (p ≤ 0.02) except for CL computer reading (p = 0.23). Reading with CLs did not lead to greater signs of dry eye (BR, NIKBUT) and symptoms compared with reading unaided (p > 0.05), although a smaller increase in TMH was observed when reading on the computer with CLs (p = 0.005). Artificial tear instillation during CL wear led to a smaller increase in symptoms (p ≤ 0.02), a smaller increase in BR (p ≤ 0.04) and a decrease in NIKBUT (p = 0.02) compared to reading without correction. CONCLUSIONS Disposable CL wear had no additive effects on signs and symptoms of dry eye when using digital devices for short periods. The instillation of artificial tears is an effective strategy for reducing the impact of display use in CL wearers.
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Affiliation(s)
- Cristian Talens-Estarelles
- Optometry Research Group, Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - José Vicente García-Marqués
- Optometry Research Group, Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - Alejandro Cerviño
- Optometry Research Group, Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - Santiago García-Lázaro
- Optometry Research Group, Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
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Uzun SL, Topcu H. The relationship of distance learning with ocular surface disorders in students in the COVID-19 pandemic. Int Ophthalmol 2022; 42:3045-3051. [PMID: 35377033 PMCID: PMC8978497 DOI: 10.1007/s10792-022-02290-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/12/2022] [Indexed: 11/28/2022]
Abstract
Purpose To evaluate ocular surface disorders in students whose daily screen time increased due to distance learning during the COVID-19 pandemic. Methods Eighty-eight eyes of 44 cases were included in this cross-sectional study. The distance learning students with complaints of redness, stinging, and increased blinking were evaluated. Biomicroscopic examination findings, spherical equivalent, keratometry values, and average daily average screen time were recorded. Ocular Surface Disease Index (OSDI) survey and non-contact tear film breakup time (BUT) assessment (Topcon CA-800) were performed. Results Forty-four cases between 15 and 25 years old were evaluated; 25 were girls (56.8%), 19 were boys (43.2%), and the mean age was 19.2 ± 3.9 years (15–25). The mean daily screen time was 4.9 ± 0.9 h. The mean non-contact BUT was 3.18 ± 2.0 s (1.24–8.80 s), and the spherical equivalent was -1.39 ± 1.79. Punctate epitheliopathy was present in 33 eyes (37.5%) on biomicroscopic examination. The mean OSDI score was 37.12 ± 20.30 (10–75) points. A significant positive correlation was present between daily average screen time, punctate epitheliopathy (r = 0,341; p = 0,001), and OSDI score (r = 0,510; p < 0,001). There was also a significant positive correlation between the OSDI score and punctate epitheliopathy (r = 0.754; p < 0.001). There was no significant correlation between the non-contact BUT and punctate epitheliopathy, OSDI score, or daily screen time (p > 0.05). Conclusion Ocular surface disorders in students can be associated with increasing daily screen time due to distance learning.
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Affiliation(s)
- Seda Liman Uzun
- Department of Ophthalmology, Fethi Sekin City Hospital, Elazıg, Turkey
| | - Husna Topcu
- Department of Ophthalmology, UHS Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
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Talens-Estarelles C, García-Marqués JV, Cerviño A, García-Lázaro S. Ocular surface predisposing factors for digital display-induced dry eye. Clin Exp Optom 2022; 106:373-379. [PMID: 35254958 DOI: 10.1080/08164622.2022.2048173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
CLINICAL RELEVANCE The use of digital displays is recognised as a consistent risk factor for dry eye disease. BACKGROUND To identify ocular parameters contributing to the impact of computer use on dry eye. METHODS The ocular surface of 82 undergraduate students with a mean age of 22.8 ± 2.1 years was assessed at baseline and after reading on a computer for 30 minutes. Measurements included the ocular surface disease index (OSDI) questionnaire, 5-item dry eye questionnaire (DEQ-5), tear meniscus height, non-invasive keratograph break-up time (NIKBUT), conjunctival bulbar redness, meibomian gland dropout percentage, spontaneous blink rate and percentage of incomplete blinks. Multiple linear regressions and generalised linear mixed models were conducted to explore the associations between baseline parameters and pre-task - post-task differences and to predict the impact of computer use, respectively. RESULTS Greater dry eye symptoms (p < 0.0005), higher tear meniscus height and conjunctival bulbar redness (p < 0.0005 and p = 0.012, respectively) and shorter NIKBUT (p = 0.03) were obtained after reading on the computer for 30 minutes. The baseline score obtained with the OSDI and DEQ-5 was positively associated with the increase in symptoms with computer use (p < 0.0005), while the change in conjunctival redness and pre-task NIKBUT were associated with the change in NIKBUT (p ≤ 0.005). No ocular surface parameter revealed an association with tear meniscus height changes. Having a positive OSDI score at baseline increased the odds of painful and sore eyes (p = 0.012), while a higher pre-task NIKBUT increased the odds of a reduction in tear stability (p = 0.038). CONCLUSIONS Participants with greater dry eye symptoms were more likely to experience a greater increase in symptomatology with computer operation, while the participants with longer NIKBUT and greater conjunctival redness were more likely to suffer a greater reduction in tear stability.
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Affiliation(s)
- Cristian Talens-Estarelles
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
| | - José Vicente García-Marqués
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
| | - Alejandro Cerviño
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
| | - Santiago García-Lázaro
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
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Barabino S. Is dry eye disease the same in young and old patients? A narrative review of the literature. BMC Ophthalmol 2022; 22:85. [PMID: 35193524 PMCID: PMC8861619 DOI: 10.1186/s12886-022-02269-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 01/20/2022] [Indexed: 12/30/2022] Open
Abstract
Advanced age is one of the most evident risk factors for dry eye disease (DED), with male/female sex, chronic drug consumption, and prolonged device use. This article aims to review the literature about the changes of the ocular surface associated with DED in the elderly and patients < 40 years. The pathophysiologic changes of the ocular surface responsible for eye dryness are linked with inflammation and neurosensory abnormalities and may occur with a different feature in young patients compared with elders. Peculiar treatment strategies may be needed for young and older subjects with DED.
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Affiliation(s)
- Stefano Barabino
- Ocular Surface & Dry Eye Center, ASST Fatebenefratelli-Sacco, Ospedale L. Sacco, Università di Milano, via GB Grassi, 57, 20157, Milan, Italy.
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Navel V, Sapin V, Henrioux F, Blanchon L, Labbé A, Chiambaretta F, Baudouin C, Dutheil F. Oxidative and antioxidative stress markers in dry eye disease: A systematic review and meta-analysis. Acta Ophthalmol 2022; 100:45-57. [PMID: 33938134 DOI: 10.1111/aos.14892] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/10/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To conduct a systematic review and meta-analysis on the levels of oxidative stress markers and antioxidants in dry eye disease (DED) compared with healthy subject. METHOD The PubMed, Cochrane Library, Embase, Science Direct and Google Scholar databases were searched on 10 January 2021 for studies reporting oxidative and antioxidative stress markers in DED and healthy controls. Main meta-analysis was stratified by type of biomarkers, type of samples (tears, conjunctival cells or biopsies), Sjögren's syndrome (SS) (patients with or without SS) and by geographical zones (Asia or Europe). RESULTS We included nine articles, for a total of 333 patients (628 eye samples) with DED and 165 healthy controls (451 eye samples). There is an overall increase in oxidative stress markers in DED compared with healthy controls (standard mean deviation = 2.39, 95% confidence interval 1.85-2.94), with a significant increase in lipid peroxide (1.90, 0.69-3.11), myeloperoxidase (2.17, 1.06-3.28), nitric oxide synthase 3 (2.52, 0.95-4.08), xanthine oxidase/oxidoreductase (2.41, 1.40-5.43), 4-hydroxy-2-nonenal (4HNE) (4.75, 1.67-7.84), malondialdehyde (3.00, 2.55-3.45) and reactive oxygen species (1.31, 0.94-1.68). Oxidative stress markers were higher in tears, conjunctival cells and conjunctival biopsies of DED than controls. Even if small number of studies were included for antioxidants, catalase seemed to be decreased in DED compared with healthy controls (-2.17, -3.00 to -1.34), with an increase of antioxidants in tears of DED patients without SS (1.13, 0.76-1.49). CONCLUSION Oxidative stress markers, and probably antioxidants, were dysregulated in DED, establishing a local oxidative environment in tears, conjunctival cells and tissues.
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Affiliation(s)
- Valentin Navel
- University Hospital of Clermont‐Ferrand CHU Clermont‐Ferrand, Ophthalmology Clermont‐Ferrand France
- Université Clermont Auvergne CNRS UMR 6293 INSERM U1103 Genetic Reproduction and Development Laboratory (GReD) Translational Approach to Epithelial Injury and Repair Team Clermont‐Ferrand France
| | - Vincent Sapin
- Université Clermont Auvergne CNRS UMR 6293 INSERM U1103 Genetic Reproduction and Development Laboratory (GReD) Translational Approach to Epithelial Injury and Repair Team Clermont‐Ferrand France
- University Hospital of Clermont‐Ferrand CHU Clermont‐Ferrand, Biochemistry and Molecular Genetics Clermont‐Ferrand France
| | - Fanny Henrioux
- Université Clermont Auvergne CNRS UMR 6293 INSERM U1103 Genetic Reproduction and Development Laboratory (GReD) Translational Approach to Epithelial Injury and Repair Team Clermont‐Ferrand France
| | - Loïc Blanchon
- Université Clermont Auvergne CNRS UMR 6293 INSERM U1103 Genetic Reproduction and Development Laboratory (GReD) Translational Approach to Epithelial Injury and Repair Team Clermont‐Ferrand France
| | - Antoine Labbé
- Department of Ophthalmology III Quinze‐Vingts National Ophthalmology Hospital IHU FOReSIGHT Paris France
- Sorbonne Université INSERM CNRS Institut de la Vision Paris France
- Department of Ophthalmology Ambroise Paré Hospital APHP Université de Versailles Saint‐Quentin en Yvelines Versailles France
| | - Frédéric Chiambaretta
- University Hospital of Clermont‐Ferrand CHU Clermont‐Ferrand, Ophthalmology Clermont‐Ferrand France
- Université Clermont Auvergne CNRS UMR 6293 INSERM U1103 Genetic Reproduction and Development Laboratory (GReD) Translational Approach to Epithelial Injury and Repair Team Clermont‐Ferrand France
| | - Christophe Baudouin
- Department of Ophthalmology III Quinze‐Vingts National Ophthalmology Hospital IHU FOReSIGHT Paris France
- Sorbonne Université INSERM CNRS Institut de la Vision Paris France
- Department of Ophthalmology Ambroise Paré Hospital APHP Université de Versailles Saint‐Quentin en Yvelines Versailles France
| | - Frédéric Dutheil
- Université Clermont Auvergne CNRS LaPSCo Physiological and Psychosocial Stress CHU Clermont‐Ferrand University Hospital of Clermont‐Ferrand, Preventive and Occupational Medicine Witty Fit Clermont‐Ferrand France
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Kazanci B, Eroglu FC. The Effects of Daily Digital Device Use on the Ocular Surface in Healthy Children. Optom Vis Sci 2022; 99:167-171. [PMID: 34889855 DOI: 10.1097/opx.0000000000001840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Digital device usage among children has increased significantly in recent years. Prolonged screen exposure can have adverse effects on the eye, especially on the ocular surface. PURPOSE We aimed to evaluate the duration of screen exposure and its effect on the ocular surface in healthy children aged 10 to 18 years. METHODS This cross-sectional observational study included 200 healthy children. Screen exposure times of the children were ascertained, and the effect of screen exposure on the ocular surface was evaluated using tear breakup time, kerato-epitheliopathy (Oxford) score, and Schirmer test. The Ocular Surface Disease Index (OSDI) was used to assess subjective dry eye symptoms. Findings for subjects with a daily screen exposure time of fewer than 2 hours were compared with those reporting more than 2 hours of screen time. Statistical evaluation included the Shapiro-Wilk test, Student t test, and Pearson correlation analysis. RESULTS The mean ± standard deviation (SD) age was 14 ± 2.6 years, and 88.5% of the participants used mobile phones or computers every day. The mean ± SD tear breakup time was 10.3 ± 4.1 seconds, and the Schirmer test score was 15.6 ± 4.7 mm. The Oxford score was 0.4 ± 1, and no corneal staining was detected in 83.5% of the subjects. The mean ± SD OSDI score was 23.5 ± 17.8, and 67.5% of subjects had a mild-to-severe ocular surface disease. When daily screen exposure times less than and greater than 2 hours were compared, there was no statistically significant difference between the two groups in tear breakup time, Schirmer test, Oxford score, and OSDI score. Whereas there was a statistically significant weak positive correlation (r = 0.307, P = .001) between OSDI score and screen exposure time, there was no correlation between tear breakup time, Schirmer test, and Oxford score and screen exposure time. CONCLUSIONS Screen exposure in healthy children may cause ocular surface symptoms without causing changes in ocular surface findings.
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Affiliation(s)
| | - Fatma Corak Eroglu
- Department of Ophthalmology, Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ankara, Turkey
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Yoon HJ, Jang WH, An S, Ji YS, Yoon KC. Tear Neuromediators in Subjects with and without Dry Eye According to Ocular Sensitivity. Chonnam Med J 2022; 58:37-42. [PMID: 35169558 PMCID: PMC8813648 DOI: 10.4068/cmj.2022.58.1.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/29/2021] [Accepted: 12/31/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hyeon-Jeong Yoon
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Won-Hee Jang
- Safety and Microbiology Lab, Amorepacific R&D Center, Yongin, Korea
| | - Susun An
- Safety and Microbiology Lab, Amorepacific R&D Center, Yongin, Korea
| | - Yong Sok Ji
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Kyung Chul Yoon
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
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40
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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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Issa LF, Alqurashi KA, Althomali T, Alzahrani TA, Aljuaid AS, Alharthi TM. Smartphone Use and its Impact on Ocular Health among University Students in Saudi Arabia. Int J Prev Med 2021; 12:149. [PMID: 34912525 PMCID: PMC8631113 DOI: 10.4103/ijpvm.ijpvm_382_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/15/2020] [Indexed: 11/04/2022] Open
Abstract
Background People are increasingly using mobile phones rather than fixed telephones. Nearly everyone has a mobile phone and the vast majority of these are smartphone. The patterns of smartphone activities may put a significant number of populations especially students at risk of negative ocular problems. To determine the prevalence, pattern, and impact of smartphone use on ocular health among University students. Methods A cross-sectional study was conducted and 760 male and female students were selected from Medical and Pharmacy Colleges by multistage random sampling. A self-administered structured questionnaire including sociodemographic and visual manifestations data was used to collect data. SPSS program version 22 was used to analyze data. Results Out of 760 students selected, 546 (71.8%) responded. The overall prevalence of smartphone use was 90.84%. However, the age range for the beginning of smartphone use was 12-18 years old (68.3%). In addition, the daily duration of smartphone use was 4-6 h/day (30.2%). Furthermore, females believed that they use smartphone more than usual compared to males. Moreover, ocular pain and/or dryness after prolonged time spent on smartphone use were more among smartphone users (39.7%). Finally, most of the students (66.0%) had one or more ocular problems after smartphone use. Conclusions There is an association between smartphone use and occurrence of ocular manifestations. Health education programs on smartphone use and its ocular hazards are highly recommended.
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Affiliation(s)
- Lotfi F Issa
- Department of Family and Community Medicine, College of Medicine, Taif University, Saudi Arabia.,Department of Public Health and Community Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Talal Althomali
- Department of Ophthalmology, College of Medicine, Taif University, Saudi Arabia
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Talens-Estarelles C, Esteve-Taboada JJ, Sanchis-Jurado V, Pons ÁM, García-Lázaro S. Blinking kinematics characterization during digital displays use. Graefes Arch Clin Exp Ophthalmol 2021; 260:1183-1193. [PMID: 34779906 PMCID: PMC8913463 DOI: 10.1007/s00417-021-05490-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/23/2021] [Accepted: 11/04/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose This study aimed to assess the differences in blinking kinematics while reading on different digital displays and a control condition. Methods Thirty-two young healthy individuals were included in this prospective clinical study. The blinks of subjects were recorded for 150 s while reading on a laptop computer, tablet, e-reader, and smartphone and a control condition. Blinks were recorded using an eye-tracking device and were analyzed by means of image analysis to obtain a non-invasive detailed description of the blink movement. Results Blink rate decreased when reading on all displays compared to the control (p < 0.0005), although no differences were obtained amongst displays (p > 0.05). The percentage of incomplete blinks was higher with the computer compared to the control (p = 0.043), and lower with the smartphone compared to the rest of the conditions (p ≤ 0.015). Blink amplitude was smaller when reading from handheld devices compared to the control (p < 0.0005) and the computer (p ≤ 0.048). Closing and opening blink durations remained unvaried amongst conditions (p > 0.05), while opening and closing speeds were greater for the control and the computer compared to the handheld displays (p < 0.0005). Finally, contact and total blink durations were shorter during computer reading compared to the control (p = 0.004 and p = 0.017, respectively). Conclusion Blinking kinematics vary considerably amongst displays and with respect to baseline, with these differences being probably attributed to differences in the way the displays are set up and the cognitive demand of the task.
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Affiliation(s)
- Cristian Talens-Estarelles
- Department of Optics & Optometry & Vision Sciences, University of Valencia, Dr. Moliner, 50, 46100, Burjassot, Valencia, Spain.
| | - José Juan Esteve-Taboada
- Department of Optics & Optometry & Vision Sciences, University of Valencia, Dr. Moliner, 50, 46100, Burjassot, Valencia, Spain
| | - Vicent Sanchis-Jurado
- Department of Optics & Optometry & Vision Sciences, University of Valencia, Dr. Moliner, 50, 46100, Burjassot, Valencia, Spain
| | - Álvaro M Pons
- Department of Optics & Optometry & Vision Sciences, University of Valencia, Dr. Moliner, 50, 46100, Burjassot, Valencia, Spain
| | - Santiago García-Lázaro
- Department of Optics & Optometry & Vision Sciences, University of Valencia, Dr. Moliner, 50, 46100, Burjassot, Valencia, Spain
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Bakkar MM, El-Sharif AK, Al Qadire M. Validation of the Arabic version of the Ocular Surface Disease Index Questionnaire. Int J Ophthalmol 2021; 14:1595-1601. [PMID: 34667738 DOI: 10.18240/ijo.2021.10.18] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/17/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To develop an Arabic version of the ocular surface disease index (OSDI) and to assess its reliability and validity. METHODS A cross sectional study was carried out to validate the Arabic version of the OSDI questionnaire. Initially, forward-backward translation was used to translate the English version of OSDI into Arabic. The translated questionnaire was tested for equivalence and cultural adaptability. Totally 200 subjects were then recruited from a non-clinical population and asked to complete the Arabic version of the OSDI (ARB-OSDI). The reliability of the questionnaire was assessed using Cronbach's-α. A subgroup of 30 participants was asked to complete the questionnaire on two occasions to test the test-retest reliability. RESULTS A total of 200 participants were enrolled in the study. The average age of the study participants was 31.21±13.2y and 57% were male. An acceptable internal consistency level for the ARB-OSDI questionnaire measured by Cronbach's-α was revealed. All questions showed good internal consistency. Test-retest reliability analysis revealed good stability (interclass correlation coefficient, r=0.832, P<0.001). The construct validity for the questionnaire was also high. CONCLUSION The ARB-OSDI questionnaire shows very good psychometric properties (acceptable internal consistency and test-retest reliability). That makes the questionnaire a valid potential tool to use in Arabic-speaking countries to monitor symptoms of dry eye disease in a larger population.
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Affiliation(s)
- May M Bakkar
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ahmad K El-Sharif
- Department of English Language and Literature, Faculty of Arts and Humanities, Al Al-Bayt University, Mafraq 25113, Jordan
| | - Mohammad Al Qadire
- Department of Adult Health, Faculty of Nursing, Al Al-Bayt University, Mafraq 25113, Jordan.,College of Nursing, Sultan Qaboos University, Muscat 123, Oman
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Talens-Estarelles C, García-Marqués JV, Cervino A, García-Lázaro S. Online Vs In-person Education: Evaluating the Potential Influence of Teaching Modality on Dry Eye Symptoms and Risk Factors During the COVID-19 Pandemic. Eye Contact Lens 2021; 47:565-572. [PMID: 34224445 DOI: 10.1097/icl.0000000000000816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the potential effects of switching to online lecture format on dry eye symptoms and dry eye disease (DED) risk factors. METHODS An anonymous cross-sectional online survey was conducted in 812 university students (mean age, 21.5±4.0 years). Participants were classified according to the number of hours the participants took online lectures into online students or in-person students. Respondents completed a total of three DED questionnaires (Ocular Surface Disease Index [OSDI]; 5-item Dry Eye Questionnaire; 8-item Contact Lens Dry Eye Questionnaire) and were surveyed on dry eye risk factors contemplated by the Tear Film and Ocular Surface Society Dry Eye Workshop II in addition to other factors potentially linked to dry eye. RESULTS Five hundred twenty-three subjects (64.4%) were classified into the online group and 289 (35.6%) into the in-person group. No statistically significant age (P=0.266) or sex (P=0.423) differences were found between groups. Students taking online lectures used the computer more, spent less time outdoors, practised more exercise, wore a face mask for less time, experienced fewer allergies and fewer psoriasis episodes, and obtained a higher OSDI score (P<0.029 for all). Multivariate logistic regression analysis revealed that the hours of online lectures taken per week was independently associated with having a positive OSDI score (P=0.022). CONCLUSIONS Taking online lectures is independently associated with having dry eye symptoms. Despite a lower prevalence of DED risk factors, a higher computer use is probably behind the greater ocular dryness reported by online students.
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Affiliation(s)
- Cristian Talens-Estarelles
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
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Bettach E, Zadok D, Abulafia A, Shoshani A, Ghebali RA, Weill Y, Smadja D. Influence of Reading on Smartphone Screens on Visual Optical Quality Metrics and Tear Film Stability. Cornea 2021; 40:1309-1315. [PMID: 33470679 DOI: 10.1097/ico.0000000000002656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/25/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the impact of a prolonged reading session on a smartphone screen on optical quality metrics and tear film stability. METHODS This prospective study was conducted in 41 healthy volunteers who were asked to read an article on a smartphone screen for 20 minutes. The following tests were performed before the reading task in this consecutive order and repeated after the reading task in the same order: automated noninvasive tear break-up time, optical quality assessment including Objective Scatter Index (OSI), modulation transfer function, Strehl ratio, and tear film dynamic analysis as follows: vision break-up time (VBUT) as a function of OSI changes within 20 seconds, using a double-pass aberrometer imaging system, and fluorescein tear break-up time (FBUT) measured using the slit lamp. RESULTS All break-up time-related parameters (noninvasive tear break-up time, FBUT and VBUT) were significantly reduced after the reading task (P < 0.01). The OSI was significantly worsened after the reading task (P = 0.01), whereas all the other optical quality metrics (modulation transfer function and Strehl ratio) slightly deteriorated, were not statistically significant. A significant correlation was found between the shortening of the FBUT, VBUT, and the worsening of the OSI (r = -0.33, P < 0.05). CONCLUSIONS A reading session on a smartphone screen in healthy subjects was found to significantly affect the tear film stability and objectively worsen the retinal image quality.
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Affiliation(s)
- Emmanuel Bettach
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel; Affiliated with the Hebrew University of Jerusalem; and
- iSEARCH, Innovation Shaarezedek Eye Advanced Research Center Hub, Jerusalem, Israel
| | - David Zadok
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel; Affiliated with the Hebrew University of Jerusalem; and
- iSEARCH, Innovation Shaarezedek Eye Advanced Research Center Hub, Jerusalem, Israel
| | - Adi Abulafia
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel; Affiliated with the Hebrew University of Jerusalem; and
- iSEARCH, Innovation Shaarezedek Eye Advanced Research Center Hub, Jerusalem, Israel
| | - Avi Shoshani
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel; Affiliated with the Hebrew University of Jerusalem; and
- iSEARCH, Innovation Shaarezedek Eye Advanced Research Center Hub, Jerusalem, Israel
| | - Rony A Ghebali
- iSEARCH, Innovation Shaarezedek Eye Advanced Research Center Hub, Jerusalem, Israel
| | - Yishay Weill
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel; Affiliated with the Hebrew University of Jerusalem; and
- iSEARCH, Innovation Shaarezedek Eye Advanced Research Center Hub, Jerusalem, Israel
| | - David Smadja
- Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel; Affiliated with the Hebrew University of Jerusalem; and
- iSEARCH, Innovation Shaarezedek Eye Advanced Research Center Hub, Jerusalem, Israel
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Al-Marri K, Al-Qashoti M, Al-Zoqari H, Elshaikh U, Naqadan A, Saeed R, Faraj J, Shraim M. The relationship between smartphone use and dry eye disease: A systematic review with a narrative synthesis. Medicine (Baltimore) 2021; 100:e27311. [PMID: 34559146 PMCID: PMC10545216 DOI: 10.1097/md.0000000000027311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Emerging research findings suggest a potential relationship between smartphone use (SPU) and dry eye disease (DED), which has not been systematically reviewed. OBJECTIVES The aim of this study was to systematically review and synthesize evidence on the relationship between SPU and DED. METHODS A systematic search of Medline, EMBASE, CINAHL, and PsychINFO bibliographic databases from their inception to January 15, 2021. Study screening, full-text assessment, study selection and exclusion, data extraction, and quality assessment was performed independently by at least two review authors. RESULTS Four studies were included in the review (3 cross-sectional studies and 1 nonrandomized clinical trial). A narrative synthesis of findings was used due to heterogeneity among study designs and measures of association summarizing the relationship between SPU and DED. All included studies were conducted in South Korea and included school children, college students, or young adults. Three of the 4 included studies showed an association between SPU and DED. CONCLUSIONS There is some evidence that SPU is associated with DED. However, this evidence is limited by a small number of studies of satisfactory methodological quality. There is a great need for high-quality studies to further investigate the relationship between SPU and DED and identify mechanisms underlying this potential relationship. This information is important for raising public awareness about the negative effect of SPU on eye health and development of clinical guidelines for this potentially emerging SPU-driven eye condition.
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Geurts SM, Koning IM, Vossen H, Van den Eijnden RJ. A Qualitative Study on Children's Digital Media Use and Parents' Self-interest. JOURNAL OF CHILD AND FAMILY STUDIES 2021; 31:2015-2026. [PMID: 34580571 PMCID: PMC8458790 DOI: 10.1007/s10826-021-02074-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
This qualitative study provides insight into the role of parents' self-interest in digital media use of children in different age groups. We conducted 31 semi-structured interviews with fathers/mothers of children aged 3-16 years who were recruited via targeted sampling. A deductive and inductive content analysis was applied. Results show that parents' self-interest in letting children use digital media includes being able to do other tasks without being bothered, having some me-time, managing children's behavior, avoiding discussions, having moments to use digital media themselves and spending quality-time together. In addition, we found that the manner in which parents let children use digital media out of self-interest seems to depend on age. With younger children, parents initiate digital media use or set times at which children are allowed to use digital media. With older children, parents use a passive manner by omitting restrictive responses to their children's media use. Current findings can be used to inform interventions aimed at reducing children's screen time.
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Affiliation(s)
- Suzanne M. Geurts
- Interdisciplinary Social Science, Youth Studies, Utrecht University, Padualaan 14, 3584 CH Utrecht, The Netherlands
| | - Ina M. Koning
- Interdisciplinary Social Science, Youth Studies, Utrecht University, Padualaan 14, 3584 CH Utrecht, The Netherlands
| | - Helen Vossen
- Education and Pedagogy, Clinical Child and Family Studies, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
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Bonini S, Labetoulle M, Messmer E, Aragona P, Benitez Castillo JM, Ciprandi G, Damiani V, Irkec M, Baudouin C, Rolando M. Association of Dry Eye with Laryngopharyngeal Reflux in Clinical Practice. Curr Eye Res 2021; 47:214-219. [PMID: 34437824 DOI: 10.1080/02713683.2021.1971721] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Dry eye disease (DED) is a common disorder, accounting for up to 35% of the general population. Therefore, we hypothesized that laryngopharyngeal reflux (LPR), inducing refluxate rising into airways, may involve the ocular surface and may either induce or worsen DED. AIM To investigate the prevalence and relevance of suspected LPR in DED patients and subjects with refractive problems (RP) without DED, they were defined as non-dry eye group (NEG) in clinical practice. METHODS This retrospective study included consecutive patients evaluated because of dry eye-like symptoms at eight tertiary ophthalmological clinics. Parameters included reflux symptom index (RSI), ocular surface disease index (OSDI), symptom assessment in dry eye (SANDE) for frequency and severity, Schirmer test, tear break-up time (BUT), and Oxford grading. RESULTS The study included 245 subjects (72.5% females; mean age 56.3 years), 152 DED patients, and 93 sex- and age-matched NEG subjects. Pathological RSI (score>13) was detected in 80 subjects (32.6%); 68 (85%) with DED and 12 (15%) CG (OR = 8; p < .0001). In NEG, pathological RSI was associated with higher SANDE (Frequency and Severity), OSDI, and Schirmer scores (OR = 16.36; 14.51; 12.54; and 7.22, respectively. In DED patients, pathological RSI was associated with higher OSDI values (OR = 8.75). CONCLUSION Patients with DED are at eight times higher risk for having pathological RSI than NEG patients. Moreover, pathological RSI was associated with more severe ocular symptoms both in DED and non-DED patients. The role of LPR in definite DED patients remains to be clarified, but this condition deserves to be investigated in managing patients with DED symptoms.
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Affiliation(s)
- S Bonini
- Ophthalmology Department, Campus Bio-Medico University, Rome, Italy
| | - M Labetoulle
- Ophthalmology Départment, Hôpitaux Universitaires Paris-Sud, APHP, Université Paris-Saclay, IDMIT Infrastructure, CEA, Inserm U1184, Fontenay-aux-Roses Cedex, France
| | - E Messmer
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - P Aragona
- Department of Biomedical Sciences, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - J M Benitez Castillo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Clínica Rementeria, Instituto Investigaciones Oftalmologicas Ramon Castroviejo, Universidad Complutense, Madrid, Spain
| | - G Ciprandi
- Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
| | - V Damiani
- DMG Italia Medical Department, Rome, Italy
| | - M Irkec
- Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - C Baudouin
- Quinze-Vingts National Eye Hospital, IHU ForeSight, Paris Saclay University, Paris, France
| | - M Rolando
- Ocular Surface Centre, ISPRE Ophthalmics, Genoa, Italy
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Clinical Performance of Samfilcon A Contact Lenses in Intensive Digital Device Users: A Multicenter, Prospective Clinical Study. Ophthalmol Ther 2021; 10:957-972. [PMID: 34487319 PMCID: PMC8419669 DOI: 10.1007/s40123-021-00389-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction To evaluate patient satisfaction with samfilcon A contact lenses (CLs) in intensive digital device users with myopia and to compare patient satisfaction with samfilcon A lenses to prior experience with senofilcon A or lotrafilcon B CLs. Methods This was a comparative, prospective, national study conducted at 14 centers in Turkey. Subjects were adults aged 18 and 45 years with myopia (range −0.25 D to −6.00 D) who spend a minimum of 3 hours viewing digital devices (e.g., computer, smartphone). A subgroup of patients were habitual lens wearers (senofilcon A or lotrafilcon B lens wear for at least 6 months prior to enrollment). The primary assessment was patient satisfaction with samfilcon A lenses (0–100 Likert scale). Secondary assessments included patient satisfaction with samfilcon A lenses compared to patients’ habitual lenses, investigator satisfaction with samfilcon A lenses and investigator-evaluated slit lamp examination findings. Results Samfilcon A lenses were given high overall ratings from both patients and investigators, with a low incidence of ocular symptoms. Overall, patients were highly satisfied with samfilcon A lenses for comfort, vision and overall performance, and stated that they would consider wearing these lenses in the future. Among habitual senofilcon A or lotrafilcon B lens wearers, samfilcon A lenses were rated significantly better than the habitual lenses in regard to comfort, vision and overall performance. Investigator assessments were also highly favorable, both at initial fit and after 4 weeks of follow-up, with no significant findings noted on slit lamp examination. Conclusion Samfilcon A lenses were rated highly by investigators in regard to fit, handling and slit lamp findings, and by novice and habitual lens wearers in regard to comfort, vision and overall performance. These results support the use of samfilcon A lenses among digital device users who seek day-long comfort and good visual acuity. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-021-00389-4.
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The effects of microwave radiation generated by mobile phones on the tear film. REV ROMANA MED LAB 2021. [DOI: 10.2478/rrlm-2021-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract
Electromagnetic radiation (ER) emitted by mobile phones and other modern devices has potentially harmful effects on ocular tissue. Their effects on the eye surface and tear film are little known so far. The aim of this paper was to investigate the effects of ER emitted by the phone mobile on the tear film. For this study, we selected a total of 50 subjects, young, healthy, without chronic treatment, who are not contact lens wearers and who have no history of ophthalmic surgery. Schirmer I test, tear pH and tear ferning test (TFT) were performed on all subjects before (“-pre”) being exposed to ER emitted by the mobile phone and after (“-post”) exposure for 5 minutes, the pH and TFT of the tears were performed. Following the analysis of the obtained results, we found that there are significant changes in tear quality and increased tear pH, which over time can lead to tear film instability, damage to the eye surface and the appearance of dry eye syndrome.
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