Computer Vision Syndrome During SARS-CoV-2 Outbreak in University Students: A Comparison Between Online Courses and Classroom Lectures

Prevalence of computer vision syndrome during the COVID-19 pandemic: a systematic review and meta-analysis

BACKGROUND

Computer vision syndrome has become a significant public health problem, especially in developing countries. Therefore, this study aims to identify the prevalence of computer vision syndrome during the COVID-19 pandemic.

METHODS

A systematic review and meta-analysis of the literature was conducted using the databases PubMed, Scopus, Web of Science, and Embase up to February 22, 2023, using the search terms "Computer Vision Syndrome" and "COVID-19". Three authors independently performed study selection, quality assessment, and data extraction, and the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used to evaluate study quality. Heterogeneity was assessed using the statistical test I2, and the R version 4.2.3 program was used for statistical analysis.

RESULTS

A total of 192 studies were retrieved, of which 18 were included in the final meta-analysis. The total sample included 10,337 participants from 12 countries. The combined prevalence of computer vision syndrome was 74% (95% CI: 66, 81). Subgroup analysis based on country revealed a higher prevalence of computer vision syndrome in Pakistan (99%, 95% CI: 97, 100) and a lower prevalence in Turkey (48%, 95% CI: 44, 52). In addition, subgroup analysis based on study subjects showed a prevalence of 82% (95% CI: 74, 89) for computer vision syndrome in non-students and 70% (95% CI: 60, 80) among students.

CONCLUSION

According to the study, 74% of the participants experienced computer vision syndrome during the COVID-19 pandemic. Given this finding, it is essential to implement preventive and therapeutic measures to reduce the risk of developing computer vision syndrome and improve the quality of life of those affected.

TRIAL REGISTRATION

The protocol for this systematic review and meta-analysis was registered in the international registry of systematic reviews, the International Prospective Register of Systematic Reviews (PROSPERO), with registration number CRD42022345965.

The Chinese version of the Computer Vision Syndrome Questionnaire: translation and cross-cultural adaptation

BACKGROUND

The Spanish version of the Computer Vision Syndrome Questionnaire (CVS-Q^©) is a validated instrument, with good psychometric properties, to measure Computer Vision Syndrome (CVS) in workers using Video Display Terminals (VDTs). To date, there are no known valid instruments in Chinese for the assessment of CVS despite the high exposure to VDTs at work that this population presents. For this, the purpose of this study is to translate and cross-culturally adapt the CVS-Q^© into Chinese.

METHODS

A study with five consecutive stages: direct translation, synthesis of translations, back translation, consolidation by a committee of experts, and pre-test. During the pre-test, a cross-sectional pilot study was conducted on VDT users (n = 44) who completed the Chinese version of the questionnaire plus an ad hoc post-test to assess the comprehensibility of the scale and to verify aspects of its applicability and feasibility. Data concerning sociodemographic information, general and ocular health, use of optical correction and varying exposure to VDTs was also collected.

RESULTS

The entire sample considered the Chinese version of the CVS-Q^© simple, clear, and easy to understand and 95.5% also found it easy to complete. 88.7% considered that the scale did not need any improvement. The final version of the Chinese scale to measure CVS was obtained (the CVS-Q CN^©). The mean age of participants was 31.3 ± 9.8 years, 47.6% were women, and 57.1% used VDTs to work for more than 8 h/day.

CONCLUSIONS

The CVS-Q CN^© can be considered an easy tool to assess CVS in workers exposed to digital devices in China. This version would facilitate research, its use in clinical practice, and the prevention of occupational hazards in the workplace.

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

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

Computer vision syndrome-related symptoms in presbyopic computer workers

PURPOSE

To evaluate the prevalence of computer vision syndrome (CVS)-related symptoms in a presbyopic population using the computer as the main work tool, as well as the relationship of CVS with the electronic device use habits and the ergonomic factors.

METHODS

A sample of 198 presbyopic participants (aged 45-65 years) who regularly work with a computer completed a customised questionnaire divided into: general demographics, optical correction commonly used and for work, habits of electronic devices use, ergonomic conditions during the working hours and CVS-related symptoms during work performance. A total of 10 CVS-related symptoms were questioned indicating the severity with which they occurred (0-4) and the median total symptom score (MTSS) was calculated as the sum of the symptoms.

RESULTS

The MTSS in this presbyopic population is 7 ± 5 symptoms. The most common symptoms reported by participants are dry eyes, tired eyes and difficulties in refocusing. MTSS is higher in women (p < 0.05), in laptop computer users (p < 0.05) and in teleworkers compared to office workers (p < 0.05). Regarding ergonomic conditions, MTSS is higher in participants who do not take breaks while working (p < 0.05), who have an inadequately lighting in the workspace (p < 0.05) and in the participants reporting neck (p < 0.01) or back pain (p < 0.001).

CONCLUSION

There is a relationship between CVS-related symptoms, the use of electronic devices and the ergonomic factors, which indicates the importance of adapting workplaces, especially for home-based teleworkers, and following basic visual ergonomics rules.

Digital Eye Strain among Peruvian Nursing Students: Prevalence and Associated Factors

There has been a high prevalence of digital eye strain (DES) among students who have received distance-learning lessons due to COVID-19. However, in low- and middle-income countries, there are few studies that have analyzed its associated factors. This study aimed to determine the prevalence of DES and its associated factors among nursing students during COVID-19 distance learning. This was a cross-sectional analytical study conducted between May and June 2021 in six Peruvian universities. The sample comprised 796 nursing students. DES was measured using the Computer Vision Syndrome Questionnaire (CVS-Q). A bivariate logistic regression analysis was performed. DES was found in 87.6% of nursing students. Sitting upright (OR, 0.47; 95% IC, 0.30-0.74), using electronic devices for more than four hours a day (OR, 1.73; 95% IC, 1.02-2.86), not following the 20-20-20 rule (OR, 2.60; 95% IC, 1.25-5.20), having the screen brightness very high (OR, 3.36; 95% IC, 1.23-11.8), and not wearing glasses (OR, 0.59; 95% IC, 0.37-0.93) are factors associated with DES. The prevalence of DES among nursing students is high. Improving the ergonomics of study environments, reducing the time of exposure to electronic devices, adjusting the screen brightness, and taking eye-care measures are key to controlling computer vision syndrome in virtual learning.

Computer-related ophthalmic syndrome in teachers of a University of the Province of Cañete

Virtual education has impacted the vision of people during the coronavirus pandemic, as by spending more time on the computer, it compromises the eye health of the person causing long-term visual problems. So the objective of this investigation is to assess computer-related ophthalmic syndrome in teachers of a University of the Province of Cañete.

Methods

This is a quantitative, nonexperimental, descriptive, cross-sectional study on a total population of 63 teachers, who answered a digital survey using the sociodemographic data and the Computer Vision Syndrome Questionnaire.

Clinical Discussion

From the results it can be observed that the results of computer ophthalmic syndrome in the university teachers of the province of Cañete, where 51 (81%) of the teachers do not present the computer vision syndrome and 12 (19%) presented with the computer vision syndrome.

Conclusion

The population conducting virtual education as well as the students should be educated on the measures to be taken to prevent computer ophthalmic syndrome and its consequences.

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.

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

Purpose

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

Patients and Methods

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

Results

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

Conclusion

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

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

Objective:

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

Methods:

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

Result:

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

Conclusion:

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

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

Purpose

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

Methods

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

Results

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

Conclusion

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

Effects of digital devices and online learning on computer vision syndrome in students during the COVID-19 era: an online questionnaire study

PURPOSE

Computer vision syndrome (CVS) describes a group of eye and vision-related problems that result from prolonged digital device use. This study aims to assess the prevalence and associated factors of CVS among students during the lockdown resulting from the COVID-19 pandemic.

METHODS

A cross-sectional, online, questionnaire-based study performed among high school students in Thailand.

RESULTS

A total of 2476 students, with mean age of 15.52±1.66 years, were included in this study. The mean number of hours of digital device use per day (10.53±2.99) increased during the COVID-19 pandemic compared with before its advent (6.13±2.8). The mean number of hours of online learning was 7.03±2.06 hours per day during the pandemic. CVS was found in 70.1% of students, and its severity correlated with both the number of hours of online learning and the total number of hours of digital device usage (p<0.001). Multiple logistic regression analysis revealed that the factors associated with CVS included age ≤15 years (adjusted OR (AOR)=2.17), overall digital device usage >6 hours per day (AOR=1.91), online learning >5 hours per day (AOR=4.99), multiple digital device usage (AOR=2.15), refractive errors (AOR=2.89), presence of back pain (AOR=2.06) and presence of neck pain (AOR=2.36).

CONCLUSIONS

The number of hours of digital device usage increased during lockdown. Over 70% of children had CVS, whose associated factors, including hours of digital device usage, hours of online learning, ergonomics and refractive errors, should be adjusted to decrease the risk of acquiring this condition. Online learning will remain, along with CVS, after this pandemic, and we hope our research will be taken into account in remodelling our education system accordingly.

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

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