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

Prevalence, predictive factors, and impacts of internet gaming disorder among adolescents: A population-based longitudinal study

BACKGROUND

Internet gaming disorder (IGD) becomes a growing concern during the digital era, especially with the pandemic's social distancing measures. It is essential to comprehend the psychosocial predictors and impacts of IGD.

METHODS

A two-wave annual panel study was conducted in Zigong, China, utilizing regional sampling through school-based surveys involving upper primary school to high school students. Data were collected in October 2020 (T1, N = 94,020) and October 2021 (T2, N = 60,551). Self-report data were collected on demographic information, internet gaming behavior, and other mental health factors. Cross-lagged panel models (CLPM) were employed to estimate the bidirectional relationships between the variables.

RESULTS

At T1, 65,643 (72.6 %) participants identified as gamers; at T2, this number decreased to 42,213 (69.7 %). T1 IGD symptoms demonstrated predictability for all T2 psychological variables. Within the framework of the CLPM examining the interplay between IGD symptoms, anxiety symptoms, and hyperactivity/inattention, we uncovered significant reciprocal cross-lagged effects between these variables over time. The relationship between T1 IGD symptoms and T2 anxiety symptoms had age-specific differences, with 13-15-year-old boys displaying the highest coefficient, which decreased for the 16-18 age group.

LIMITATIONS

Our study is subject to potential recall bias associated with self-reported retrospective data. Additionally, our analysis assumes temporal ordering between variables, an assumption that may not always hold in complex systems.

CONCLUSIONS

There are reciprocal relationships between IGD symptoms, anxiety symptoms, and hyperactivity/inattention in adolescents, underscoring the imperative need for comprehensive strategies aimed at addressing the impact of IGD on mental health and overall well-being.

Digital Challenges: Investigating Computer Vision Syndrome in Thai Esports Through a Case-Control Approach

Purpose

To determine the factors associated with eyestrain in esports athletes in Bangkok compared with controls.

Patients and Methods

A cross-sectional descriptive study was conducted between April and June 2023, involving 160 male participants (aged 20-35 years) who used digital devices, consisting of esports athletes and a control group. Data were collected using a general information questionnaire, Computer Vision Syndrome Questionnaire (CVS-Q), and Depression anxiety stress scale-21 (DASS-21). Ophthalmic instruments were used for the eye examinations by an optometrist.

Results

Seventy-six esports athletes showed significantly lower visual performance than controls in logMAR visual acuity (p < 0.020), phoria (p < 0.001), negative fusional vergence (blur, break, and recovery) (p < 0.012, p < 0.004 and p < 0.039), positive fusional vergence (blur, break, and recovery) (p < 0.005, p < 0.001 and p < 0.005), monocular estimation method (p < 0.001), monocular and binocular accommodative facility (p < 0.001), and vergence facility (p < 0.001). A study on risk factors for CVS found that esports athletes were significantly more likely to have CVS (p < 0.001). Work environments with high-intensity lighting significantly increase the risk of CVS compared to low-intensity lighting (p < 0.001). The use of a digital device for >4 h/day, having a history of alcohol consumption, and stress significantly increased the risk of CVS (p < 0.001, p < 0.023, p < 0.048).

Conclusion

This study found that esports athletes experienced vision health problems, indicating the need to prevent eyestrain caused by the use of digital devices.

Internet Altruistic Behaviors in Adolescents: Roles of Attention-Deficit/Hyperactivity Disorder, Impulsiveness, and Perceived Social Support

This study examined the associations of an attention-deficit/hyperactivity disorder (ADHD) diagnosis, impulsivity, and perceived social support with Internet altruistic behaviors (IABs) in adolescents and the associations of IABs with depression, suicidality, and nonsuicidal self-injury in this group. In total, 176 adolescents aged between 11 and 18 years with ADHD and 173 adolescents without ADHD (matched with the ADHD group by sex and age) participated in this study. The adolescents rated their IABs on the Internet altruistic behavior scale, impulsivity on the Barratt impulsiveness scale version 11, and perceived family and peer support on the family and social relationship domains of the Taiwanese quality of life questionnaire for adolescents. The associations of ADHD, impulsivity, and social support with IABs and the associations of IABs with depression, suicidality, and nonsuicidal self-injury were examined through multivariable linear regression analysis. The present study found that more time spent on the Internet (p < 0.001), greater perceived peer support (p < 0.001), greater impulsiveness characterized by a lack of self-control and perseverance (p < 0.001), poorer ability to plan and look ahead (p < 0.001), and an ADHD diagnosis (p = 0.003) were significantly associated with a higher level of IABs. IABs were not significantly associated with severe depression, suicidality, or nonsuicidal self-injury (all p > 0.05). The results of this study indicated that multiple individual and social factors were associated with IABs in adolescents. IABs were not significantly associated with severe depression, suicidality, or nonsuicidal self-injury in adolescents.

Investigating the interplay between gaming disorder and functional impairments in professional esports gaming

The relationship between Gaming Disorder (GD) and the experience of functional impairments has received considerable theoretical attention in the recent past and current diagnostic approaches underscore the centrality of functional impairments as a requirement for GD diagnosis. However, there is limited empirical evidence illuminating the interplay between GD and functional impairments, particularly among specific vulnerable groups. The present study seeks to bridge this gap by investigating an English-speaking sample (N = 5198) comprising an age- and gender-matched group of Professional Gamers (PG, n = 2599) and Non-Professional Gamers (NPG, n = 2599) sub-sampled from a larger sample of 192,260 individuals. The results revealed that PG were at a greater risk for GD compared to NPG as the prevalence rate of GD among PG (3.31%) was significantly higher and almost doubled that of NPG (1.73%), with PG further exhibiting higher overall GD symptom-load and weekly time spent gaming compared to NPG. Furthermore, PG reported experiencing significantly higher frequency of gaming-related functional impairments compared to NPG, with the in particular affected areas for both PG and NPG being 'school and/or work', 'physical health', and 'family', with other key differences emerging in relation to other outcomes. Overall, the present findings show that not only GD symptom-load but also some functional impairment is higher in PG compared to NPG which highlights the need to develop and support prevention and intervention strategies for this at-risk population.

Screen Time at 6 Years Old and Visual Function in Early Adolescence

Excessive screen time has been linked to adverse health outcomes in children, including vision-related problems such as myopia. However, very few studies have evaluated the effect of moderate screen exposure on the development of visual functions. This study aimed to examine the association between screen time during middle childhood and color discrimination, contrast sensitivity, and short-range visual acuity in 12-year-old children (n = 305) from the mother-child PELAGIE cohort (France) for the whole sample and for boys and girls separately. Visual functions were assessed using the Freiburg Acuity and Contrast Test and an adapted version of the Cambridge Color Test. Screen exposure was documented using a parent self-report questionnaire. Regression models showed that screen exposure at 6 years of age was significantly associated with higher contrast sensitivity across the entire sample at 12 years of age. However, when controlling for covariates, this association remained statistically significant in girls only. Sex-stratified analyses also showed that moderate screen exposure was linked to improved tritan-axis color vision in boys only. These findings suggest that moderate screen exposure in middle childhood is not harmful to visual function development and as such, provide new insights into the impact of digital technology on children's visual health and development.

Eye movement verification and evaluation of initial sandplay picture system for internet addiction symptoms in Chinese adolescents

BACKGROUND

Sandplay therapy is a psychotherapeutic technique, based on the psychoanalytic theory of the unconscious. Nearly a century after it was developed, sandplay can now be applied for the initial diagnosis tools for sand players. The goal of the current research is to demonstrate the role of sandplay in identifying internet-addicted adolescents in China. The study aims to evaluate the reliability and validity for sandplay as a diagnosis and evaluation tool for internet addiction symptoms, and to verify the consistency that exists between results based on sandplay pictures and those based on the Pathological Internet Usage Scale for Adolescents (APIUS).

METHODS

The research was conducted with a 2 × 2 mixed factorial design - two types of participants (addicts and non-addicts) and two types of sandplay pictures (pictures for addicts and pictures for non-addicts). An absolute recognition-judgment paradigm was used along with eye movement evaluations to evaluate the existing initial sandplay picture system for internet addiction symptoms (22 sandplay pictures, 11 related to addicts and 11 related to non-addicts, respectively). Sixty Chinese adolescents were selected as the participants (30 as addicts and 30 as non-addicts) according to the APIUS.

RESULTS

(1) The initial sandplay pictures for internet addicts are clearly preferred by Chinese internet-addicted adolescents, which are more familiar and easier to process; (2) Such pictures have a higher level of emotional arousal and cognitive resonance for the addicts; (3) Track and heat maps indicate that young internet addicts mainly fixate on the initial sandplay pictures for internet addicts.

CONCLUSION

This initial sandplay picture system can be used to screen and identify young Chinese internet addicts based on symptoms, and the evaluation results are consistent with those based on the APIUS.

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

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

Spotlight on Digital Eye Strain

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

Digital game addiction of preschool children in the Covid-19 pandemic: social emotional development and parental guidance

The Covid 19 pandemic has caused children to spend more time at home and an increase in their digital addiction tendencies. Children's digital game addictions were affected by parents' strategies and negatively affected their social and emotional development. The study was carried out in order to determine the digital game addiction tendency levels of children and the strategies applied by the parents, and to examine the correlation between the results obtained and the social-emotional development of the children. The study was designed as a cross-sectional study. 142 children attending pre-school education for 60-72 months were included in the study. Personal Information Form, Digital Game Addiction Tendency Scale, Digital Game Parental Mediation Scale and Ages & Stages Questionnaires: Social-Emotional were used. As a result, the increase in digital game addiction in children has negatively affected social and emotional development. The level of digital game addiction tendency is associated with parents' digital game manipulation strategies. Active parental guidance strategy prevented children's digital game addiction tendency, while digital oriented guidance and free parental strategies increased addiction tendency.

Myopia and its associated factors among pregnant women at health institutions in Gondar District, Northwest Ethiopia: A multi-center cross-sectional study

Background

Myopia is the most common form of uncorrected refractive error with a growing burden worldwide. It is the principal complaint of most women during pregnancy. Although myopia has led to several consequences across the standard life of pregnant women, there is no previous study in Ethiopia regarding this topic. Thus, this study determined the prevalence of myopia and identifies its associated factors among pregnant women attending antenatal care units at governmental health institutions in Gondar City District, Northwest Ethiopia.

Methods

An institution-based cross-sectional study design was conducted from 08 February to 08 April 2021. From the selected health centres, study participants were recruited by systematic random sampling technique. A pre-tested, structured-interviewer-administered questionnaire consisting of socio-demographic variables, obstetric and clinical-related variables was used to collect the required data. Non-cycloplegic refraction was performed using trial lenses, trial frames, and retinoscopy in a semi-dark examination room. EpiData 3 and STATA 14 were used for data entry and statistical analysis respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of myopia. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with myopia. Model fitness was checked by Hosmer and Lemeshow goodness of test (at p > 0.05).

Results

A total of four-hundred and twenty-three pregnant women participated with a 100% response rate in this study. The overall prevalence of myopia among pregnant women was 26.48% (95% CI: 22.48-30.91). Eighty-Eight (20.81%) and Eighty-Four (19.85%) of the study participants had myopia in their right and left eyes respectively. The prevalence of myopia was significantly associated with age (AOR = 1.17; 95% CI: 1.09-1.28), the third trimester of gestation (AOR = 2.05, 95% CI: 1.08-3.90), multi & grand multipara (AOR = 3.15; 95% CI: 1.59-6.25), and history of contraceptive use (AOR = 3.30; 95% CI: 1. 50-7.28).

Conclusion

The finding of our study shows that there is a higher prevalence of myopia among pregnant women in our study area. Further prospective analytical studies regarding visual systems among pregnant women, particularly as a result of pregnancy, are strongly recommended.

Musculoskeletal problems, attitudes and behaviors related to physical activity, and social media addiction in musicians during the COVID-19 pandemic

BACKGROUND

Musculoskeletal problems are common in musicians. Coronavirus 2019 (COVID-19) has brought with it lockdowns and quarantine periods, and as a result, caused physical and psychological problems.

OBJECTIVE

To evaluate musculoskeletal problems, attitudes and behaviors related to physical activity, and social media addiction in musicians during the COVID-19 pandemic.

METHODS

This cross-sectional study was conducted on a total of 137 musicians (string, keyboard, wind, percussion instrument players, and vocalists) online. Musculoskeletal problems with Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), attitudes and behaviors related to physical activity with Cognitive Behavioral Physical Activity Questionnaire (CBPAQ), social media addiction with Bergen Social Media Addiction Scale (BSMAS) were evaluated.

RESULTS

In CMDQ, it was found that upper back, lower back, and neck problems were more common in all musicians. There were no differences between instrument groups in terms of CBPAQ sub-dimensions, total CBPAQ, and total BSMAS (p > 0.05).

CONCLUSION

Considering the dramatic effects of COVID-19, it may be important not to ignore musicians' musculoskeletal problems. It is recommended to design future studies investigating the effects of social media platforms on physical activity awareness by turning the opportunities of COVID-19 into advantages for challenges in musicians.

Parent's Awareness of Preventive Measures for Digital Eye Strain Syndrome among Saudi Students after 1 Year of Online Studies - A Survey

PURPOSE

The digital eye strain (DES) is of public health magnitude in students undertaking online studies during the COVID-19 pandemic. The DES prevention strategies will be effective if all stakeholders, including parents, work together. We present an awareness level of preventive measures among parents of students studying online for 1 year.

METHODS

This web-based survey was held in December 2021. Parents of Saudi students in the Qassim region responded to 15 questions about the preventive measures for DES. The responses were summed up and graded into very poor, poor, good, and excellent. The level of awareness was associated with determinants.

RESULTS

The awareness was excellent in 566 of 704 (80.4%) (95% confidence interval 77.5-83.3) participants. Parents had poor awareness about the importance of the 20-20-20 rule (43.8%), frequent blinking (56.7%), using digital devices beyond studies (57.4%), using eye lubricants while using a digital device (56%), and using devices at night in lying position (69.6%). Excellent awareness was significantly associated with primary-level students (P = 0.0004), those having ophthalmic consultation in the past (P = 0.02), and students with DES (P = 0.0006). Parents with excellent awareness were not satisfied with online studies of their wards (P = 0.001).

CONCLUSION

Awareness of parents about preventive measures to address DES in students is relatively high. However, health promotion is recommended, especially focusing on the weak areas to improve DES and its impact on students.

Examining the Indirect Effect of Online Gaming on Depression via Sleep Inequality and Anxiety-A Serial and Parallel Mediation Analysis

Stress-related disorders are highly prevalent among first-year college students. Gaming disorder (GD) is an emerging disorder linked to physical and psychological consequences. We aimed to investigate the mechanism linking GD with anxiety, depression, and sleep disorders among first-year undergraduate students. Four hundred fifty-seven participants were recruited, and the survey included the Internet Gaming Disorder Scale Short-Form (IGDS9-SF), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI). Our results showed that female students scored significantly higher than males in anxiety and depression. Furthermore, we found that depression is positively and strongly correlated to anxiety, and both are moderately associated with sleep quality. Gaming is positively related to depression, anxiety, and sleep quality. Interestingly, the health sciences tracks showed lower sleep quality than undergraduates from other tracks. There was a 64% variance in depression explained by many predictors, including anxiety, sleep quality, gaming, painkiller use, and gender. In addition, the mediation models showed that the association between gaming and depression is mediated indirectly by sleep quality, and sleep quality may be mediated directly by anxiety. The first year in college occurs at a critical developmental and professional stage, and our results highlight the need to establish support programs and conduct mental health educational workshops.

Risk factor assessment of digital eye strain during the COVID-19 pandemic: a cross-sectional survey

Background

Shifting to online learning during the coronavirus pandemic has increased the number of individuals symptomatic of digital eye strain (DES). This study aimed to determine the frequency and potential risk factors of DES among university staff members and students in this pandemic era.

Methods

A cross-sectional online survey was conducted during the pandemic, in May and June 2020. The online questionnaire was designed to collect data on DES-related ocular and extraocular manifestations. The survey was sent via social media to the previous year's students and staff within the Faculty of Medicine, Tanta University, Tanta, Egypt. The responses were downloaded and analyzed.

Results

Of the 412 participants completing the questionnaire, 34 (8.3%) were university staff members with a mean (standard deviation [SD]) age of 36.7 (6.6) years, and 378 (91.7%) were university students with a mean (SD) age of 20.8 (1.8) years. Participants with DES symptoms numbered 294 (71.4%) before the lockdown, increasing to 366 (88.8%) during the last month, with 84 developing new-onset DES. Most participants reported ocular symptoms associated with DES. After the lockdown, both students and staff had a significant prolongation of nighttime digital screen use and TV watching, an increase in the 4-item Patient Health Questionnaire (PHQ-4) severity scale scores, and anxiety and depression, with a reduced duration of daytime reading (all P < 0.05). Students had a significant prolongation of daytime digital screen use and TV watching and an increase in the frequency of eye lubricant use and mean Perceived Stress Scale (PSS)-4 scores (all P < 0.05). Multiple logistic regression analysis revealed that studenthood and increased nighttime screen use were independent risk factors for DES by odds ratios (95% confidence intervals) of 10.60 (2.12 - 53.00) and 3.99 (1.71 - 9.34), respectively (both P < 0.05).

Conclusions

Lockdown and closure of the university, with a shift to online learning, increased the exposure of staff and students to digital screens and the number of individuals with DES. Studenthood and prolonged nighttime digital screen use were independent risk factors for DES. Further studies investigating the prevalence and risk factors of DES, comparing similar data during and after the pandemic, may reveal other aspects of DES caused by virtual reality-based training.

The prevalence and possible risk factors of internet gaming disorder among adolescents and young adults: Systematic reviews and meta-analyses

BACKGROUND

As a spreading addictive behaviour in recent years, internet gaming disorder (IGD) has been studied a lot and the overall research results indicate that IGD has a high prevalence among adolescents and young adults (AYAs). To update the status quo of prevalence, it is necessary to conduct comprehensive analyses.

METHODS

On the premise of following the PRISMA statement, the study conducted two systematic reviews and meta-analyses to assess the global prevalence of IGD among AYAs and identify its possible risk factors. To achieve the goals, PubMed and CNKI databases were used to select the concerned studies published up to May 31, 2021. Heterogeneity was assessed using a funnel plot, Begg's test, Egger's test, and trim-and-fil method, followed by sensitivity analysis, subgroup analysis, and meta-regression analysis.

RESULTS

For the meta-analysis of prevalence, 407,620 participants from 155 reports in 33 countries were included. The pooled prevalence of IGD among AYAs was 9.9% (95% CI: 8.6%-11.3%, P = 0.000, I² = 94.4%), including 8.8% (95% CI: 7.5%-10.0%) among adolescents and 10.4% (95% CI: 8.8%-11.9%) among young adults. The following 12 factors are the possible risk factors of IGD among AYAs, which are stress, long average game time, family dysfunction, poor academic performance, being bullied, bullying, interpersonal problems, hyperactivity/inattention, anxiety, depression, emotional distress and low self-esteem.

CONCLUSIONS

This study confirms the prevalence and possible risk factors for IGD among AYAs. It's valuable in understanding the threat of IGD and finding intervention strategies for IGD among AYAs.

Effects of different interventions on internet addiction: A meta-analysis of random controlled trials

OBJECTIVE

To evaluate the effects of different interventions on Internet addiction (IA), a meta-analysis and network meta-analyses were performed.

METHODS

We searched PubMed, Cochrane, Embase, Web of Science, PsycINFO, ProQuest, CNKI, WanFang, VIP database, and CBM from their inception to August 2021 to identify randomized controlled trials (RCTs) where the effects of interventions on IA were assessed. The risk of bias was evaluated according to the Revised Cochrane risk-of-bias tool for randomized trials (RoB2). The R studio Software and Stata 14.0 were used to perform traditional meta-analysis and network meta-analyses.

RESULTS

A total of 59 RCTs including 3832 participants were incorporated into meta-analysis. The results of the traditional meta-analysis of 24 studies showed that CBT, group counseling, sports intervention, and Internet-based intervention could significantly reduce IA levels (SMD = -1.90, 95%CI: -2.26 to -1.55, P < 0.01, I² = 85.9%) as compared to no-treatment control groups. Network meta-analyses based on different scales showed that combined interventions had the highest probability of being the best interventions for IA (SUCRA = 91.0 % based on IAT; SUCRA = 89.0 % based on CIAS).

DISCUSSION

Most interventions have significant effects on the treatment of IA. Compared with single interventions, combined interventions showed a more pronounced improvement in Internet addiction symptoms.

Associations between Mobile Internet Use and Self-Rated and Mental Health of the Chinese Population: Evidence from China Family Panel Studies 2020

With societal and technological developments, mobile Internet has become the most popular and widespread means to use the Internet in China. Thus, exploring the relationship between mobile Internet use and the self-rated health and mental health of the Chinese population is of great importance. This study empirically examined the impact of mobile Internet use on residents’ health using data from the China Family Panel Studies 2020 and conducted a heterogeneity analysis. The results revealed a significant negative association between mobile Internet use and the self-rated health of the population, but a significant positive association was found relative to their mental health. The results of this analysis passed a robustness test. The results of the heterogeneity analysis showed that mobile Internet use had a more significant association with the health of residents with secondary school education and university education compared to those with primary school education or below and graduate education. Furthermore, this study addresses the endogeneity problem using the propensity-score matching model, which is shown to be better at eliminating sample selectivity bias. If endogeneity is not addressed, the negative association with mobile Internet use on residents’ self-rated health will be underestimated and its positive association with their mental health will be overestimated. The Chinese government should issue guidelines on the duration of Internet use, strictly regulate exaggerated and harmful content on mobile network platforms, and strengthen people’s online skills through training to improve their digital literacy, especially for rural populations.

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

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

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

Background

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

Methods

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

Results

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

Conclusions

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

Hydrogen sulfide protects retina from blue light-induced photodamage and degeneration via inhibiting ROS-mediated ER stress-CHOP apoptosis signal

Background: Hydrogen sulfide (H₂S) is a small reducing gas molecule with various biological functions such as anti-oxidative, anti-apoptotic and anti-inflammatory activities. In this study, we investigated the therapeutic effects of exogenous H₂S in the experimental models of retinal photodamage in vivo and in vitro.

Methods: Rats with open eyelids were pretreated with H₂S (80~120 μmol/kg) for 10 days and then continuously exposed to blue light (435~445nm, 11.2W/m2) for 8 h to establish in vivo experimental model. ARPE-19 cells were pretreated with H₂S and then exposed to blue light to establish in vitro experimental model.

Results: In vivo experiments, H₂S significantly ameliorated blue light-induced retinal oxidative stress, apoptosis and degeneration. Moreover, H₂S inhibited the activation of blue light-induced endoplasmic reticulum (ER) stress CHOP apoptotic signaling. In vitro experiments, H₂S improved blue light-induced oxidative stress and oxidative damage. H₂S inhibited ROS-mediated activation of ER stress CHOP apoptotic signaling. H₂S alleviated blue light-induced apoptosis and increases cell viability. The ER stress inhibitor 4-PBA alleviated blue light-induced apoptosis and increases cell viability.

Conclusion: Taken together, these results indicate that H₂S can inhibit ROS-mediated ER stress-CHOP apoptosis signal, thereby alleviating blue light-triggered retinal apoptosis and degeneration.

Awareness and practice regarding use of digital devices and ocular health among Saudi adolescents

PURPOSE

To review the knowledge of ocular health and practices of digital device usage among adolescent Saudi Arabia population.

METHODS

This cross-sectional web-based survey was conducted in 2021 at a university in central Saudi Arabia. We asked questions regarding demographics, knowledge related to computer vision syndrome (CVS), and the use of digital devices for participants' daily activities. The acceptable grades of knowledge ("excellent" and "good") and practice scores were associated with the determinants using the nonparametric method of analysis.

RESULTS

Of 521 participating students, knowledge about CVS and its relation to digital device usage were excellent in 41 students (7.9%), good in 161 (39%), poor in 300 (57.6%), and very poor in 19 (3.6%). Twenty-eight (5.4%) students scored an "excellent" grade on practices for digital device usage, 216 (41.4%) scored "good," and 277 (53.2%) scored "poor." The knowledge score median was 1.0 (interquartile range 1.0; 2.0), and the practice score median was 6.0 (4.0; 9.0). Health studies students had better knowledge than other students (P = 0.004). Smartphone users had worse knowledge than users of other devices (P = 0.017). Females (P < 0.001) and health studies students (P = 0.004) were significantly associated with acceptable practices of using digital devices.

CONCLUSIONS

Awareness of ocular health because of abuse of digital devices was poor among participating students. The practice of digital device use was not healthy and needed improvement through preventive measures and counseling.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Visual impairment and associated factors among pregnant women attending antenatal care units at health institutions in Gondar City Administration, Northwest Ethiopia

Background

Visual impairment is a major public health concern among women of reproductive age groups in Ethiopia, which is getting worse during pregnancy. Though visual impairment has lots of serious consequences across the life course of pregnant women, there is no previous study on this topic in Ethiopia. Thus, this study determined the prevalence of visual impairment and identified associated factors among pregnant women attending antenatal care units at the governmental health institutions in Gondar City Administration, Northwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted. A systematic random sampling technique was used to recruit the study participants. We used an interviewer-administered questionnaire comprising of socio-demographic, clinical and pregnancy-related variables to collect the required data. Snellen’s illiterate “E” chart was used to determine visual impairment. EpiData 3 and Stata 14 were used for data entry and statistical analysis, respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of visual impairment. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with visual impairment.

Results

A total of 417 (response rate = 98.6%) participants were involved in this study, with a median age of 27 years. The overall prevalence of visual impairment was 22.5% (95% CI: 18.5–26.6). Thirty (7.2%) and thirty-two (7.7%) of the study participants had moderate to severe visual impairments in their right and left eyes, respectively. Participants aged from 31 to 49 years (AOR = 2.1; 95% CI: 1.1–4.0), being 3rd trimester (AOR = 2.4; 95% CI: 1.3–4.5), multi & grand multipara (AOR = 2.3; 95% CI: 1.2–4.6), and history of contraceptive use (AOR = 2.7; 95% CI: 1.2–6.3) had higher chance of visual impairment.

Conclusion

The magnitude of visual impairment among pregnant women was high in the study area. Therefore, routine screening and evaluation of pregnant women for visual condition during antenatal care visits is recommended. Further investigations of visual changes, particularly as a result of pregnancy, are warranted.

Covid-19 pandemic and its impact on increasing the risks of children's addiction to electronic games from a social work perspective

Children are among the social groups most affected by the COVID-19 pandemic because they have found themselves forced to stay at home, far from their schoolmates, their friends, and far from all the activities they used to do before the pandemic. so, it was their only refuge for recreation during their stay in Home is staying in front of the screens of tablets, smartphones, and computers to play electronic games for long hours, and there is no doubt that the sudden shift in the lifestyle of children during the Covid-19 pandemic had serious consequences and risks threatening their stability at all levels. In light of that, the current study aimed to determine the impact of the Covid-19 pandemic on increasing the social, psychological, behavioral, and health risks of children's addiction to electronic games from a social work perspective. This study falls under the type of descriptive-analytical studies that are based on describing the reality of the problem under study. The study sample included 289 children in the age group 6-17 years in the first grade to the twelfth grade at school. The researcher designed a questionnaire that reflects the four risks facing children to assess these risks. The results showed is that the value of all impacts of the Covid-19 pandemic on the increasing risks of children's addiction to electronic games came to a total weight of (27907), weighted relative weight of (80.47%). This indication is High, indicating that the level of impact is High for the Covid-19 pandemic on the increase in all types of risks of children's addiction to electronic games. It ranked first " Behavioral Risks " at 91.15%, It is followed by the ranked second "Social risks " at 85.5%, Then came third place " Psychological Risks" at 80.91%, and in finally in fourth place " Health Risks" at 64.28%, which necessitates the need to take a set of serious measures by educating parents to monitor the content of electronic games that their children play, especially violent games, in addition to, reduce the number of hours the child spends practicing these games, and to encourage parents to form a bridge of communication and constructive dialogue between them and their children, and that parents put controls and restrictions on their children's practice of electronic games to confront abnormal behavioral, psychological and social patterns such as aggression, violence, deception, lying, imitation, vigilance, physical stress, poor eyesight, distance from practicing religious rituals, academic delay, introversion, depression, intolerance, selfishness, sadness, isolation from society, social withdrawal and lack of forming social relationships and lack of communication with others. The researcher took care that the results of the current study are very accurate and representative of the reality of the research problem, in light of the researcher's emphasis on the commitment to observe ethical rules to ensure the confidentiality of data. finally, the current study will greatly benefit researchers interested in the field of childhood and its problems and they will rely on its results and recommendations in how to protect children from the dangers of electronic game addiction in light of the Covid-19 crisis in particular.

Visual and Ocular Characteristics of eSports Participants

SIGNIFICANCE

The popularity of competitive video game play is growing rapidly. Little is known about the ocular characteristics of esports participants. Refractive error and binocular measures in young adult gamers were similar to population norms. However, tear breakup time was lower, and accommodative lag was higher.

PURPOSE

In a recent report, very young video game players were found to have greater levels of refractive error and heterophoria and reduced stereopsis. The purpose of this study was to assess the visual and ocular characteristics of a group of recreational esports athletes to determine if the findings in young children were similar to findings in a group of young adult video game players.

METHODS

Vision tests were performed on 36 college students during a video game combine event. Testing included high- and low-contrast visual acuity, autorefraction at distance and at 33 cm, stereoacuity, near heterophoria, and tear breakup time. Participants also indicated their level or rank in the game Overwatch.

RESULTS

Fifteen participants were myopic, and 21 did not wear vision correction. The mean local stereopsis was 31.9 seconds. The mean of the esophoric value was 3.2 prism diopters, and the mean of the exophoric value was 5.7 prism diopters. The mean lag of accommodation was 0.81 D. The mean tear breakup time was 5.8 seconds. Average hours of play did not differ between those who wore vision correction and those who did not. There were no significant relationships between the hours of play and the ocular findings.

CONCLUSIONS

The prevalence of refractive error and the mean heterophoria were similar to population norms, and the mean stereoacuity was normal. However, accommodative lag was slightly higher, and the tear breakup time was lower than expected. Differences in these latter values were also noted between high- and low-level Overwatch players.

Magnitude and determinants of computer vision syndrome among college students at a Saudi University

PURPOSE:

To review students’ perceived symptom-based computer vision syndrome (CVS) and its determinants and to suggest preventive measures.

METHODS:

This cross-sectional survey was conducted in 2021 at a university in Central Saudi Arabia. The presence and severity of symptoms related to CVS were investigated. The total CVS symptom score was the outcome variable. The CVS score was correlated to participants’ demographics, visual habits when using digital devices, and knowledge about CVS. Due to skewed distribution, a nonparametric method was used for analysis.

RESULTS:

Overall, 521 students were surveyed. The prevalence of CVS based on at least one symptom was 96% (95% confidence interval 94.3–97.7). The median score was 8.0 (interquartile range 4.0–12.0). Of the 24 possible CVS scores, 42 students (8%) had scores of 18 or more (severe CVS). Being female (Mann–Whitney [MW] P < 0.001), being older (Spearman P < 0.001), refractive error (MW P < 0.001), the presence of dry eye (MW P < 0.001), using devices other than a desktop computer (KruskalWallis) P = 0.03), and more than 6 h constantly working with a device (MW P = 0.001) were correlated with a higher CVS score. Older age, female, refractive error, and using digital devices for more than 6 h were the independent and significant predictors of CVS in college students.

CONCLUSION:

Most of the students suffered from mild-to-moderate CVS symptoms. Health promotion for prevention and periodic ophthalmic consultations are recommended. Identified predictors should be the focus when implementing strategies to combat CVS in the adolescent Saudi population.