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

Digital eye strain among medical students associated with shifting to e-learning during COVID-19 pandemic: An online survey

PURPOSE

This study aimed to determine the prevalence, risk factors, symptoms, and awareness of computer vision syndrome (CVS) among medical students during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

A cross-sectional observational study was conducted among 283 undergraduate medical students at a tertiary healthcare center. An electronic survey was conducted to collect the data. Data were analyzed using Statistical Package for Social Sciences (SPSS version 23). The Chi-square test (Fisher's exact test when required) was used to study the significance of associations. A P value <0.05 was considered statistically significant.

RESULTS

A high prevalence of CVS was observed in which 92% reported at least one symptom while using a digital device, the most frequent being eye strain (49%). Among extraocular complaints, joint pain in the wrist and fingers was most frequent. Significant association (P < 0.05) of CVS was found with increased duration of digital device usage, refractive error, use of glasses or contact lens, preexisting dry eye disease, and use of topical eye drops. 37% of the participants were aware of the 20-20-20 rule, while only 11% followed it.

CONCLUSION

CVS is a common health concern among medical students. Hence, to increase the productivity of work, significant risk factors need to be addressed and awareness must be raised.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

Although computer vision syndromes are becoming a major public health concern, less emphasis is given to them, particularly in developing countries. There are primary studies on different continents; however, there are inconsistent findings in prevalence among the primary studies. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of computer vision syndrome. In this study, the review was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Online electronic databases, including PubMed/Medline, CINAHL, and Google Scholar, were used to retrieve published and unpublished studies. The study was conducted from December 1 to April 9/2022. Study selection, quality assessment, and data extraction were performed independently by two authors. Quality assessment of the studies was performed using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument tool. Heterogeneity was assessed using the statistical test I². STATA 14 software was used for statistical analysis. A total of 7,35 studies were retrieved, and 45 studies were included in the final meta-analysis. The pooled prevalence of computer vision syndrome was 66% (95% CI: 59, 74). Subgroup analysis based on country was highest in Pakistan (97%, 95% CI: 96, 98) and lowest in Japan (12%, 95% CI: 9, 15). Subgroup analysis based on country showed that studies in Saudi Arabia (I² = 99.41%, p value < 0.001), Ethiopia (I² = 72.6%, p value < 0.001), and India (I² = 98.04%, p value < 0.001) had significant heterogeneity. In the sensitivity analysis, no single study unduly influenced the overall effect estimate. Nearly two in three participants had computer vision syndrome. Thus, preventive practice strategic activities for computer vision syndrome are important interventions.

Analysis of the Outcomes of the Screen-Time Reduction in Computer Vision Syndrome: A Cohort Comparative Study

Purpose

To analyze the outcomes of screen-time reduction on the foveal responses that associates computer vision syndrome (CVS) using multifocal electroretinogram (mfERG) examination.

Methods

This prospective multicenter cohort comparative study included 49 eyes of 49 medical students divided into two groups. Group A (control group) included 25 eyes with no CVS diagnosis while group B (CVS group) included 24 eyes with CVS diagnosis. All students responded to the valid and reliable CVS-Form 3 (CVS-F3) questionnaire and underwent complete ophthalmic and mfERG examinations twice at the time recruitment in the study and four weeks after strict reduction of the daily screen-hours to ≤1 screen-hour daily to document associated foveal responses.

Results

We documented statistically significant reduction in foveal responses in CVS versus control groups in mean mfERG Rings 1, 2, and 5 with Quadrants 1, 2, and 4 (P=<0.0001, 0.0001, 0.0003, 0.001, 0.002, and 0.006, respectively). Following the screen-time reduction, the second mfERG examination revealed significant post-reduction improvements in foveal responses in CVS group particularly in mean mfERG Rings 1, 2, 3, and 5 with Quadrants 1 and 4 (P=<0.0001, <0.0001, 0.0005, 0.02, <0.0001, and 0.04, respectively).

Conclusion

This study documented the screen-induced foveal dysfunction that associates CVS using mfERG examination, which revealed remarkable significant improvements in foveal responses in the 4 weeks following strict screen-time reduction. These improvements were also associated with corresponding improvements in the visual performances. We suggest that the potential screen-induced foveal dysfunction outcomes might be reversible with strict screen-time reduction. We also recommend that educational institutional policies should limit online education-hours and redesign the mandated computer system use program to guard against visual sequelae of CVS.

Clinical Trials Registration

ClinicalTrials.gov (ID: NCT04405648).

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

Objective:

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

Methods:

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

Result:

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

Conclusion:

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

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

BACKGROUND

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

AIM

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

METHODS

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

RESULTS

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

CONCLUSION

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