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Pena-Verdeal H, Noya-Padin V, Garcia-Queiruga J, Nores-Palmas N, Giraldez MJ, Yebra-Pimentel E. Temporal Variations in Convergence Insufficiency Symptomatic Status among University Students before and after COVID-19: A Longitudinal Analysis from 2018 to 2023. Life (Basel) 2024; 14:800. [PMID: 39063555 PMCID: PMC11278426 DOI: 10.3390/life14070800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
The present study aimed to assess the symptomatic status of Convergence Insufficiency (CI) in university students from 2018 to 2023 considering the educational environment pre- and post-COVID-19 pandemic confinements. A Convergence Insufficiency Symptom Survey (CISS) was conducted annually from 2018 to 2023, excluding 2020, in an initial group of 217 third-year Optics and Optometry degree university student participants. In the final group (178 participants), the statistical differences in CISS scores between years were analysed, both overall and by questionnaire subgroup, along with associations between CISS diagnostic categories before and after 2020. Significant differences were found between years in the subscale and total score analyses (Kruskal-Wallis, both p ≤ 0.049). Pairwise comparisons showed significant differences for the performance subgroup in 2021 vs. 2019 and 2018 (Mann-Whitney, both p ≤ 0.004), while in terms of the total score, there was a statistical difference in 2021 vs. 2018 (Mann-Whitney, p < 0.001). The distribution analysis indicated a significant difference between groups (Chi, p = 0.004), with participants from 2021 or later more likely to exhibit higher CISS scores (OR = 3.47, 95%CI 1.04-8.58). The present study shows significant temporal increments in symptomatic status related to CI among university students from 2018 to 2023, indicating a potential impact of the COVID-19 pandemic educational landscape on these outcomes.
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Affiliation(s)
- Hugo Pena-Verdeal
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
- Optometry Group, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Veronica Noya-Padin
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
- Optometry Group, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Jacobo Garcia-Queiruga
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
- Optometry Group, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Noelia Nores-Palmas
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
| | - Maria J. Giraldez
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
- Optometry Group, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Eva Yebra-Pimentel
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
- Optometry Group, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
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Bhowmick A, Kumar PP, Ratra D. Frequency of Non-strabismic Binocular Vision Anomalies among Optometrists in a Tertiary Eye Care Center in Southern India. Indian J Occup Environ Med 2024; 28:138-142. [PMID: 39114096 PMCID: PMC11302529 DOI: 10.4103/ijoem.ijoem_243_23] [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: 09/29/2023] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 08/10/2024] Open
Abstract
Purpose Lifestyle in the modern era has drastically changed across the globe, and the healthcare profession was no exception. The increased time spent in the virtual space for various purposes, including online classes and webinars, is hypothesized to increase the risk of vision-related disorders such as asthenopia, dry eyes, and visual fatigue. The purpose of this study was to evaluate fusional vergence and ocular accommodation among optometry professionals in a tertiary eye care center during the immediate post-coronavirus disease 2019 (post-COVID-19) lockdown period. Methods Optometrists posted in the general out-patient department, specialty clinics, and the ocular diagnostics department were included in the study. A total of 65 optometrists were included in the study. All optometrists underwent a comprehensive binocular vision assessment. Convergence Insufficiency Symptom Survey questionnaires were administered to all optometrists at the beginning of the assessment. Results Out of 65 optometrists, 48 (73.8%) were women. The mean (standard deviation) age of the participants was 24 (3) years. Eleven (16.9%) optometrists had normal binocular vision parameters, and the rest 54 (83.1%) had non-strabismic binocular vision anomalies. Reduced accommodative facility and convergence insufficiency were seen among 43 (66.2%) optometrists, whereas 30 (46.2%) had reduced accommodative facility alone. Twelve (18.5%) participants were symptomatic as per the convergence insufficiency symptom survey. Conclusion This study highlights the fact that a large proportion of optometrists have undetected non-strabismic binocular vision anomalies in a tertiary eye care center. It is important for eye care professionals to undergo regular binocular vision assessments in association with ophthalmic examinations and relevant management. This will ensure that these dysfunctions do not impede work productivity and overall quality of life.
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Affiliation(s)
- Amit Bhowmick
- Department of Binocular Vision and Vision Therapy, Sankara Nethralaya, Nungambakkam, Chennai, Tamil Nadu, India
| | - P Praveen Kumar
- Department of Binocular Vision and Vision Therapy, Sankara Nethralaya, Nungambakkam, Chennai, Tamil Nadu, India
| | - Dhanashree Ratra
- Department of Vitreo-Retina, Sankara Nethralaya, Nungambakkam, Chennai, Tamil Nadu, India
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Niechwiej-Szwedo E, Brin TA, Thompson B, Christian LWT. Kinematic Assessment of Fine Motor Skills in Children: Comparison of a Kinematic Approach and a Standardized Test. Vision (Basel) 2024; 8:6. [PMID: 38391087 PMCID: PMC10885072 DOI: 10.3390/vision8010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
Deficits in fine motor skills have been reported in some children with neurodevelopmental disorders such as amblyopia or strabismus. Therefore, monitoring the development of motor skills and any potential improvement due to therapy is an important clinical goal. The aim of this study was to test the feasibility of performing a kinematic assessment within an optometric setting using inexpensive, portable, off-the-shelf equipment. The study also assessed whether kinematic data could enhance the information provided by a routine motor function screening test (the Movement Assessment Battery for Children, MABC). Using the MABC-2, upper limb dexterity was measured in a cohort of 47 typically developing children (7-15 years old), and the Leap motion capture system was used to record hand kinematics while children performed a bead-threading task. Two children with a history of amblyopia were also tested to explore the utility of a kinematic assessment in a clinical population. For the typically developing children, visual acuity and stereoacuity were within the normal range; however, the average standardized MABC-2 scores were lower than published norms. Comparing MABC-2 and kinematic measures in the two children with amblyopia revealed that both assessments provide convergent results and revealed deficits in fine motor control. In conclusion, kinematic assessment can augment standardized tests of fine motor skills in an optometric setting and may be useful for measuring visuomotor function and monitoring treatment outcomes in children with binocular vision anomalies.
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Affiliation(s)
- Ewa Niechwiej-Szwedo
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Taylor A Brin
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Benjamin Thompson
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada
- Centre for Eye and Vision Research, 17W Science Park, Hong Kong
- Liggins Institute, University of Auckland, Auckland 1010, New Zealand
| | - Lisa W T Christian
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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Shah C, Goyal A, Sen P, Peeush P, Sen A, More A, Jain E. Mobile battery blast injuries: An emerging ocular health hazard in children. Indian J Ophthalmol 2023; 71:3620-3625. [PMID: 37991293 PMCID: PMC10788765 DOI: 10.4103/ijo.ijo_1169_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/19/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE To assess clinical features, visual outcomes, and setting of mobile battery blast-induced eye injuries in children. METHODS Retrospective case sheets of children with mobile battery blast injuries were reviewed at a tertiary eye care center from January 2015 to March 2022. We noted the mode of injury, battery status, and clinical presentation and analyzed the treatment outcomes. RESULTS The study included 14 eyes of 11 patients. Three patients (27%) had bilateral ocular injuries. The most common reasons for the blast were wiring a bulb to the battery or charging the battery with a universal mobile charger, seen in four cases each. Three eyes had closed-globe injuries (CGIs), whereas 11 had open-globe injuries (OGIs). Of the 11 eyes with OGI, four also had a retained intraocular foreign body (IOFB). Only four (36%) eyes having OGI could achieve vision better than 6/60. All three eyes with CGIs developed secondary glaucoma, and two underwent trabeculectomy. However, the visual prognosis was better (>6/36) in eyes with CGI. Overall, mean visual acuity at the final follow-up was improved to 1.41 ± 1.14 logMAR from 2.32 ± 0.76 logMAR at presentation. This was also found to be statistically significant with a P value of 0.02. CONCLUSION Battery blast-induced ocular injuries, although rare, often lead to poor outcomes. Apart from charging, playing with discarded or damaged batteries was a common reason for battery blasts in our series.
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Affiliation(s)
- Chintan Shah
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Anand Goyal
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Pradhnya Sen
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Parimal Peeush
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Alok Sen
- Department of Retina and Uvea, Sadguru Netra Chikitsalaya and Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Amruta More
- Department of Retina and Uvea, Sadguru Netra Chikitsalaya and Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Elesh Jain
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Post Graduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
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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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Mylona I, Glynatsis MN, Floros GD, Kandarakis S. Spotlight on Digital Eye Strain. CLINICAL OPTOMETRY 2023; 15:29-36. [PMID: 36875935 PMCID: PMC9983433 DOI: 10.2147/opto.s389114] [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: 01/09/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Ioanna Mylona
- Department of Ophthalmology, General Hospital of Katerini, Katerini, Greece
| | - Mikes N Glynatsis
- Department of Ophthalmology, ‘Hippokration’, General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Georgios D Floros
- 2nd Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stylianos Kandarakis
- 1st Department of Ophthalmology, General Hospital “G. Gennimatas”, National and Kapodistrian University of Athens, Athens, Greece
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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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Cortés-Albornoz MC, Ramírez-Guerrero S, Rojas-Carabali W, de-la-Torre A, Talero-Gutiérrez C. Effects of remote learning during the COVID-19 lockdown on children's visual health: a systematic review. BMJ Open 2022; 12:e062388. [PMID: 35922104 PMCID: PMC9352565 DOI: 10.1136/bmjopen-2022-062388] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Increased exposure to digital devices as part of online classes increases susceptibility to visual impairments, particularly among school students taught using e-learning strategies. This study aimed to identify the impact of remote learning during the COVID-19 lockdown on children's visual health. DESIGN Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES Scopus, PubMed and ScienceDirect databases from the year 2020 onwards. ELIGIBILITY CRITERIA We included cross-sectional, case-control, cohort studies, case series and case reports, published in English, Spanish or French, that approached the effects of remote learning during the COVID-19 lockdown on visual health in neurotypical children. DATA EXTRACTION AND SYNTHESIS We included a total of 21 articles with previous quality assessments using the Joanna Briggs checklist. Risk of bias assessment was applied using the National Institutes of Health quality assessment tool for before-and-after studies with no control group; the tool developed by Hoy et al to assess cross-sectional studies; the Murad et al tool to evaluate the methodological quality of case reports and case series; and the Newcastle-Ottawa Scale for cohort studies. RESULTS All but one study reported a deleterious impact of the COVID-19 lockdown on visual health in children. Overall, the most frequently identified ocular effects were refractive errors, accommodation disturbances and visual symptoms such as dry eye and asthenopia. CONCLUSIONS Increased dependence on digital devices for online classes has either induced or exacerbated visual disturbances, such as rapid progression of myopia, dry eye and visual fatigue symptoms, and vergence and accommodation disturbances, in children who engaged in remote learning during the COVID-19 lockdown. PROSPERO REGISTRATION NUMBER CRD42022307107.
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Affiliation(s)
- María Camila Cortés-Albornoz
- Neuroscience Research Group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogota D.C, Colombia
| | - Sofía Ramírez-Guerrero
- Neuroscience Research Group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogota D.C, Colombia
| | - William Rojas-Carabali
- Neuroscience Research Group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogota D.C, Colombia
| | - Alejandra de-la-Torre
- Neuroscience Research Group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogota D.C, Colombia
| | - Claudia Talero-Gutiérrez
- Neuroscience Research Group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogota D.C, Colombia
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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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10
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Binocular vision findings in normally-sighted school aged children who used digital devices. PLoS One 2022; 17:e0266068. [PMID: 35390023 PMCID: PMC8989299 DOI: 10.1371/journal.pone.0266068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/14/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose To determine the binocular vision status in normally-sighted school aged children who used digital devices. Methods A cross-sectional study was conducted at B.P. Koirala Lions Center for Ophthalmic Studies, Kathmandu, Nepal for a duration of one year. One hundred and eighty school aged children (71 female and 109 male) aged 7 to 17 years were included in the study. All the children underwent detailed ophthalmic and binocular vision examinations. The duration of the use of digital devices by the children were asked to either the parents or guardians present at the time of the study. The study participants were divided into two groups: children who used digital devices for the last six months (users group) and those who hadn’t used digital devices for the last six months (non users group). The users group was again divided into two subgroups: children who used digital devices for less than 3 hours per day and a day per week (low digital device users subgroup) and children who used digital devices for more than 3 hours per day and all days in a week (high digital device users subgroup). Results Accommodative amplitudes, accommodative facility, and positive fusional vergence for both near and distance were significantly reduced in the high digital device users group than in the low digital device users subgroup (p <0.01). Stereo acuity, near point of convergence, and negative fusional vergences for both near and distance were not statistically significantly different between the two subgroups. Prevalence of accommodative and vergence anomalies (except convergence insufficiency) was more in the high digital device users subgroup than in the low digital device users subgroup (p<0.01). Conclusions Children who used digital devices for a significantly greater amount of time had significantly reduced amplitudes of accommodation, accommodative facility, and positive fusional vergence both at near and distance.
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Aldukhayel A, Baqar SM, Almeathem FK, Alsultan FS, AlHarbi GA. Digital Eye Strain Caused by Online Education Among Children in Qassim Region, Saudi Arabia: A Cross-Sectional Study. Cureus 2022; 14:e23813. [PMID: 35530919 PMCID: PMC9067335 DOI: 10.7759/cureus.23813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Online learning is the educational format adopted by schools and universities during the coronavirus disease 2019 (COVID-19) pandemic. It comprises Internet-based learning, computer-based learning, virtual classrooms, and digital collaborations. This study aims to assess digital eye strain (DES) among children attending online classes in the Qassim region, Saudi Arabia. Materials and methods This is a cross-sectional study conducted among children aged 3 to 18 years old in the Qassim region, Saudi Arabia. We sent out a self-administered questionnaire to parents of the targeted children by using social media, such as WhatsApp (Meta Platforms, Inc., Menlo Park, California, United States), Telegram (Telegram FZ LLC, Dubai), and Twitter (Twitter, Inc., San Francisco, California, United States). The questionnaire included questions on socio-demographic profile, smart devices being used, frequency of devices used per day before and during the lockdown, and DES. Results A total of 547 children were involved (50.3% males vs. 49.7% females). During online classes, the most commonly used device was tablets (51.2%). A significant increase was noticed in the use of devices during the COVID-19-related lockdown among children (p<0.001). The prevalence of DES-positive symptoms was 69.8%. The presence of DES symptoms was associated with age group (p=0.003), school level (p=0.040), device preferred for online classes (p=0.001), number of hours spent attending online classes (p=0.010), and number of hours spent using an electronic device during the lockdown (p<0.001). Conclusion Our study underlines a higher prevalence rate of DES among children during this time of the COVID-19 pandemic. Children who used a digital device for more than five hours during the lockdown had a greater risk of having DES than the rest.
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Mohan A, Sen P, Mujumdar D, Shah C, Jain E. Series of cases of acute acquired comitant esotropia in children associated with excessive online classes on smartphone during COVID-19 pandemic; digital eye strain among kids (DESK) study-3. Strabismus 2021; 29:163-167. [PMID: 34223812 DOI: 10.1080/09273972.2021.1948072] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Extra time of sitting in front of a digital device is required for e-learning by children during Corona virus (COVID-19) pandemic which can lead to many ocular problems including digital eye strain (DES). In view of increased incidence of DES in children, multiple studies had been conducted in central India to assess the eye strain in children due to excessive online classes as a research project named "Digital eye strain among kids (DESK) study." This study DESK-3 aimed to report series of cases of acute acquired comitant esotropia (AACE) in children attending online classes during COVID-19 pandemic. Children aged 6-18 years with recent onset of esotropia of < 1-month duration without any similar history in past presented in month of July-August 2020 at a tertiary children eye care hospital were evaluated. Data collection included age and gender of child, presence or absence of diplopia, visual acuity, duration of smartphone use, duration of online classes, angle of deviation for near and distance and cycloplegic refraction. Total eight children of AACE were included in the study. The mean age of children was 12.5 ± 4.2 years. All eight were males. The mean duration of smartphone use was 4.6 + 0.7 hours per day. All children were attending online classes > 4 hours per day on smartphone of average size 5.5 inches. Five children were emmetropic, one myopic, one pseudomyopic and one hyperopic. The angle of deviation for near and distance were 48.1 ± 16.4 PD and 49.3 ± 15.9 PD respectively with normal ocular motility. Seven children complained of horizontal diplopia in all gazes. Neurological examination and CT scan of brain and orbit was normal in all patients. Two months before the lockdown only one case was identified as compared to eight during the lockdown. Prolonged near work during smart phone use for e-learning might lead to the development of AACE in children.
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Affiliation(s)
- Amit Mohan
- Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, MP
| | - Pradhnya Sen
- Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, MP
| | - Deepti Mujumdar
- Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, MP
| | - Chintan Shah
- Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, MP
| | - Elesh Jain
- Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, MP
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