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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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Iqbal M, Elmassry A, Elgharieb M, Said O, Saeed A, Ibrahim T, Kotb A, Abdelhalim M, Shoughy S, Elgazzar A, Shamselden H, Hammour A, Eid M, Elzembely H, Abdelaziz K. Visual, ocular surface, and extraocular diagnostic criteria for determining the prevalence of computer vision syndrome: a cross-sectional smart-survey-based study. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2024; 13:1-15. [PMID: 38978825 PMCID: PMC11227667 DOI: 10.51329/mehdiophthal1489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/27/2024] [Indexed: 07/10/2024]
Abstract
Background The American Optometric Association defines computer vision syndrome (CVS), also known as digital eye strain, as "a group of eye- and vision-related problems that result from prolonged computer, tablet, e-reader and cell phone use". We aimed to create a well-structured, valid, and reliable questionnaire to determine the prevalence of CVS, and to analyze the visual, ocular surface, and extraocular sequelae of CVS using a novel and smart self-assessment questionnaire. Methods This multicenter, observational, cross-sectional, descriptive, survey-based, online study included 6853 complete online responses of medical students from 15 universities. All participants responded to the updated, online, fourth version of the CVS questionnaire (CVS-F4), which has high validity and reliability. CVS was diagnosed according to five basic diagnostic criteria (5DC) derived from the CVS-F4. Respondents who fulfilled the 5DC were considered CVS cases. The 5DC were then converted into a novel five-question self-assessment questionnaire designated as the CVS-Smart. Results Of 10 000 invited medical students, 8006 responded to the CVS-F4 survey (80% response rate), while 6853 of the 8006 respondents provided complete online responses (85.6% completion rate). The overall CVS prevalence was 58.78% (n = 4028) among the study respondents; CVS prevalence was higher among women (65.87%) than among men (48.06%). Within the CVS group, the most common visual, ocular surface, and extraocular complaints were eye strain, dry eye, and neck/shoulder/back pain in 74.50% (n = 3001), 58.27% (n = 2347), and 80.52% (n = 3244) of CVS cases, respectively. Notably, 75.92% (3058/4028) of CVS cases were involved in the Mandated Computer System Use Program. Multivariate logistic regression analysis revealed that the two most statistically significant diagnostic criteria of the 5DC were ≥2 symptoms/attacks per month over the last 12 months (odds ratio [OR] = 204177.2; P <0.0001) and symptoms/attacks associated with screen use (OR = 16047.34; P <0.0001). The CVS-Smart demonstrated a Cronbach's alpha reliability coefficient of 0.860, Guttman split-half coefficient of 0.805, with perfect content and construct validity. A CVS-Smart score of 7-10 points indicated the presence of CVS. Conclusions The visual, ocular surface, and extraocular diagnostic criteria for CVS constituted the basic components of CVS-Smart. CVS-Smart is a novel, valid, reliable, subjective instrument for determining CVS diagnosis and prevalence and may provide a tool for rapid periodic assessment and prognostication. Individuals with positive CVS-Smart results should consider modifying their lifestyles and screen styles and seeking the help of ophthalmologists and/or optometrists. Higher institutional authorities should consider revising the Mandated Computer System Use Program to avoid the long-term consequences of CVS among university students. Further research must compare CVS-Smart with other available metrics for CVS, such as the CVS questionnaire, to determine its test-retest reliability and to justify its widespread use.
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Affiliation(s)
- Mohammed Iqbal
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Ahmed Elmassry
- Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mervat Elgharieb
- Department of Ophthalmology, Faculty of Medicine, Suez Canal University, Suez, Egypt
| | - Omar Said
- Department of Ophthalmology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Ahmed Saeed
- Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Tamer Ibrahim
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmed Kotb
- Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mahmoud Abdelhalim
- Department of Ophthalmology, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Samir Shoughy
- Department of Ophthalmology, Damanhour Teaching Hospital, Damanhour, Egypt
| | - Akram Elgazzar
- Department of Ophthalmology, Faculty of Medicine, Alazhar University, Damietta, Egypt
| | - Hassan Shamselden
- Department of Ophthalmology, Faculty of Medicine, Alazhar University, Assuit, Egypt
| | - Abdallah Hammour
- Department of Ophthalmology, Faculty of Medicine, Alazhar University-Males, Cairo, Egypt
| | - Mohammed Eid
- Department of Ophthalmology, Faculty of Medicine, Alazhar University-Males, Cairo, Egypt
| | - Hosam Elzembely
- Department of Ophthalmology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Khaled Abdelaziz
- Department of Ophthalmology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt
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Dafallah MA, Mohamed Ahmed OA, Ibrahim Mohamed MM, Zakaria Abubakar RA, Ebraheem AA, Ahmed GMA. Computer vision syndrome among Sudanese medical students: a growing medical issue in the digital world. Ann Med Surg (Lond) 2024; 86:2572-2578. [PMID: 38694278 PMCID: PMC11060282 DOI: 10.1097/ms9.0000000000001917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/25/2024] [Indexed: 05/04/2024] Open
Abstract
Computer vision syndrome (CVS) refers to a set of eye-related symptoms that arise from prolonged computer usage. A survey was conducted to investigate the demographic characteristics, factors contributing to, and preventive measures against CVS. Out of 159 participants, 31.0% experienced seven or more symptoms, indicating a notable prevalence. The study found no significant correlation between age or academic years and CVS occurrence (P values of 0.481 and 0.392, respectively). However, gender exhibited a statistically significant relationship, with females students showing a higher prevalence than males (P=0.018; τ=0.105*). Notably, the distance from the screen had a highly significant inverse correlation with CVS occurrence (P=0.000; τ=-0.207**), indicating that greater distance reduced the risk. Additionally, using a screen filter (P=0.000; τ=0.184**) and adjusting screen brightness (P=0.017; τ=0.101*) were associated with CVS occurrence. Among preventive measures, only the use of an anti-glare screen showed a significant association with reducing CVS risk (P=0.018; τ=-0.099*). Given these findings, raising awareness about CVS among medical students is recommended, especially as curricula in medical colleges evolve.
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Affiliation(s)
| | | | | | | | | | - Gamal M. A. Ahmed
- Surgery, Faculty of Medicine, University of Gezira, Wad Medani, Gezira State, Sudan
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Ccami-Bernal F, Soriano-Moreno DR, Romero-Robles MA, Barriga-Chambi F, Tuco KG, Castro-Diaz SD, Nuñez-Lupaca JN, Pacheco-Mendoza J, Galvez-Olortegui T, Benites-Zapata VA. Prevalence of computer vision syndrome: A systematic review and meta-analysis. JOURNAL OF OPTOMETRY 2024; 17:100482. [PMID: 37866176 PMCID: PMC10785422 DOI: 10.1016/j.optom.2023.100482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 10/24/2023]
Abstract
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.
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Affiliation(s)
- Fabricio Ccami-Bernal
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Santa Catalina 117, Arequipa 04000, Peru
| | - David R Soriano-Moreno
- Unidad de Investigación Clínica y Epidemiológica, Universidad Peruana Unión, Lima, Carretera Central Km 19.5 Ñaña, Chosica, 15464 Peru
| | | | - Fernanda Barriga-Chambi
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Santa Catalina 117, Arequipa 04000, Peru
| | - Kimberly G Tuco
- Unidad de Investigación Clínica y Epidemiológica, Universidad Peruana Unión, Lima, Carretera Central Km 19.5 Ñaña, Chosica, 15464 Peru
| | - Sharong D Castro-Diaz
- Unidad de Investigación Clínica y Epidemiológica, Universidad Peruana Unión, Lima, Carretera Central Km 19.5 Ñaña, Chosica, 15464 Peru
| | - Janeth N Nuñez-Lupaca
- Escuela Profesional de Medicina Humana, Universidad Nacional Jorge Basadre Grohmann, Tacna, Miraflores S/N, 23000 Peru
| | | | - Tomas Galvez-Olortegui
- Unidad de Oftalmología Basada en Evidencias (Oftalmoevidencia), Scientia Clinical and Epidemiological Research Institute, Trujillo, Mz. G Lt. 22 Urb. Vista Hermosa, 13001 Peru; Departamento de Oftalmología, Hospital Nacional Guillermo Almenara Yrigoyen, Jirón García Naranjo 840, La Victoria 13, Lima 15033, Peru
| | - Vicente A Benites-Zapata
- Unidad de investigación para la Generación y Síntesis de Evidencias en Salud (UGIES), Universidad San Ignacio de Loyola, Av. La Fontana 550, La Molina, Lima 15024, Peru.
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Lin N, Li XM, Yang MY, Tian L, Li ZH, Mao JL, Zhang JF, Chen J, Lyu F, Deng RZ. Development of a new 17-item Asthenopia Survey Questionnaire using Rasch analysis. Int J Ophthalmol 2023; 16:1867-1875. [PMID: 38028524 PMCID: PMC10626358 DOI: 10.18240/ijo.2023.11.20] [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: 03/09/2023] [Accepted: 08/31/2023] [Indexed: 12/01/2023] Open
Abstract
AIM To develop the 17-item Asthenopia Survey Questionnaire (ASQ)-17 by Rasch analysis, and to generate a predictiveness score. METHODS Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective, cross-sectional study. Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options. RESULTS Phase 1 assessed the original ASQ-19, adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item. Phase 2 deleted the 11th item. Phases 3 and 4 assessed the new ASQ-17. All the evaluation indexes of ASQ-17 were acceptable. The Infit and Outfit MnSq values of items were 0.67-1.48, the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40% and 1.50-1.80 in three dimensions. The curve peaks of scores in each dimension were separated and in the same order. The PSR and PSI values were 2.80 and 0.89, respectively. The mean scores of dimensions A (9.5±4.1 vs 3.5±3.2), B (7.3±3.3 vs 2.5±2.7), C (4.3±2.2 vs 1.4±2.0) and total (21.1±8.1 vs 7.4±7.0) in asthenopia participants were significantly higher than those without asthenopia (all P<0.001). The area under the curve in two groups was 0.899 (P<0.001). Youden's index was up to the maximum value of 0.784 when the cut-off value was 12.5. CONCLUSION ASQ-17 has stronger option sorting and suitability than ASQ-19. It is an effective assessment tool for asthenopia with an optimal cut-off threshold value of 12.5, which is suitable for diagnosis and curative effect evaluation.
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Affiliation(s)
- Na Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xiao-Man Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Mao-Yuan Yang
- Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Li Tian
- Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Zhi-Hua Li
- Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jie-Li Mao
- Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jia-Fang Zhang
- Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jie Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Fan Lyu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Ru-Zhi Deng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
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AlQarni AM, AlAbdulKader AM, Alghamdi AN, Altayeb J, Jabaan R, Assaf L, Alanazi RA. Prevalence of Digital Eye Strain Among University Students and Its Association with Virtual Learning During the COVID-19 Pandemic. Clin Ophthalmol 2023; 17:1755-1768. [PMID: 37351540 PMCID: PMC10284626 DOI: 10.2147/opth.s406032] [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: 02/02/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023] Open
Abstract
Introduction The prolonged use of digital devices is a major risk factor for digital eye strain (DES) syndrome. Aim To estimate the prevalence of DES symptoms among students at Imam Abdulrahman University who use digital devices for virtual learning and leisure activities. Methods This was a retrospective cross-sectional study conducted by asking medical students of Imam Abdulrahman bin Faisal University to complete a self-administered online questionnaire. The questionnaire was used to determine the effect of the hours spent on digital devices and other factors, such as screen distance and not using artificial tears, on the development of DES. The severity (moderate or severe) and frequency (occasionally, always, or never) of 16 eye strain-related symptoms, including eye pain, headache, and itching, were evaluated by using the Computer Vision Syndrome Questionnaire. Results The overall prevalence of DES in the sample was found to be 68.53%. The largest proportion of students were found to have mild DES (43.20%), and only 11% had severe DES. The most common symptoms reported in our sample were headache, dryness, and burning. Female gender, using smartphones for online classes, and not using eye lubricants were significantly associated with increased severity of DES. Conclusion In the wake of the COVID-19 pandemic, virtual learning has become an integral part of education, leading to increased use of digital technology. The aim of this study was to investigate the impact of virtual learning on eye strain and to determine the prevalence and effects of DES. A questionnaire was administered to participants, and the findings revealed a DES prevalence of 68.53%. The use of eye drops for lubrication and smartphones for classes was significantly associated with DES. Furthermore, females were found to be more susceptible to severe DES symptoms than males. The development of a tool such as the Computer Vision Syndrome Questionnaire to predict DES prevalence could reduce clinic time and resources by minimizing unnecessary follow-up and ophthalmology referrals.
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Affiliation(s)
- Amani M AlQarni
- Family and Community Medicine Department, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Assim M AlAbdulKader
- Family and Community Medicine Department, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Asma N Alghamdi
- Medical Intern, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Jumana Altayeb
- Medical Intern, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Raghad Jabaan
- Medical Intern, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Lujain Assaf
- Epidemiology Senior Specialist, Clinical Leadership, Center for National Health Insurance, Riyadh, Saudi Arabia
| | - Rawan A Alanazi
- Family and Community Medicine Department, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
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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: 24] [Impact Index Per Article: 24.0] [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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Cantó-Sancho N, Porru S, Casati S, Ronda E, Seguí-Crespo M, Carta A. Prevalence and risk factors of computer vision syndrome-assessed in office workers by a validated questionnaire. PeerJ 2023; 11:e14937. [PMID: 36890870 PMCID: PMC9987297 DOI: 10.7717/peerj.14937] [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: 11/04/2022] [Accepted: 01/31/2023] [Indexed: 03/06/2023] Open
Abstract
Background Computer vision syndrome (CVS) is a common occupational health problem, but its clinical definition, prevalence and risk factors are not well defined. In general, non-validated diagnostic instruments have been used to assess its prevalence. For this reason, the aim of this study is to estimate the prevalence and potential risk factors for CVS using a validated questionnaire. Methods A cross-sectional study (n = 238) was carried out in Italian office workers using digital devices. All participants responded to an anamnesis, a digital exposure questionnaire, and the validated Italian version of the Computer Vision Syndrome Questionnaire. A battery of 3 ocular surface and tear ophthalmic tests (break-up time, BUT), Schirmer II and corneal staining) was performed. Results The mean age (±SD) was 45.55 (11.02) years, 64.3% were female. 71.4% wore glasses to work, whose design was monofocal (for distance) in 47.6%, monofocal (for near) in 26.5%, general progressive in 16.5% and occupational progressive in 8.8% of cases. 35.7% used digital devices >6 hours/day in the workplace. The prevalence of CVS was 67.2%. In the multivariate model, female sex (aOR: 3.17; 95% CI [1.75-5.73]), the use of digital devices >6 hours/day at workplace (aOR: 2.07; 95% CI [1.09-3.95]) and the use of optical correction at work (aOR: 2.69; 95% CI [1.43-5.08]) significantly increased the odds of CVS. Association was observed between presenting CVS and having abnormal BUT (χ2 = 0.017). Conclusions The prevalence of CVS in Italian office workers, especially among females, was high. Intensive use of digital devices at work (>6 hours/day) and the use of optical correction at work significantly increased the odds of CVS. There is an association between poor tear stability and CVS. Further research is needed on the influence of wearing optical correction on CVS. The use of a validated questionnaire in health surveillance of digital workers is strongly recommended.
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Affiliation(s)
- Natalia Cantó-Sancho
- Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig, Alicante, Spain
| | - Stefano Porru
- Department of Diagnostics and Public Health, University of Verona, Verona, Véneto, Italy.,Mistral-Interuniversity Research Centre 'Integrated Models of Study for Health Protection and Prevention in Living and Working Environments', University of Brescia, Milano Bicocca and Verona, University of Verona, Verona, Véneto, Italy
| | - Stefano Casati
- Eye Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Véneto, Italy
| | - Elena Ronda
- Public Health Research Group, University of Alicante, San Vicente del Raspeig, Alicante, Spain.,Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), Madrid, Madrid, Spain
| | - Mar Seguí-Crespo
- Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig, Alicante, Spain.,Public Health Research Group, University of Alicante, San Vicente del Raspeig, Alicante, Spain
| | - Angela Carta
- Department of Diagnostics and Public Health, University of Verona, Verona, Véneto, Italy.,Mistral-Interuniversity Research Centre 'Integrated Models of Study for Health Protection and Prevention in Living and Working Environments', University of Brescia, Milano Bicocca and Verona, University of Verona, Verona, Véneto, Italy
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Kaur K, Gurnani B, Nayak S, Deori N, Kaur S, Jethani J, Singh D, Agarkar S, Hussaindeen JR, Sukhija J, Mishra D. Digital Eye Strain- A Comprehensive Review. Ophthalmol Ther 2022; 11:1655-1680. [PMID: 35809192 PMCID: PMC9434525 DOI: 10.1007/s40123-022-00540-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/14/2022] [Indexed: 11/02/2022] Open
Abstract
Digital eye strain (DES) is an entity encompassing visual and ocular symptoms arising due to the prolonged use of digital electronic devices. It is characterized by dry eyes, itching, foreign body sensation, watering, blurring of vision, and headache. Non-ocular symptoms associated with eye strain include stiff neck, general fatigue, headache, and backache. A variable prevalence ranging from 5 to 65% has been reported in the pre-COVID-19 era. With lockdown restrictions during the pandemic, outdoor activities were restricted for all age groups, and digital learning became the norm for almost 2 years. While the DES prevalence amongst children alone rose to 50-60%, the symptoms expanded to include recent onset esotropia and vergence abnormalities as part of the DES spectrum. New-onset myopia and increased progression of existing myopia became one of the most significant ocular health complications. Management options for DES include following correct ergonomics like reducing average daily screen time, frequent blinking, improving lighting, minimizing glare, taking regular breaks from the screen, changing focus to distance object intermittently, and following the 20-20-20 rule to reduce eye strain. Innovations in this field include high-resolution screens, inbuilt antireflective coating, matte-finished glass, edge-to-edge displays, and image smoothening graphic effects. Further explorations should focus on recommendations for digital screen optimization, novel spectacle lens technologies, and inbuilt filters to optimize visual comfort. A paradigm shift is required in our understanding of looking at DES from an etiological perspective, so that customized solutions can be explored accordingly. The aim of this review article is to understand the pathophysiology of varied manifestations, predisposing risk factors, varied management options, along with changing patterns of DES prevalence post COVID-19.
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Affiliation(s)
- Kirandeep Kaur
- Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, 605007, India.
| | - Bharat Gurnani
- Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, 605007, India
| | - Swatishree Nayak
- Department of Ophthalmology, AIIMS, Raipur, Chhattisgarh, 492001, India
| | | | - Savleen Kaur
- Advanced Eye Center, Post Graduate Institute of Ophthalmology, Chandigarh, 160012, India
| | - Jitendra Jethani
- Baroda Children Eye Care and Squint Clinic, Vadodara, Gujarat, 390007, India
| | | | - Sumita Agarkar
- Department of Pediatric Ophthalmology and Adult Strabismus, Sankara Nethralaya, 18 College Road, Chennai, Tamil Nadu, 600006, India
| | | | - Jaspreet Sukhija
- Advanced Eye Center, Post Graduate Institute of Ophthalmology, Chandigarh, 160012, India
| | - Deepak Mishra
- Department of Ophthalmology, Regional Institute of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
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