Digital eye strain and its impact on working adults in the UK and Ireland

CLINICAL RELEVANCE

Digital eye strain (DES) is a condition encompassing visual and ocular symptoms that may arise due to the prolonged use of digital devices. The 2023 Tear Film Ocular Surface Lifestyle report defined DESas"the development or exacerbation of recurrent ocular symptoms and / or signs related specifically to digital device screen viewing". Studies vary as to the prevalence of DES with some reporting values as low as 10 % and some reporting values over 90 %, however no study has examined the prevalence of DES in the UK or Ireland (UK&I).

PURPOSE

To determine the prevalence of DES amongst adults who work with digital devices in UK&I, their symptoms and ameliorative approaches taken by those affected.

METHODS

A web-based survey of digital device users was conducted. Adults who used a device for at least 1 h per day for work purposes were eligible to participate. The questionnaire was designed to determine the prevalence of DES, daily device usage, musculoskeletal and ocular symptoms, how they manage their symptoms and eye care history.

RESULTS

Based on a Computer Vision Syndrome Questionnaire score ≥ 6, the occurrence of DES was high at 62.6 %. The mean number of hours devices were used for was 9.7 h. Musculoskeletal symptoms were reported by 94.3 % of users and ocular symptoms by 89.5 % with symptoms most likely to occur with those working from home. 8.1 % of respondents considered their symptoms significant enough to affect their work.

CONCLUSION

This study provides a valuable insight into DES in digital device users in UK&I and is the first of its kind to be completed. It shows, that while the level of DES is high in device users, at 62.6 %, the actual effect or consequences of it on many does not appear to be significant.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Ergonomic intervention program for office workers: a case study about its effect in computer vision syndrome and musculoskeletal discomfort

This study aims to develop and implement an ergonomic intervention program at the workplace of knowledge workers, and to evaluate its impact on the reduction of Computer Vision Syndrome (CVS) and musculoskeletal symptoms. 84 workers were part of the study (mean age 43.2 ± 9.7 years). The intervention included training, delivery of a packaging of artificial tears, and adjustments in workstations. It was conducted intensively along 6 weeks. Data was collected on-site, with questionnaires administered pre-intervention, 2 months after, and 4 months after. Participants exhibited behavioural changes, especially in workplace adjustments and visual rest. By the intervention's end, over 90% had correctly adjusted screens and adopted appropriate postures, while 42.7% adhered to the 20x20x20 rule. CVS severity and prevalence decreased, but not significantly across the three time points. Significant improvements were observed in upper back and neck musculoskeletal symptoms at the end of workdays. Findings suggest that an ergonomic intervention program can benefit employees by reducing visual and musculoskeletal symptoms.

Tear film changes in symptomatic versus asymptomatic video display terminal users following computer challenge test

PURPOSE

To assess the real-time changes in the tear film and ocular surface of symptomatic video display terminal (VDT) versus asymptomatic users.

METHODS

A total of 35 symptomatic (29 ± 5.6 years; Group 1, mild dry eye disease) and 35 asymptomatic (24.1 ± 4.6 years; Group 2) VDT users with a mean OSDI of 28 ± 11 and 0.86 ± 2.1, respectively, had tear film examination (Oculus Keratograph 5 M and Tearlab Osmolarity System) at baseline and after 1 h of watching a movie on the laptop inside a controlled environment chamber along with blink rate calculation.

RESULTS

The mean VDT use was 11.4 ± 3.2 h/day in Group 1 and 2.3 ± 2.3 h/day in Group 2. In Group 1, the mean pre- and post-VDT task values for NIBUT and bulbar congestion were 10.7 ± 3.7s and 6.7 ± 3.1s (P = 0.007), and 0.8 ± 0.4 and 1.1 ± 0.5 (P = 0.01), respectively. There were no significant changes in tear meniscus height (P = 0.77), Schirmer I (P =0.14), corneal staining score (P = 1.0), and tear osmolarity (P > 0.05). Group 2 showed insignificant change in all parameters. Only 16.2% individuals in Group 1 met modified TFOS-DEWS II diagnostic criteria at baseline that increased to 67.6% following VDT task. The blink rate reduced significantly during the last 15 min (6.8 ± 3.4 vs. 9.3 ± 4.5; P = 0.006) compared to the first 15 min of the task in Group 1, whereas no significant change occurred in Group 2.

CONCLUSION

Tear film instability and increased bulbar congestion are observed in symptomatic VDT users after computer work despite baseline stable tear film. The changes are significantly altered in symptomatic VDT users compared to asymptomatic users.

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.

Determinants of digital eye strain among university students in a district of India: a cross-sectional study

Aim

Digital device usage, especially during the pandemic, has catapulted into a new age problem, the computer vision syndrome. This study aimed to quantify the prevalence and determinants of digital eye strain (DES).

Subject and Methods

A total of 345 university students in India were surveyed in June-July 2022, by a validated tool, the Computer Vision Syndrome Questionnaire (CVS-Q) © in this cross-sectional study. According to American Optometric Association, digital eye strain and computer vision syndrome are synonyms. Non-parametric tests of medians were used to compare the median DES scores, Chi square test to compare categorical variables, and binary logistic regression to find the determinants of DES.

Results

The average age of the study participants was 21.0 ± 2.2 years, ranging between 18-26 years with 52.8% females and 47.2% males. The prevalence of DES was 45.5% (CI 95% = 40.2%-50.8%). Any existing eye disease (p-value = 0.000, OR = 0.41, 95% CI = 0.26-0.65), average daily screen time (p-value = 0.001, OR = 1.61, 95% CI = 1.22-2.13) and using gadgets in the dark (p-value = 0.000, OR = 0.37, 95% CI = 0.23-0.61) were significant determinants of the same.

Conclusion

Framing guidelines limiting the hours allotted for online classes for university students are imperative, with promotion of ergonomic practices for digital device usage such as blue light filters and night mode on devices.

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.

The effects of breaks on digital eye strain, dry eye and binocular vision: Testing the 20-20-20 rule

PURPOSE

To evaluate the benefits on the eyes of taking breaks based on the 20-20-20 rule.

METHODS

Bespoke computer software using the laptop webcam to assess user breaks, eye gaze and blinking, and emitting personalized reminders of breaks based on the 20-20-20 rule, was downloaded onto the laptops of 29 symptomatic computer users. Digital eye strain (DES), binocular vision and dry eye were assessed before and after two weeks of using the reminders and one week after the discontinuation of the strategy. Binocular measurements included visual acuity, accommodative posture, stereopsis, fixation disparity, ocular alignment, accommodative facility, positive/negative vergences and near point of convergence. Symptoms were evaluated using the computer vision syndrome questionnaire, ocular surface disease index (OSDI), and symptom assessment in dry eye questionnaire (SANDE) versions one and two. Dry eye signs were assessed by measuring tear meniscus height, conjunctival redness, blink rate and incomplete blinking, lipid layer thickness, non-invasive keratograph break-up time, corneal and conjunctival staining and lid wiper epitheliopathy.

RESULTS

A decrease in the duration of computer work and the duration of breaks, along with an increase in the number of breaks taken per day was observed as a result of the 20-20-20 rule reminders (p ≤ 0.015). No changes on any binocular parameter were observed after the management period (p ≥ 0.051), except for an increase in accommodative facility (p = 0.010). Dry eye symptoms and DES decreased with the rule reminders (p ≤ 0.045), although this improvement was not maintained one week after discontinuation (p > 0.05). No changes on any ocular surface and tear film parameter were observed with the rule reminders (p ≥ 0.089).

CONCLUSIONS

The 20-20-20 rule is an effective strategy for reducing DES and dry eye symptoms, although 2 weeks was not enough to considerably improve binocular vision or dry eye signs.

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

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

Digital eye strain in young screen users: A systematic review

Digital eye strain (DES) or computer vision syndrome (CVS) is a phenomenon linked to ever increasing digital screen use globally, affecting a large number of individuals. Recognizing causative and alleviating factors of DES may help establish appropriate policies. We aimed to review factors that aggravate or alleviate DES symptoms in young, i.e. pre-presbyopic (<40 years old), digital device users. We searched PubMed, Scopus, EMBASE, Cochrane, Trip Database, and grey literature up to 1st July 2021. Among a plethora of studies with heterogeneous diagnostic criteria for DES, we only included those using a validated questionnaire for the diagnosis and evaluating associated factors in young subjects. Relevant data were extracted, risk of bias assessment of the included studies and GRADE evaluation of each outcome were performed. Ten studies were included (five interventional, five observational) involving 2365 participants. Evidence coming from studies with moderate risk of bias suggested that blue-blocking filters do not appear to prevent DES (2 studies, 130 participants), while use of screens for >4-5 h/day (2 studies, 461 participants) and poor ergonomic parameters during screen use (1 study, 200 participants) are associated with higher DES symptoms'score. GRADE evaluation for the outcomes of blue-blocking filters and duration of screen use showed low to moderate quality of evidence. It appears advisable to optimize ergonomic parameters and restrict screen use duration, for minimizing DES symptoms. Health professionals and policy makers may consider recommending such practices for digital screen users at work or leisure. There is no evidence for use of blue-blocking filters.

Evaluation of the effectiveness of the Super Enhanced Single Vision Lens 01 (SESL01) in reducing symptoms of computer vision syndrome (CVS): A study protocol for a double-blind, two-arm parallel randomized controlled trial

BACKGROUND

The increased use of digital devices has implications for health and, particularly, the eyes, due to Computer Vision Syndrome (CVS). Millions of individuals of all ages are at risk of CVS, and its prevalence ranges from 25% to 93%. This trial will evaluate the effectiveness of the Super Enhanced Single Vision Lens 01 (SESL01) versus standard single vision lens in reducing symptoms of CVS assessed by the Computer Vision Syndrome Questionnaire (CVS-Q®) scores.

METHOD

A double-blind, two-arm parallel randomized controlled trial will be conducted at the University of Central Lancashire, Preston (UK), recruiting students and staff with CVS-Q score ≥ 6. A 1:1 randomization and a sample size of 300 participants will be sufficient to detect a 2-point difference in the CVS-Q score between the intervention and control groups with an alpha of 5%, two-sided, allowing for a dropout of 10%. The control group will use standard single vision lenses, and the intervention group SESL01. The primary outcome to week 14 will be the difference in the CVS-Q score between SESL01 and standard single vision lenses. Secondary outcomes include the percentage of participants with CVS-Q score < 6 (no symptoms) and CVS-Q score ≥ 6 (symptoms) in the SESL01 and the standard single vision group at weeks 6, 10 and 14; the percentage of participants in each group with a total CVS-Q score < 6, 6-12, 13-19, and ≥ 20 at weeks 6, 10 and 14. The primary analysis will be the intention to treat.

DISCUSSION

Findings may inform decisions about adopting the SESL01 lenses to reduce CVS.

TRIAL REGISTRATION

clinicaltrial.gov identifier: NCT05545878. Registered: Sept. 19, 2022.

The relationship between visual display terminal usage at work and symptoms related to computer vision syndrome

Background

Although it is well known that the usage of visual display terminal (VDT) at the workplace causes computer vision syndrome (CVS), previous studies mainly focused on computer use and the health of white-collar workers. In this study, we explored the relationship between the usage of VDT including various devices, and symptoms related to CVS in a large population including pink-collar workers and blue-collar workers.

Methods

21,304 wage workers over the age of 20 years were analyzed from the 6th Korean Working Conditions Survey. To investigate the association between VDT use at work and symptoms related to CVS among wage workers, odds ratios (ORs) and 95% confidence interval (CI) were calculated by multivariate logistic regression models.

Results

In the group with the highest VDT usage at work, the OR of headache/eyestrain was 2.16 (95% CI: 1.86-2.52). The OR of suspected CVS patients was significantly increased in the highest group of usage of VDT at work (OR: 1.69; 95% CI, 1.39-2.06). Compare with the reference group, the OR for headache/eyestrain in the highest group of VDT usage was 2.81 (95% CI: 2.13-3.70) in white-collar workers, 1.78 (95% CI: 1.32-2.40) in pink-collar workers, and 1.59 (95% CI: 1.18-2.15) in blue-collar workers.

Conclusions

We observed a relationship in which the use of VDT in the workplace increases the risk of headache/eyestrain regardless of occupational classification. Our findings emphasize the importance of paying attention to the health of VDT workers and making plans to improve their working conditions.

Blue-blocking filters do not alleviate signs and symptoms of digital eye strain

CLINICAL RELEVANCE

There is some controversy about the utility of prescribing blue-blocking filters to mitigate digital eye strain. We found that using commercially available blue-blocking filters was ineffective in reducing orbicularis oculi muscle activity and visual symptomatology during a 30-min reading task from a computer screen.

BACKGROUND

There are some claims that blue-blocking (B-B) filters may be effective in reducing symptoms and signs of digital eye strain. However, recent studies have suggested that there is no sufficient evidence to support their use. This study assessed the short-term effects of a commercially available, B-B filter on orbicularis oculi (OO) muscle activity and symptoms of digital eye strain during the execution of a 30-min reading tas.

METHODS

Twenty-three healthy young adults (22.9 ± 3.2 years of age) performed two reading tasks from a computer screen with or without a B-B filter on two different days. OO muscle activity was recorded by surface electromyography 4-5, 9-10, 14-15, 19-20, 24-25 and 29-30 min into the trial. Participants reported their perceived levels of visual discomfort and activation before and after completing the reading task.

RESULTS

A Bayesian analysis favoured the null hypothesis that there was no change in OO muscle activity with or without using the B-B filter (Bayes Factor01 [BF01] = 7.08). Regarding symptomatology, the analysis favoured the time model that reading increased visual fatigue and discomfort but reduced activation levels (BF01 < 0.33 in all cases). However, our data did not support the alternative model that using B-B filter affected these visual symptoms.

CONCLUSIONS

The B-B filter did not alter OO muscle activity or visual symptomatology significantly during the execution of a 30-min reading task in asymptomatic subjects. These findings support the idea that B-B filters do not attenuate signs and symptoms of digital eye strain.

Assessment of risk factors on eye dryness in young adults using visual display device in both contact lens wearers and non-wearers

PURPOSE

Researchers are interested in examining the impact of visual display devices (VDDs) on the development of dry eye illness because their use is becoming more common among college students. The goal of this study was to see if there was a link between certain risk factors and the development of eye dryness in VDDs using young adults who wore contact lenses and those who did not.

METHODS

The self-administrated survey was hosted in Google Forms, sent via e-mail to the participants. It consisted of two parts of assessing different risk factors (i.e., environmental conditions, angle of gaze, and years of VDD use) with contact lens use and Ocular Surface Disease Index (OSDI) questionnaire. The OSDI scores of the entire sample who suffer from dry eye and the subgroup using contact lenses were calculated. The relationship between different risk factors with the OSDI scores was also assessed.

RESULTS

A total of 274 young adults from college students and academic staff (216 female, 58 male) were suffering from eye dryness. Eighty-eight of the 274 participants wore contact lenses. The mean OSDI scores of the 274 young adults were 32.92. Mean OSDI scores in contact lens wearers and non-wearers were 34.36 and 32.24, respectively (p < 0.01). There was a statistically significant relationship between OSDI score and indoor environmental conditions in computer using VDD group. Using a computer in a dark environment and above the line of sight resulted in a higher OSDI scores. Females who wore contact lenses while using a computer for more than three years had significantly higher OSDI scores than non-wearer females. Tablet type VDD use increased the mean ODSI scores of the contact lens wearers significantly.

CONCLUSIONS

Dry eye symptoms were shown to be increased in the contact lens wearer group with the increased duration of computer VDD use, decreased indoor environmental brightness conditions, and above the line of sight.

Prevalence and risk factors of computer vision syndrome-assessed in office workers by a validated questionnaire

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.

Population perceived eye strain due to digital devices usage during COVID-19 pandemic

PURPOSE

To assess the magnitude severity and determinants of eyestrain and the use of digital devices in a Saudi population during the COVID-19 pandemic lockdown.

METHODS

This web-based survey was conducted in September 2020 and enrolled only Saudi nationals 15 years or older. Data were collected on demographics, eye strain related symptoms, severity, and the use of optical aids during the COVID-19 lockdown. The frequency and severity of eye strain were calculated. A Computer Vision Syndrome (CVS) score was graded as none/mild moderate and severe, based on the sum of 15-eye strain related signs and symptoms. Correlation analysis was performed for determinants of CVS.

RESULTS

The study sample was comprised of 2009 individuals with median age of 20 years. Among those who used digital devices for more than 6 h daily, the main reasons for use were work and social purposes among 68.4%, and 61% of respondents, respectively. The prevalence of knowledge on CVS and the '20-20 rule for using digital devices' was 9.4% and 6.9, respectively. The most common symptoms of eye strain from digital device usage were headache, burning, itching, tearing, and redness of eyes. Six hours of daily usage of digital devices was positively associated to the grade of eye strain severity during the COVID-19 lockdown (P < 0.05)).

CONCLUSION

The Saudi population experienced eye strain during COVID-19 lockdown due to excessive digital devices usage. Longer duration of digital device usage was associated to eye strain. Health care providers should educate the general population on measures to mitigate eye strain due to digital devices. Trial registration ID None applicable.

Knowledge, attitude, and practice on digital eye strain during coronavirus disease-2019 lockdown: A comparative study

BACKGROUND

Computer vision syndrome is a group of eye and vision-related problems that result from prolonged computer use. The worldwide pandemic of coronavirus disease-2019 (COVID-19) lockdown has led to an increase in the digital screen exposure as jobs as well as academic learning have majorly shifted online. This has caused an increase in digital eye strain (DES) globally. The aims and objectives of this study were to compare the knowledge, attitude, and practices among medical and nonmedical professionals with regard to DES in a background of COVID-19 lockdown.

MATERIALS AND METHODS

A cross-sectional, observational, online questionnaire-based research survey analysis was conducted among medical professionals with age- and sex-matched nonmedical professionals. Responses were collected over a week and analyzed. The level of significance was set at a P < 0.05. Statistical Package for the Social Sciences software version 23.0 was used for the result analysis.

RESULTS

Our study included 353 (50.4%) medical and 347 (49.6%) nonmedical personnel. It was noted that 266 (75.4%) of medical professionals and 268 (77.2%) of nonmedical professionals experienced eye problems after prolonged digital screen exposure. A significant proportion of respondents experienced an increase in symptoms following COVID-19 lockdown with 140 (52.6%) being medical professionals and 163 (60.8%) nonmedical professionals (P = 0.015).

CONCLUSIONS

DES is a preventable lifestyle-associated disorder. Awareness among the masses can reduce the adverse effects. Proper lighting, adequate viewing distance, voluntary blinking, and using lubricating eye drops are a few ways to reduce the chances of DES. Further studies are needed to formulate standardized guidelines for the management of DES.

Computer Vision Syndrome: Prevalence and Associated Risk Factors Among Computer-Using Bank Workers in Pakistan

Objectives:

The aim of this study was to investigate the prevalence of symptoms of computer vision syndrome (CVS) and identify its associated risk factors among computer-using bank workers in Pakistan.

Materials and Methods:

This cross-sectional study was conducted on computer-using bank workers. The data collection procedure included a self-administered questionnaire and comprehensive ocular health examination. The prevalence of CVS and its associated risk factors were investigated. The chi-square test was used to study the significance of the association of CVS with potential risk factors.

Results:

Of 127 participants, 95 (74.8%) were men. Most of the participants (n=53; 41.7%) were in the 30-40 years age group. A total of 101 participants (79.5%) reported any ocular symptom, with burning eyes being the most frequent ocular symptom (77.2%). General body fatigue was the most common non-ocular symptom of CVS (92.9%), followed by headache (83.5%). Out of 127 participants, 71 men and 30 women had some degree of CVS. Female participants had significantly higher risk of CVS than male participants (p=0.01). Total duration of computer use per day and duration of uninterrupted computer use were significantly associated with the occurrence of CVS (p=0.001 and p=0.008, respectively). No significant association was found between CVS and distance from computer screen (p=0.89), frequency of breaks (p=0.18), or font size (p=0.12).

Conclusion:

A high prevalence of CVS-related symptoms was observed among computer-using bank workers. Non-ocular symptoms associated with computer use were more common than ocular symptoms (92.9% vs. 77.2%).

Prevalence and Associated Factors of Computer Vision Syndrome Among Academic Staff in the University of Gondar, Northwest Ethiopia: An Institution-Based Cross-Sectional Study

INTRODUCTION

Computer vision syndrome (CVS) is the leading occupational hazard of the 21st century, which causes the critical public health issues in the present era. In developing countries, including Ethiopia, data on the proportion and the causes of CVS are scarce among academic staff for policy conclusions. Accordingly, this study was conducted to determine the prevalence and factors associated with CVS among academic staff at the University of Gondar.

METHODS

Institution-based cross-sectional study design was conducted from March to April, 2021. A simple random sampling technique was used to select 525 study participants. Data were collected using a pre-tested self-administered structured questionnaire. The collected data were then entered into EpiData version 4.6 and analyzed using STATA version 14 software. The association between dependent and independent variables was computed with a binary logistic regression.

RESULTS

The prevalence of CVS was found to be 78.8% out of a total of 500 participants [95% CI (74.95, 82.30)], of which the majority (71.60%) of them were males. Using a computer for more than 9 years [AOR = 1.65, 95% CI (1.01, 2.71)], using visual display terminals [AOR = 2.63, 95% CI (1.60, 4.32)], and working in improper illumination levels (300 and >500 lux) [AOR = 2.47, 95% CI (1.47, 4.33)] increased the risk of CVS, whereas, Using eye droplets [AOR = 0.30, 95% CI (0.15, 0.58)] and taking rest breaks [AOR = 0.55, 95% CI (0.34-0.92)] were protective factors.

CONCLUSION

This study disclosed that CVS was common among academicians. In the current study, the manifestation of CVS was affected by years of computer use, visual display terminals use, workplace illumination level, rest breaks, and eye droplets. Taking rest breaks in between the work, reducing exposure to display screens, use of eye drops, and optimizing workplace illumination levels are recommended to reduce the problem.

Interventions for the management of computer vision syndrome: a systematic review and meta-analysis

TOPIC

To evaluate the efficacy and safety of interventions for treating eye strain related to computer use relative to placebo or no treatment.

CLINICAL RELEVANCE

Computer use is pervasive and often associated with eye strain, referred to as "computer vision syndrome" (CVS). Currently, there are no clinical guidelines to help practitioners provide evidence-based advice about CVS treatments, many of which are directly marketed to patients. This systematic review and meta-analysis will help inform best practice for eye care providers.

METHODS

Eligible randomized controlled trials (RCTs) were identified in Ovid MEDLINE, EMBASE, CENTRAL, and trial registries, searched from inception to November 23, 2021. Eligible studies were appraised for risk of bias, and synthesized. The certainty of the body of evidence was judged using GRADE. Standardized mean differences (SMD) were used when differently scaled measures were combined.

RESULTS

Forty-five RCTs, involving 4497 participants, were included. Multifocal lenses did not improve visual fatigue scores compared to single-vision lenses (three RCTs, SMD: 0.11; 95% confidence interval (CI) -0.14 to 0.37; p=0.38). Visual fatigue symptoms were not reduced by blue-blocking spectacles (three RCTs), with evidence judged to be of low certainty. Relative to placebo, oral berry extract supplementation for 4 to 12 weeks did not improve visual fatigue (seven RCTs, SMD: -0.27; 95%CI -0.70 to 0.16; p=0.22), and dry eye symptoms (four RCTs, SMD: -0.10; 95%CI -0.54 to 0.33; p=0.65). Likewise, berry extract supplementation had no effect on critical flicker-fusion frequency (CFF) or accommodative amplitude. Oral omega-3 fatty acid supplementation for 45 days to 3 months improved dry eye symptoms (two RCTs, mean difference, MD: -3.36 units out of 18; 95%CI -3.63 to -3.10; p<0.00001) relative to placebo. Oral carotenoid supplementation improved CFF (two RCTs, MD: 1.55 Hz; 95%CI 0.42 to 2.67; p=0.007) relative to placebo, although the clinical significance of this finding is unclear.

CONCLUSIONS

We found no high certainty evidence supporting the use of any of the therapies analyzed. There was low certainty evidence that oral omega-3 supplementation reduces dry eye symptoms in symptomatic computer users.

Translation, cross-cultural adaptation and validation of the Computer Vision Syndrome Questionnaire into Persian (CVS-Q FA©)

Purpose

To translate, cross-culturally adapt and validate the Computer Vision Syndrome Questionnaire (CVS-Q^©) into Persian.

Methods

This study was carried out in 2 phases: (1) the CVS-Q^© was translated and cross-culturally adapted into Persian and (2) the validity and reliability of CVS-Q FA^© were assessed in a cross-sectional validation study. An expert committee composed of 15 optometrists evaluated content validity (item-level (I-CVI) and scale-level (S-CVI) content validity index were calculated). A pretest was performed (n = 20 participants) to verify the comprehensibility of the questionnaire. A total of 102 computer users completed the final questionnaire. Criterion validity and diagnostic performance of the CVS-Q FA^© were assessed by calculating sensitivity, specificity and receiver characteristic operator curve. Cronbach's alpha was calculated for the assessment of internal consistency and 46 participants refilled the questionnaire for the second time and the interclass correlation coefficient (ICC) and Cohen's kappa (κ) were evaluated for test–retest reliability.

Results

The translation and cross-cultural adaptation process was performed successfully according to accepted scientific recommendations without any major difficulties. The I-CVI was above 0.80 for all items (symptoms) except item 15 (feeling that sight is worsening) and the S-CVI was 0.92. The CVS-Q FA^© showed good sensitivity (81.1%) and acceptable specificity (69.2%). Also, it achieved good internal consistency (Cronbach's alpha = 0.80) and test–retest reliability (ICC = 0.81 and κ = 0.65).

Conclusion

The CVS-Q FA^© was successfully translated, cross-culturally adapted, and validated into Persian. This study provides a valid and reliable tool for the assessment of computer vision syndrome among the Iranian working population.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10792-022-02340-3.

Computer vision syndrome and predictors among computer users in Ethiopia: a systematic review and meta-analysis

Background

A computer is one of the most widely used office tools. The leading occupational health problem of the twenty-first century is computer vision syndrome (CVS). Research findings across Ethiopia on the magnitude and predictors of CVS among computer users are highly variable and inconsistent. Therefore, this study aimed to estimate the overall prevalence of CVS and its predictors among computer users in Ethiopia.

Methods

We searched articles in all databases and other sources. Cochrane Q test statistics and I² tests were used. A random-effect meta-analysis model was used. In addition, the association between risk factors and CVS among computer users was examined.

Results

Eight eligible studies were included. The pooled prevalence of CVS among computer users in Ethiopia was 73.21% (95% CI 70.32–76.11). Sub-group analysis by profession has shown that the highest prevalence of CVS was observed in bank employees [73.76% (95% CI 70.40–77.13)]. The most common reported symptoms of CVS were blurred vision (34.26%; 95% CI 22.08, 46.43). The previous history of eye disease (95% CI 2.30, 5.47), inappropriate sitting position (95% CI 1.76, 3.22), the frequent use of a computer (95% CI 2.04, 3.60), and using eyeglass/spectacles (95% CI 1.10, 3.91) were significantly associated with CVS among computer users in Ethiopia.

Conclusions

According to this study, computer vision syndrome was high among computer users in Ethiopia. Computer vision syndrome (CVS) was significantly associated with a previous history of eye disease, inappropriate sitting position, frequent use of a computer, and the use of spectacles. Based on the findings, it is suggested that efforts be made to optimize computer exposure time. It is also worth noting that employees should be properly seated when using a computer. Furthermore, people with vision problems should be extra cautious when using a computer. Finally, community awareness of the safety precautions that can be taken to reduce CVS is critical.

Association of screen time, quality of sleep and dry eye in college-going women of Northern India

Purpose:

To evaluate the association of daily screen time and quality of sleep with the prevalence of dry eye among college-going women.

Methods:

This study was a cross-sectional, comparative questionnaire-based study of 547 college-going women in northern India. A 10-item Mini Sleep Questionnaire was used to check the quality of sleep, and the Standard Patient Evaluation of Eye Dryness (SPEED) scale was used to examine the prevalence of dry eye among college-going women.

Results:

Multinomial logistic regression showed a significant association between dry eye with daily screen time spent (P < 0.05) and the quality of sleep (P < 0.05) among college-going girls. Using Latent Class Analysis, two latent classes were selected based on the Bayesian Information Criteria. It was found that the majority population falls in class two and was having Severe Sleep-Wake difficulty. It was seen that the participants in class two belonged to the age bracket of 18–21 years, were from stream Humanities, education of father and mother equal to graduation, father working only, belonging to the nuclear family, having one sibling, hailing from the urban locality, spending more than 6 h daily on-screen, a majority of them using mobile phones, not using eye lubricants, and reported an increase in screen time during COVID-19.

Conclusion:

Dry eye and sleep quality are essential global health issues, and coupled with increased screen time, may pose a challenge in the present era. Preventive strategies need to be incorporated in school and college curriculums to promote physical, social, and psychological well-being and quality of life.

Computer visual syndrome in graduate students of a private university in Lima, Perú

BACKGROUND

In recent decades, several studies have found a strong association between prolonged use of video display terminals and ophthalmological symptoms encompassed in the so-called computer visual syndrome (CVS). Few studies have addressed this syndrome in graduate students.

METHODS

Observational, cross-sectional descriptive study. A total of 106 postgraduate students were surveyed without ophthalmological pathologies. The diagnosis of CVS was made by means of the questionnaire of Seguí et al. validated in Spanish, which evaluates the frequency and intensity of 16 ocular symptoms.

RESULTS

The prevalence of CVS among graduate university students was 62.3% (95% CI: 52.3-71.5). It was found that the highest proportion of students with the syndrome was in the group of older than 40 years old (88.2%) and in the group 21-30 years old (70.0%), showing statistically significant differences (p = 0.004). According to the device and its time of use, students who used the mobile phone for 7-10 h a day showed a higher prevalence of CVS compared to those who used the device for less time (p = 0.030). The business School had the highest prevalence (75.0%).

CONCLUSION

Three out of every five graduate students presented CVS with this prevalence being like reported in other populations. There is a need to investigate possible interventions that can help reduce this entity.

Clinical Performance of Samfilcon A Contact Lenses in Intensive Digital Device Users: A Multicenter, Prospective Clinical Study

Introduction

To evaluate patient satisfaction with samfilcon A contact lenses (CLs) in intensive digital device users with myopia and to compare patient satisfaction with samfilcon A lenses to prior experience with senofilcon A or lotrafilcon B CLs.

Methods

This was a comparative, prospective, national study conducted at 14 centers in Turkey. Subjects were adults aged 18 and 45 years with myopia (range −0.25 D to −6.00 D) who spend a minimum of 3 hours viewing digital devices (e.g., computer, smartphone). A subgroup of patients were habitual lens wearers (senofilcon A or lotrafilcon B lens wear for at least 6 months prior to enrollment). The primary assessment was patient satisfaction with samfilcon A lenses (0–100 Likert scale). Secondary assessments included patient satisfaction with samfilcon A lenses compared to patients’ habitual lenses, investigator satisfaction with samfilcon A lenses and investigator-evaluated slit lamp examination findings.

Results

Samfilcon A lenses were given high overall ratings from both patients and investigators, with a low incidence of ocular symptoms. Overall, patients were highly satisfied with samfilcon A lenses for comfort, vision and overall performance, and stated that they would consider wearing these lenses in the future. Among habitual senofilcon A or lotrafilcon B lens wearers, samfilcon A lenses were rated significantly better than the habitual lenses in regard to comfort, vision and overall performance. Investigator assessments were also highly favorable, both at initial fit and after 4 weeks of follow-up, with no significant findings noted on slit lamp examination.

Conclusion

Samfilcon A lenses were rated highly by investigators in regard to fit, handling and slit lamp findings, and by novice and habitual lens wearers in regard to comfort, vision and overall performance. These results support the use of samfilcon A lenses among digital device users who seek day-long comfort and good visual acuity.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40123-021-00389-4.

Is reading rate in digital eyestrain influenced by binocular and accommodative anomalies?

INTRODUCTION

Symptoms experienced when using digital devices are known as digital eyestrain (DES) or computer vision syndrome. They can be categorised as either external (associated with dry eye) or internal (related to refractive, accommodative or binocular vision anomalies). In a large cohort of adults with DES, we investigate the prevalence of binocular and accommodative anomalies, contrasting different diagnostic approaches, to evaluate potential mechanisms for the benefit from +0.75D addition lens that has been previously reported.

METHODS

Participants (20-40y) were selected using the Computer Vision Syndrome Questionnaire (CVS-Q) tool as suffering with DES. A comprehensive eye examination was given to each participant, and this paper concentrates on "internal factors", detected with a refraction and comprehensive testing of binocular and accommodative functions. The effects of low-powered addition lenses (+0.50D, +0.75D, +1.25D; and plano controls) were assessed by double-masked testing with the Wilkins Rate of Reading Test (WRRT) and by subjective preference.

RESULTS

As previously reported, most participants showed a subjective preference for one of the three convex lenses we used, with +0.75D chosen most frequently. Performance at the WRRT was significantly improved with +0.50D and +0.75D, but not +1.25D. Using a variety of diagnostic criteria, there were no strong associations between WRRT results or CVS-Q scores and any binocular or accommodation functions. The one finding of significance is that a disproportionate number of participants who benefited from adds had an eso-fixation disparity on the near Mallett unit, although this only affected 5% of the population.

CONCLUSIONS

DES is a collection of diverse symptoms that have a multifactorial aetiology. In the sample described here, binocular and accommodative anomalies do not seem to be a major cause of DES. Nevertheless, in view of the multifactorial aetiology it is recommended that patients with the symptoms of DES are assessed with a comprehensive eye examination. Patients with an esophoric fixation disparity on the near Mallett unit are particularly likely to benefit from near additions.

Computer visual syndrome in graduate students of a private university in Lima, Perú

BACKGROUND

In recent decades, several studies have found a strong association between prolonged use of video display terminals and ophthalmological symptoms encompassed in the so-called computer visual syndrome (CVS). Few studies have addressed this syndrome in graduate students.

METHODS

Observational, cross-sectional descriptive study. A total of 106 postgraduate students were surveyed without ophthalmological pathologies. The diagnosis of CVS was made by means of the questionnaire of Seguí et al. validated in Spanish, which evaluates the frequency and intensity of 16 ocular symptoms.

RESULTS

The prevalence of CVS among graduate university students was 62.3% (95% CI: 52.3-71.5). It was found that the highest proportion of students with the syndrome was in the group of older than 40 years old (88.2%) and in the group 21-30 years old (70.0%), showing statistically significant differences (p=0.004). According to the device and its time of use, students who used the mobile phone for 7 to 10hours a day showed a higher prevalence of CVS compared to those who used the device for less time (p=0.030). The business School had the highest prevalence (75.0%).

CONCLUSION

Three out of every five graduate students presented CVS with this prevalence being like reported in other populations. There is a need to investigate possible interventions that can help reduce this entity.

Impact of the COVID-19 lockdown on digital device-related ocular health

Purpose:

Since the declaration of the lockdown due to COVID-19, the usage of digital devices has gone up across the globe, resulting in a challenge for the visual systems of all ages. The purpose of this study is to assess the impact of the lockdown on digital device usage, and consequently, the ocular surface health implications and circadian rhythm abnormalities related to digital eye strain.

Methods:

An open online survey was sent through various social media platforms and was open for a period of 2 weeks.

Results:

A total of 407 usable responses were obtained; the average age of respondents was 27.4 years. Typically, 93.6% of respondents reported an increase in their screen time since the lockdown was declared. The average increase in digital device usage was calculated at about 4.8 ± 2.8 h per day. The total usage per day was found to be 8.65 ± 3.74 hours. Sleep disturbances have been reported by 62.4% of people. Typically, 95.8% of respondents had experienced at least one symptom related to digital device usage, and 56.5% said that the frequency and intensity of these symptoms increased since the lockdown was declared.

Conclusion:

The study highlighted the drastic increase in use of digital devices after the initiation of the COVID-19 lockdown, and along with it, the slow deterioration of ocular health across all age groups. Awareness about prevention of digital eye strain should be stressed, and going forward, measures to bring these adverse effects to a minimum should be explored.

Use of digital displays and ocular surface alterations: A review

Digital display use has been accepted to be implicated as a contributing factor for dry eye disease (DED). Abnormal blinking during computer operation, including a reduced blink rate and an incomplete eyelid closure, increased palpebral fissure as consequence of high visualization angles, and meibomian gland dysfunction associated to long-term display use, are behind the increased prevalence of dry eye signs and symptoms found in digital display users. Previous research reveals significant reductions in tear volume and stability, alterations in tear film composition, including increased osmolarity, inflammatory cytokines, oxidative stress markers and reduced mucin secretion, eyelid abnormalities and ocular surface damage, encompassing corneal and conjunctival staining and bulbar redness, as a direct consequence of digital display use. In this regard, individual differences in the way that the various digital displays are typically set up and used may account for differences in their effects on induced dryness signs and symptoms. Furthermore, factors such as the use of contact lenses or inappropriate working environments, usually accompanying the use of displays, may significantly increase the prevalence and the severity of induced dry eye. Other factors, such as old age and female gender are also relevant in the appearance of associated alterations. Finally, clinicians should adopt a treatment strategy based on a multidirectional approach, with various treatments being applied in conjunction.

Ocular symptoms associated with digital device use in contact lens and non-contact lens groups

PURPOSE

Previous reports indicate that "eye fatigue" occurs in roughly 60 % of the adult population using digital devices and may negatively impact quality of life. However, the construct of eye fatigue remains poorly understood. The goal of this study was to quantify the relationship among symptoms most frequently associated with eye fatigue in those using digital devices.

METHODS

Six hundred and two soft contact lens (SCL) wearers and 127 non-contact lens (non-CL) wearers who reported using digital devices at least 4 hours per day completed a questionnaire assessing the frequency and severity of ten symptoms commonly associated with digital device-related eye fatigue. Subjective ratings were made separately for each symptom using unipolar, five-point Likert scales.

RESULTS

From the initial pool of respondents, 89 % of the SCL wearers reported experiencing eye fatigue more than once per month, while over 60 % reported more than once per week. Notably, eye fatigue frequency did not differ between the soft contact and non-contact lens groups. Although eye strain/pain, dryness, and tired eyes were the most frequently endorsed symptoms by both groups, only dryness and eye irritation were significant factors that discriminated the SCL from the non-CL wearers on the basis of frequency and severity. Principal component analysis indicated that eye strain/pain, soreness, tired eyes, and headaches may comprise a "primary sensations" factor, whereas burning, eye irritation, tearing and dryness comprise a "secondary or surface sensations" factor, and blurred/double vision and words move/float comprise a "visual sensations" factor. Confirmatory factor analysis (CFA) of frequency and severity ratings for SCL wearers yielded excellent fits (RMSEA = 0.046 and 0.050, respectively) with construct reliabilities ranging from 0.729 to 0.824.

CONCLUSION

Frequent and severe eye fatigue is highly prevalent among both soft contact lens and non-contact lens wearers. Those utilizing SCL do not experience symptoms at higher frequency or severity. Key descriptors of digital eye fatigue have been identified and may then be used to help identify and evaluate specific causative, palliative, or ameliorating factors.

An investigation of low power convex lenses (adds) for eyestrain in the digital age (CLEDA)

INTRODUCTION

Digital eye strain (DES; computer vision syndrome) is a common cause of symptoms when viewing digital devices. Low-powered convex lenses (adds) have been recommended for the condition and "accommodative support" designs developed on this premise. The present research reports the extent to which dry eye is present in this population and the effect of convex lenses on symptoms and visual performance.

METHODS

The CVS-Q instrument was used to select pre-presbyopic adults with the symptoms of DES. Participants received a full eye examination including an assessment of dry eye with a modified SANDE questionnaire and using DEWS I criteria. The immediate effect of low-powered convex lenses (low adds: +0.50D, +0.75D, +1.25D) was investigated using subjective preference and a double-masked comparison with plano lenses with the Wilkins Rate of Reading Test (WRRT). Throughout this testing, participants wore their full distance refractive correction, based on non-cycloplegic retinoscopy and subjective refraction.

RESULTS

The signs and symptoms of dry eye were frequently present. Most participants reported a subjective preference for low adds, with +0.75D the most commonly preferred lens. Low adds (+0.50D and +0.75D; but not +1.25D) were associated with significantly improved performance at the WRRT. One quarter of participants read more than 10% faster with these additional convex lenses.

CONCLUSIONS

The study population was aged 20-40y and mostly worked on desktop computers. It is possible that +1.25D add may be more advantageous for people who are older or work more at closer viewing distances. Many symptomatic users of digital devices report a preference for low adds and use of these lenses is often associated with an improvement in reading performance.

Computer vision symptoms in people with and without neck pain

BACKGROUND

Sixty-four to 90% of computer users experience symptoms of computer vision syndrome (CVS). People with CVS symptoms experience neck pain (NP), and people with NP can have visual symptoms.

OBJECTIVES

(1) To examine differences in CVS symptoms in computer users with and without persistent NP. (2) To determine relationships between visual ergonomics, demographics, and CVS in those with and without persistent NP DESIGN: Comparative cross-sectional observational study METHOD: An online survey consisting of multiple questionnaires including the Computer Vision Syndrome Questionnaire (CVS-Q), Visual Symptoms Survey (VSS), and Convergence Insufficiency Symptoms Survey (CISS) was completed by 167 participants.

RESULTS

The persistent NP group had significantly higher CVS-Q, VSS, and CISS scores (p <0.01) compared to controls. No relationships were found between visual ergonomics, demographics, and visual symptoms in both groups.

CONCLUSIONS

People with persitent NP are more likely to present with CVS than controls. Clinicians should consider assessing visual symptoms in people presenting with persisting NP.

Computer Vision Syndrome: Darkness Under the Shadow of Light

Radiologists typically spend long hours staring at the computer monitor. This unavoidable nature of our work can lead to detrimental effects on the eyes. Moreover, there is little awareness among radiologists with regards to such potential harm. Ocular hazards, such as computer vision syndrome, are increasingly becoming more relevant to the radiology community. In this article, we discuss the ocular occupational hazards faced by radiologists and suggestions that may help in minimizing such hazards.

Computer vision syndrome prevalence, knowledge and associated factors among Saudi Arabia University Students: Is it a serious problem?

OBJECTIVES

Computers and other visual display devices are now an essential part of our daily life. With the increased use, a very large population is experiencing sundry ocular symptoms globally such as dry eyes, eye strain, irritation, and redness of the eyes to name a few. Collectively, all such computer related symptoms are usually referred to as computer vision syndrome (CVS). The current study aims to define the prevalence, knowledge in community, pathophysiology, factors associated, and prevention of CVS.

METHODS

This is a cross-sectional study conducted in Qassim University College of Medicine during a period of 1 year from January 2015 to January 2016 using a questionnaire to collect relevant data including demographics and various variables to be studied. 634 students were inducted from a public sector University of Qassim, Saudi Arabia, regardless of their age and gender. The data were then statistically analyzed on SPSS version 22, and the descriptive data were expressed as percentages, mode, and median using graphs where needed.

RESULTS

A total of 634 students with a mean age of 21. 40, Std 1.997 and Range 7 (18-25) were included as study subjects with a male predominance (77.28%). Of the total patients, majority (459, 72%) presented with acute symptoms while remaining had chronic problems. A clear-cut majority was carrying the symptoms for <5 days and >1 month. The statistical analysis revealed serious symptoms in the majority of study subjects especially those who are permanent users of a computer for long hours.

CONCLUSION

Continuous use of computers for long hours is found to have severe problems of vision especially in those who are using computers and similar devices for a long duration.

The effect of Vaccinium uliginosum extract on tablet computer-induced asthenopia: randomized placebo-controlled study

Background

To investigate the alleviation effect of Vaccinium uliginosum extract (DA9301) on tablet computer-induced asthenopia.

Methods

This was a randomized, placebo-controlled, double-blind and parallel study (Trial registration number: 2013–95). A total 60 volunteers were randomized into DA9301 (n = 30) and control (n = 30) groups. The DA9301 group received DA9301 oral pill (1000 mg/day) for 4 weeks and the control group received placebo. Asthenopia was evaluated by administering a questionnaire containing 10 questions (responses were scored on a scales of 0–6; total score: 60) regarding ocular symptoms before (baseline) and 4 weeks after receiving pills (DA9301 or placebo). The participants completed the questionnaire before and after tablet computer (iPad Air, Apple Inc.) watching at each visit. The change in total asthenopia score (TAS) was calculated and compared between the groups

Results

TAS increased significantly after tablet computer watching at baseline in DA9301 group. (from 20.35 to 23.88; p = 0.031) However, after receiving DA9301 for 4 weeks, TAS remained stable after tablet computer watching. In the control group, TAS changes induced by tablet computer watching were not significant both at baseline and at 4 weeks after receiving placebo. Further analysis revealed the scores for “tired eyes” (p = 0.001), “sore/aching eyes” (p = 0.038), “irritated eyes” (p = 0.010), “watery eyes” (p = 0.005), “dry eyes” (p = 0.003), “eye strain” (p = 0.006), “blurred vision” (p = 0.034), and “visual discomfort” (p = 0.018) significantly improved in the DA9301 group.

Conclusions

We found that oral intake of DA9301 (1000 mg/day for 4 weeks) was effective in alleviating asthenopia symptoms induced by tablet computer watching.

Trial registration

The study is registered at www.clinicaltrials.gov (registration number: NCT02641470, date of registration December 30, 2015).

Visual consequences of electronic reader use: a pilot study

BACKGROUND

With the increasing prevalence of electronic readers (e-readers) for vocational and professional uses, it is important to discover if there are visual consequences in the use of these products. There are no studies in the literature quantifying the incidence or severity of eyestrain, nor are there clinical characteristics that may predispose to these symptoms with e-reader use.

PURPOSE

The primary objective of this pilot study was to assess the degree of eyestrain associated with e-reader use compared to traditional paper format. The secondary outcomes of this study were to assess the rate of eyestrain associated with e-reader use and identify any clinical characteristics that may be associated with the development of eyestrain.

METHODS

Forty-four students were randomly assigned to study (e-reader iPAD) and control (print) groups. Participant posture, luminosity of the room, and reading distance from reading device were measured during a 1-h session for both groups. At the end of the session, questionnaires were administered to determine symptoms.

RESULTS

Significantly higher rates of eyestrain (p = 0.008) and irritation (p = 0.011) were found among the iPAD study group as compared to the print 'control' group. The study group was also 4.9 times more likely to report severe eyestrain (95 % CI [1.4, 16.9]). No clinical characteristics predisposing to eyestrain could be identified.

CONCLUSIONS

These findings conclude that reading on e-readers may induce increased levels of irritation and eyestrain. Predisposing factors, etiology, and potential remedial interventions remain to be determined.

Computer and visual display terminals (VDT) vision syndrome (CVDTS)

Computer and visual display terminals have become an essential part of modern lifestyle. The use of these devices has made our life simple in household work as well as in offices. However the prolonged use of these devices is not without any complication. Computer and visual display terminals syndrome is a constellation of symptoms ocular as well as extraocular associated with prolonged use of visual display terminals. This syndrome is gaining importance in this modern era because of the widespread use of technologies in day-to-day life. It is associated with asthenopic symptoms, visual blurring, dry eyes, musculoskeletal symptoms such as neck pain, back pain, shoulder pain, carpal tunnel syndrome, psychosocial factors, venous thromboembolism, shoulder tendonitis, and elbow epicondylitis. Proper identification of symptoms and causative factors are necessary for the accurate diagnosis and management. This article focuses on the various aspects of the computer vision display terminals syndrome described in the previous literature. Further research is needed for the better understanding of the complex pathophysiology and management.

Vision-related problems among the workers engaged in jewellery manufacturing

Background:

American Optometric Association defines Computer Vision Syndrome (CVS) as “complex of eye and vision problems related to near work which are experienced during or related to computer use.” This happens when visual demand of the tasks exceeds the visual ability of the users. Even though problems were initially attributed to computer-related activities subsequently similar problems are also reported while carrying any near point task. Jewellery manufacturing activities involves precision designs, setting the tiny metals and stones which requires high visual attention and mental concentration and are often near point task. It is therefore expected that the workers engaged in jewellery manufacturing may also experience symptoms like CVS.

Aim:

Keeping the above in mind, this study was taken up (1) To identify the prevalence of symptoms like CVS among the workers of the jewellery manufacturing and compare the same with the workers working at computer workstation and (2) To ascertain whether such symptoms have any permanent vision-related problems.

Setting and Design:

Case control study.

Materials and Methods:

The study was carried out in Zaveri Bazaar region and at an IT-enabled organization in Mumbai. The study involved the identification of symptoms of CVS using a questionnaire of Eye Strain Journal, opthalmological check-ups and measurement of Spontaneous Eye Blink rate. The data obtained from the jewellery manufacturing was compared with the data of the subjects engaged in computer work and with the data available in the literature.

Statistical Analysis:

A comparative inferential statistics was used.

Results and Conclusion:

Results showed that visual demands of the task carried out in jewellery manufacturing were much higher than that of carried out in computer-related work.

The diagnostic value and accuracy of conjunctival impression cytology, dry eye symptomatology, and routine tear function tests in computer users

AIMS AND OBJECTIVES

To compare the diagnostic value and accuracy of dry eye scoring system (DESS), conjunctival impression cytology (CIC), tear film breakup time (TBUT), and Schirmer's test in computer users.

METHODS

A case-control study was done at two referral eye centers. Eyes of 344 computer users were compared to 371 eyes of age and sex matched controls. Dry eye questionnaire (DESS) was administered to both groups and they further underwent measurement of TBUT, Schirmer's, and CIC. Correlation analysis was performed between DESS, CIC, TBUT, and Schirmer's test scores. A Pearson's coefficient of the linear expression (R (2)) of 0.5 or more was statistically significant.

RESULTS

The mean age in cases (26.05 ± 4.06 years) was comparable to controls (25.67 ± 3.65 years) (P = 0.465). The mean symptom score in computer users was significantly higher as compared to controls (P < 0.001). Mean TBUT, Schirmer's test values, and goblet cell density were significantly reduced in computer users (P < 0.001). TBUT, Schirmer's, and CIC were abnormal in 48.5%, 29.1%, and 38.4% symptomatic computer users respectively as compared to 8%, 6.7%, and 7.3% symptomatic controls respectively. On correlation analysis, there was a significant (inverse) association of dry eye symptoms (DESS) with TBUT and CIC scores (R (2) > 0.5), in contrast to Schirmer's scores (R(2) < 0.5). Duration of computer usage had a significant effect on dry eye symptoms severity, TBUT, and CIC scores as compared to Schirmer's test.

CONCLUSION

DESS should be used in combination with TBUT and CIC for dry eye evaluation in computer users.

Computer vision syndrome and associated factors among medical and engineering students in chennai

Background:

Almost all institutions, colleges, universities and homes today were using computer regularly. Very little research has been carried out on Indian users especially among college students the effects of computer use on the eye and vision related problems.

Aim:

The aim of this study was to assess the prevalence of computer vision syndrome (CVS) among medical and engineering students and the factors associated with the same.

Subjects and Methods:

A cross-sectional study was conducted among medical and engineering college students of a University situated in the suburban area of Chennai. Students who used computer in the month preceding the date of study were included in the study. The participants were surveyed using pre-tested structured questionnaire.

Results:

Among engineering students, the prevalence of CVS was found to be 81.9% (176/215) while among medical students; it was found to be 78.6% (158/201). A significantly higher proportion of engineering students 40.9% (88/215) used computers for 4-6 h/day as compared to medical students 10% (20/201) (P < 0.001). The reported symptoms of CVS were higher among engineering students compared with medical students. Students who used computer for 4-6 h were at significantly higher risk of developing redness (OR = 1.2, 95% CI = 1.0-3.1,P = 0.04), burning sensation (OR = 2.1,95% CI = 1.3-3.1, P < 0.01) and dry eyes (OR = 1.8, 95% CI = 1.1-2.9, P = 0.02) compared to those who used computer for less than 4 h. Significant correlation was found between increased hours of computer use and the symptoms redness, burning sensation, blurred vision and dry eyes.

Conclusion:

The present study revealed that more than three-fourth of the students complained of any one of the symptoms of CVS while working on the computer.

Computer use and vision-related problems among university students in ajman, United arab emirate

Background:

The extensive use of computers as medium of teaching and learning in universities necessitates introspection into the extent of computer related health disorders among student population.

Aim:

This study was undertaken to assess the pattern of computer usage and related visual problems, among University students in Ajman, United Arab Emirates.

Materials and Methods:

A total of 500 Students studying in Gulf Medical University, Ajman and Ajman University of Science and Technology were recruited into this study. Demographic characteristics, pattern of usage of computers and associated visual symptoms were recorded in a validated self-administered questionnaire. Chi-square test was used to determine the significance of the observed differences between the variables. The level of statistical significance was at P < 0.05. The crude odds ratio (OR) was determined using simple binary logistic regression and adjusted OR was calculated using the multiple logistic regression.

Results:

The mean age of participants was 20.4 (3.2) years. The analysis of racial data reveals that 50% (236/471) students were from Middle East, 32% (151/471) from other parts of Asia, 11% (52/471) from Africa, 4% (19/471) from America and 3% (14/471) from Europe. The most common visual problems reported among computer users were headache - 53.3% (251/471), burning sensation in the eyes - 54.8% (258/471) and tired eyes - 48% (226/471). Female students were found to be at a higher risk. Nearly 72% of students reported frequent interruption of computer work. Headache caused interruption of work in 43.85% (110/168) of the students while tired eyes caused interruption of work in 43.5% (98/168) of the students. When the screen was viewed at distance more than 50 cm, the prevalence of headaches decreased by 38% (50-100 cm – OR: 0.62, 95% of the confidence interval [CI]: 0.42-0.92). Prevalence of tired eyes increased by 89% when screen filters were not used (OR: 1.894, 95% CI: 1.065-3.368).

Conclusion:

High prevalence of vision related problems was noted among university students. Sustained periods of close screen work without screen filters were found to be associated with occurrence of the symptoms and increased interruptions of work of the students. There is a need to increase the ergonomic awareness among students and corrective measures need to be implemented to reduce the impact of computer related vision problems.

Evaluation of the Factors which Contribute to the Ocular Complaints in Computer Users

CONTEXT

Use of information technology hardware given new heights to professional success rate and saves time but on the other hand its harmful effect has introduced an array of health related complaints causing hazards for our human health. Increased use of computers has led to an increase in the number of patients with ocular complaints which are being grouped together as computer vision syndrome (CVS). In view of that, this study was undertaken to find out the ocular complaints and the factors contributing to occurrence of such problems in computer users.

AIMS

To evaluate the factors contributing to Ocular complaints in computer users in Teerthanker Mahaveer University, Moradabad, U.P. India.

SETTINGS AND DESIGN

Community-based cross-sectional study of 150 subjects who work on computer for varying period of time in Teerthanker Mahaveer University, Moradabad, Uttar Pradesh.

MATERIALS AND METHODS

Two hundred computer operators working in different institutes offices and bank of were selected randomly in Teerthanker Mahaveer University, Moradabad, and Uttar Pradesh. 16 were non responders 18 did not come for assessment and 16 were excluded due to complaints prior to computer use making no response rate Twenty-one did not participate in the study, making the no response rate 25%. Rest of the subjects (n = 150) were asked to fill a pre-tested questionnaire, after obtaining their verbal consent Depending on the average hours of usage in a day, they were categorized into three categories viz. <2 hrs, 2-6 hrs, >6 hrs of usage. All the responders were asked to come to the Ophthalmic OPD for further interview and assessment.

STATISTICAL ANALYSIS USED

Simple proportions and Chi-square test.

RESULTS

Among the 150 subjects studied major ocular complaint reported in descending order were eyestrain. (53%). Occurrence of eye strain, ( 53.8%), itching ( 47.6%) and burning (66.7%) in subjects using computer for more than 6 hours. distance from computer screen with respect to eyes, use of antiglare screen, taking frequent breaks, use of LCD monitor and adjustment of brightness of monitor screen bear a significant association with these ocular complaints in computer users.

CONCLUSIONS

Eye strain is the most common ocular complaints among computer users working for more than 6 hours a day. We also found that maintaining ideal distance from screen, keeping level of eyes above the top of screen, taking frequent breaks, using LCD monitors and using antiglare screen and adjusting brightness levels according to workplace reduced these ocular complaints to a significant level.

Clinical efficacy of Ayurvedic management in computer vision syndrome: A pilot study

Improper use of sense organs, violating the moral code of conduct, and the effect of the time are the three basic causative factors behind all the health problems. Computer, the knowledge bank of modern life, has emerged as a profession causing vision-related discomfort, ocular fatigue, and systemic effects. Computer Vision Syndrome (CVS) is the new nomenclature to the visual, ocular, and systemic symptoms arising due to the long time and improper working on the computer and is emerging as a pandemic in the 21(st) century. On critical analysis of the symptoms of CVS on Tridoshika theory of Ayurveda, as per the road map given by Acharya Charaka, it seems to be a Vata-Pittaja ocular cum systemic disease which needs systemic as well as topical treatment approach. Shatavaryaadi Churna (orally), Go-Ghrita Netra Tarpana (topically), and counseling regarding proper working conditions on computer were tried in 30 patients of CVS. In group I, where oral and local treatment was given, significant improvement in all the symptoms of CVS was observed, whereas in groups II and III, local treatment and counseling regarding proper working conditions, respectively, were given and showed insignificant results. The study verified the hypothesis that CVS in Ayurvedic perspective is a Vata-Pittaja disease affecting mainly eyes and body as a whole and needs a systemic intervention rather than topical ocular medication only.

Understanding and preventing computer vision syndrome

The invention of computer and advancement in information technology has revolutionized and benefited the society but at the same time has caused symptoms related to its usage such as ocular sprain, irritation, redness, dryness, blurred vision and double vision. This cluster of symptoms is known as computer vision syndrome which is characterized by the visual symptoms which result from interaction with computer display or its environment. Three major mechanisms that lead to computer vision syndrome are extraocular mechanism, accommodative mechanism and ocular surface mechanism. The visual effects of the computer such as brightness, resolution, glare and quality all are known factors that contribute to computer vision syndrome. Prevention is the most important strategy in managing computer vision syndrome. Modification in the ergonomics of the working environment, patient education and proper eye care are crucial in managing computer vision syndrome.