Search

RESUMEN Objetivos: Determinar la validez y confiabilidad del instrumento “Computer Vision Syndrome Questionnaire (CVS-Q)” en la medición del Síndrome Visual Informático en personal de salud de Lima. Material y métodos: Estudio observacional, descriptivo y de corte transversal, de tipo evaluación de cuestionario, realizado en 82 trabajadores de salud. La validez de contenido se evaluó mediante juicio de expertos con método estadístico de V de Aiken; Validez de constructo, mediante análisis factorial; validez discriminante, a través de la curva operador-receptor (ROC) contrastada con el cuestionario CSSV17; confiabilidad de consistencia interna, con alfa de Cronbach; confiabilidad test - re-test (con 7 días de diferencia); con Rho de Spearman y Coeficiente de Correlación Intraclase (CCI), con intervalos de confianza (IC) del 95%. Se empleó para el procesamiento el software SPSS versión 20.0 para Windows con licencia de prueba. Resultados: El V de Aiken obtuvo un valor de 100%. El análisis factorial extrajo 3 componentes principales que explicaron el 69,455% de la varianza total. El área bajo la curva ROC fue 0,889 [(0,845-0,934); IC=0,95] (p=0,000), sensibilidad 72,22% y especificidad 100%. El alfa de Cronbach fue 0,939, Rho de Spearman 0,884 (p=0,000) y CCI 0,856 [(0,777 - 0,907); IC=0,95] (p=0,000). Conclusiones: El Cuestionario CVS-Q es válido y confiable para ser aplicado sobre el grupo ocupacional de profesionales de la salud con buenas propiedades psicométricas. SUMMARY Objectives: To determine the validity and reliability of the instrument "Computer Vision Syndrome Questionnaire (CVS-Q)" in the measurement of the Computer Visual Syndrome in health personnel in Lima. Methods: A quantitative, observational, descriptive, cross-sectional and questionnaire study was carried out in 82 health workers. Content validity was evaluated by expert judgment with the Aiken V statistical method; construct validity, through factor analysis; discriminant validity, through the receiver operating characteristic curve (ROC) curve contrasted with the CSSV17 questionnaire; internal consistency reliability, with Cronbach's alpha; reliability test - re-test (7 days apart); with Spearman's Rho and Interclass Correlation Coefficient (ICC) with 95% CI. The SPSS software version 20.0 for Windows with a trial license was used for its processing. Results: The V of Aiken obtained a value of 100%. The factor analysis extracted 3 main components that explain 69.455% of the total variance. The area under the ROC curve was 0.889 [(0.845-0,934); CI=0.95] (p=0.000), sensitivity 72.2% and specificity 100%. Cronbach's alpha was 0.939, Spearman's Rho 0.884 (p=0.000) and ICC 0.856 [(0.777 - 0.907); CI=0.95] (p=0.000). Conclusions: The CVS-Q questionnaire is valid and reliable to be applied in the health professionals’ occupational group with good psychometric properties.

Purpose: To assess the prevalence of digital eye strain among children and extrapolate the association between knowledge, attitude, and practice patterns related to device use during the coronavirus disease 2019 (COVID-19) lockdowns. Methods: A cross-sectional, descriptive, questionnaire-based analysis was done to assess the knowledge, attitude, and practice patterns related to digital device use among parents of children attending online classes. Results: A total of 305 responses were obtained. The most common reason for device use was online classes (288 children; 94.4%) and the most common mode was smartphone (263 children; 86.3%). The prevalence of digital eye strain was 64.6%. The mean knowledge score was 48.5 ± 5.1, the mean attitude score was 26.7 ± 4.9, and the mean practice score was 17.8 ± 3.5. The difference between knowledge, attitude, and practice scores among parents of children with and without glasses was not statistically significant ( P = .580, .521, and .503, respectively). A direct correlation was found between the knowledge and practice scores ( P = .002), but attitude scores did not show a significant correlation ( P = .712). Conclusions: Digital devices have been a boon to continue education during the ongoing COVID-19 pandemic. This study reveals a large knowledge gap among parents related to safe digital device use. Further, there is a need to adopt methods that would help spread awareness to the masses about the effects of excessive screen time in children in the form of digital eye strain and myopia and the corrective measures to avoid the same. [ J Pediatr Ophthalmol Strabismus . 2022;59(4):224–235.]

In optical see-through augmented reality (AR), information is often distributed between real and virtual contexts, and often appears at different distances from the user. To integrate information, users must repeatedly switch context and change focal distance. If the user's task is conducted under time pressure, they may attempt to integrate information while their eye is still changing focal distance, a phenomenon we term transient focal blur. Previously, Gabbard, Mehra, and Swan (2018) examined these issues, using a text-based visual search task on a one-eye optical see-through AR display. This paper reports an experiment that partially replicates and extends this task on a custom-built AR Haploscope. The experiment examined the effects of context switching, focal switching distance, binocular and monocular viewing, and transient focal blur on task performance and eye fatigue. Context switching increased eye fatigue but did not decrease performance. Increasing focal switching distance increased eye fatigue and decreased performance. Monocular viewing also increased eye fatigue and decreased performance. The transient focal blur effect resulted in additional performance decrements, and is an addition to knowledge about AR user interface design issues.

To explore the intervention effect of traditional Chinese medicine hot pressing combined with health education in adolescents with asthenopia, 92 adolescents with asthenopia admitted to the outpatient department of Guangming Traditional Chinese Medicine Hospital in Pudong New Area from October 2019 to January 2021 were selected and randomly divided into two groups: the control group and the test group, each with 46 cases. Both received health education. The control group was given sodium hyaluronate eye drops, and the test group was given traditional Chinese medicine hot ironing technique intervention. After 2 courses of treatment, the scores of visual fatigue symptoms, clinical curative effect, and eye refractive power of the two groups were observed. The satisfaction of treatment was compared between the two groups. The scores of asthenopia of the two groups were compared at 6 months after intervention. After the intervention, the scores of visual fatigue symptoms in the control group and the test group were reduced after one or two courses of treatment (control group: t = 4.167, 6.318, and P = 0.027 , 0.010; test group: t = 4.820, 6.834, and P = 0.013 , P < 0.05 ; the total clinical effective rate of the trial group was 93.48%, which was significantly higher than that of the control group (80.43%). The difference between the groups was statistically significant P < 0.05 ; the left and right eyes of the control group did not change significantly before and after the intervention P > 0.05 . After the intervention, the left and right eyes of the paper group were significantly reduced P < 0.05 . After the intervention, the difference of the two groups in the refractive power of the left and right eyes was statistically significant P < 0.05 . After treatment, the satisfaction of the experimental group was significantly higher than that of the control group P < 0.05 . After 6 months, there was no significant change in the visual fatigue score of the experimental group, while the visual fatigue score of the control group increased significantly. The traditional Chinese medicine ironing combined with health education intervention can improve the symptoms of adolescents’ asthenopia and improve the treatment efficiency. The method is safe, and the operation is convenient. It is worthy of clinical promotion.

Dissertação de mestrado em Optometria Avançada, A excessiva utilização de dispositivos digitais, incorporados com emissores de luz díodo (LED), é cada vez mais evidente na vida quotidiana para inúmeras tarefas, maioritariamente em visão próxima. Devido à elevada exposição à luz azul do espetro visível, emitida por estes aparelhos, foram desenvolvidos filtros para proteção à luz azul. Considerando a variedade de filtros à luz azul incorporados em lentes oftálmicas, é relevante perceber de que forma se relacionam com a acomodação. O principal objetivo deste estudo foi avaliar a influência dos filtros à luz azul nos parâmetros acomodativos em sujeitos com acomodação normal. Dezassete sujeitos saudáveis, com idades compreendidas entre os 19 e 29 anos (22,65 ± 2,71 anos), realizaram uma tarefa em visão de perto (VP) durante vinte minutos num computador portátil, colocado a 40 cm de distância, enquanto utilizavam três tipos de lentes oftálmicas diferentes, um par de lentes de controlo (lente 2) e dois pares de lentes com filtros à luz azul diferentes (lente 1 e 3). Tanto antes como depois da tarefa de VP foi medida a amplitude de acomodação (AmAc), o atraso acomodativo (AA) e a flexibilidade acomodativa em VP (FA). Os resultados obtidos mostraram que a amplitude de acomodação não sofreu diferenças estatisticamente significativas com a lente 1 (p = 0,15), com a lente 2 (p = 0,17) e com a lente 3 (p = 0,13) no decorrer da tarefa de VP. O atraso acomodativo aumentou com a utilização das três lentes de estudo, no entanto esta variação só foi estatisticamente significativa para a lente 2 (p = 0,05). A flexibilidade acomodativa não variou de forma estatisticamente significativa com a lente 1 (p = 0,42), lente 2 (p = 0,72) e lente 3 (p = 0,30), na realização da tarefa de VP. Concluiu-se que a amplitude de acomodação e a flexibilidade acomodativa não foram influenciadas pelas três lentes testadas neste estudo. Para além disso, o atraso acomodativo aumentou significativamente com a lente de controlo, concluindo-se que os dois tipos de filtros à luz azul avaliados não influenciaram este parâmetro acomodativo. Em suma, o resultado principal deste estudo sugere que os diferentes filtros à luz azul incorporados em lentes oftálmicas não têm influência nos parâmetros acomodativos em sujeitos com acomodação normal., The excessive use of digital devices, incorporated with light emitting diodes (LED), is increasingly evident in everyday life for the numerous tasks, mostly in near vision. Due to the high exposure to blue light of the visible spectrum emitted by these devices, blue light filters have been developed. Considering the variety of blue light filters incorporated in ophthalmic lenses, it is relevant to understand how they are related to accommodation. The aim of this study was to evaluate the influence of blue light filters on accommodative parameters in subjects with normal accommodation. Seventeen healthy subjects, aged between 19 and 29 years (22.65 ± 2.714 years), performed a task in near vision (NV) for twenty minutes on a laptop computer, placed 40 cm away, while using three types of different ophthalmic lenses, a pair of control lenses (lens 2) and two pairs of lenses with different blue light filters (lens 1 and 3). Both before and after the NV task, amplitude of accommodation (AmAc), lag of accommodation (AA) and accommodative facility in near vision (FA) were measured. The results obtained showed that the amplitude of accommodation did not suffer statistically significant differences with lens 1 (p = 0,15), lens 2 (p = 0,17) and lens 3 (p = 0,13) in the during NV task. The lag of accommodation increased with use of the three study lenses, however this variation was only statistically significant for lens 2 (p = 0,05). Accommodative facility did not vary statistically significantly with lens 1 (p = 0,42), lens 2 (p = 0,72) and lens 3 (p = 0,30) in performing the NV task. It was concluded that the amplitude of accommodation and the accommodative facility were not influenced by the three lenses tested in this study. Moreover, the lag of accommodation increased significantly with the control lens, concluding that the two types of blue light filters evaluated do not influence this accommodative parameter. In summary, the main result of this study suggests that the different blue light blocking filters incorporated in ophthalmic lenses have no influence on accommodative parameters in subjects with normal accommodation.

Problemstellung: Diese Arbeit beschäftigt sich mit dem Fallbeispiel einer jungen Patientin, bei welcher vor mehr als zehn Jahren ein Verdacht auf einen Akkommodationsspasmus und Pseudomyopie gestellt wurde. Später zeigt sich, dass es sich um eine Exophorie, die über die akkommodative Konvergenz kompensiert wird, handelt. Es folgen eine Analyse sowie Diskussion der angewendeten Untersuchungs- und Behandlungsmethoden. Methoden: In diesem Kapitel erfolgt die genaue Beschreibung der Untersuchungsmethoden, die bei der Patientin zur Anwendung gekommen sind. Darunter fallen sowohl die orthoptischen, auch der ausschlaggebende 4-Prismen-Basis-Innen-Test, als auch ophthalmologischen Untersuchungen. Ergebnisse: In diesem Abschnitt werden die Ergebnisse der im Patientenfall erhobenen Untersuchungen beschrieben. Des Weiteren wird der Krankheitsverlauf bis zur passenden Therapie dargestellt. Nachdem der 4-Prismen-Basis-Innen-Test positiv ausfiel, wurde eine Prismenbrille verordnet. Diskussion/Schlussfolgerung: Es wird die Literatur mit dem Patientenfall verglichen und mithilfe dessen der Verdacht auf das Krankheitsbild Exophorie, die durch die akkommodative Konvergenz kompensiert wird, bestätigt. Im Rahmen dessen ist die Differentialdiagnose „Akkommodationsspasmus“ ebenfalls Thema dieses Kapitels. Introduction: This paper analyzes the case of a young patient who was suspected of having an accommodative spasm and pseudomyopia more than ten years ago. However, the patient seems to have exophoria which is compensated by accommodative convergence. An analysis and discussion of the performed examination and treatment methods follows. Methods: In this chapter, a detailed description of the methods used during the examination is given. This includes orthoptic as well as ophthalmological examinations. In addition to these, the decisive 4-prism base-inside test was done also. Results: This chapter describes the results of the examinations carried out in the patient's case. Furthermore, the course of the disease up to the appropriate therapy is presented. After the 4-prism base-inside test was positive, prism glasses were prescribed. Discussion/conclusion: The literature is compared with the patient's case and a suspicion of exophoria compensated by accommodative convergence is confirmed. The differential diagnosis “accommodation spasm” is also part of this chapter.

This paper aims to investigate the efficacy of circularly polarized light smartphones in affecting dry eye symptoms and asthenopia through a comparison with linearly polarized smartphones. One hundred twenty participants were randomly divided into four groups. Dry eye and asthenopia symptoms were evaluated using the Ocular Surface Disease Index (OSDI), Computer Vision Syndrome Scale 17 (CVSS17), Convergence Insufficiency Symptom Survey (CISS), and visual analogue scale (VAS). Objective ocular examinations were assessed by confusion flicker frequency (CFF), tear meniscus height (TMH), noninvasive break-up time (NIBUT), conjunctiva redness, fluorescein tear break-up time (FTBUT), corneal fluorescein staining, and the Schirmer I test. Tests were performed before and after a reading task. Subjective evaluations including the OSDI, CVSS17, and CISS were all significantly increased after reading on a linearly polarized smartphone, whereas no change was observed in the circular polarization groups in both light and dark environments. A significantly enlarged VAS was shown in all of the four groups, but a significant increase in ΔVAS only appeared in the linear polarization groups. There were significant decreases in TMH, NIBUT, conjunctiva redness, FTBUT, and CFF after reading on a linearly polarized smartphone but the circularly polarized smartphone had lesser effects on these parameters. Our study indicated that reading on linearly polarized smartphones may cause dry eye disorder, asthenopia, and ocular discomforts, whereas circularly polarized smartphones appears to minimize these adverse effects on eye dryness and visual fatigue in light and dark environments.

Relevance. It is well known that asthenopic complaints, such as increased visual fatigue when working at close range, lacrimation, eye pain and headache after corneal refractive operations in recent years are increasingly common at routine ophthalmological practice. They cause significant subjective discomfort in patients and reduce the satisfaction of the surgery. The pathogenesis of asthenopia is a violation of the coordinated work of the accommodation and binocular systems as a result of their overstrain with excessive visual loads.Purpose. To study the role of the lack of adequate optical correction before surgery in the development of asthenopia in patients with mild and moderate myopia after ReLEx SMILE surgery, as well as to evaluate the effectiveness of drug correction of this condition.Patients and methods. This study included 84 patients (128 eyes) who spend more than 8 hours at a computer due to their professional activity, without pathology of the visual organ that prevents keratorefractive operations, whose average age was 33.2 ± 1.9 years.Results and discussion. The ReLEx SMILE operations in all patients were carried out without complications with the achievement of uncorrected visual acuity equal to the preoperative values of the maximum corrected visual acuity in the period of 1 week and 1 month. In the group with a preoperative lack of adequate optical correction, signs of asthenopia were more often manifested than in patients using full eyeglass or contact correction before surgery. The appointment of the drug Mydrimax® allows to improve the subjective state of patients with asthenopia and leads to the normalization of functional parameters.Conclusion. Corneal refractive operations in patients with the lack of adequate correction of refractive disorders before surgery leads to a significantly significant increase in the initially impaired functional parameters compared to preoperative values, however, it does not reach normal values in most cases and is accompanied by a greater probability of developing postoperative asthenopia.

Background: Ongoing Pandemic led to embrace technology like never before, which can lead to a rise in the number of ocular complaints grouped under computer vision syndrome (CVS) and put them at a higher risk for developing myopia and serious eye problems in future. Objectives: To assess the magnitude of the emerging significant ocular health problems addressed as CVS and awareness regarding preventive measures to be taken to maintain good ocular health. Methodology: A modified structured Performa was distributed as google form among different sections of Indian society working digitally to collect socio-demographic information, knowledge about CVS, preventive measures taken while working digitally, and questions regarding screen time. A validated CVS questionnaire was administered to assess 16 symptoms, scored using two rating scales for frequency and intensity. A total score of ≥ 6 points is said to suffer from CVS. Statistical analysis was done by mean, standard deviation, chi-square test of independence, and p-value. Results: 506 digitally working people having a mean age of 32.37±12.69 years; 54.74% were male and 45.26% were females. The majority (36.36%) fell under 21-30 years. Prevalence of CVS was 49.81% in males and 50.12% in females. The most commonly reported complaint was headache (70.35%). The majority of subjects (78.10%) with CVS experienced symptoms in moderate intensity. Majority (36.95%) adjusted screen brightness between 25-50%, while 8.89% kept their screen brightness to 6 hours per day, duration of continuously staring at the screen, screen brightness levels, pre-existing refractory error, Knowledge about preventive measures to maintain good ocular hygiene were significantly associated with the development of CVS.

Purpose: To analyze the correlation between eye movements and asthenopia so as to explore the possibility of using eye-tracking techniques for objective assessment of asthenopia.Methods: This prospective observational study used the computer visual syndrome questionnaire to assess the severity of asthenopia in 93 enrolled college students who complained about asthenopia. Binocular accommodation and eye movements during the reading task were also examined. The correlations between the questionnaire score and accommodation examination results and eye movements parameters were analyzed. Differences in eye movement parameters between the first and last reading paragraphs were compared. The trends in eye movement changes over time were observed. Results: About 81.7% subjects suffered from computer visual syndrome.The computer visual syndrome questionnaire total score was positively correlated with positive relative accommodation (PPPPPPConclusion: Eye tracking could be used as an effective assessment for asthenopia.

AIM: To investigate and analyze the status of visual fatigue of naval crew on continuous voyage, explore the risk factors related to visual fatigue, and build a decision tree model for visual fatigue prediction.METHODS:A total of 373 naval fleet members were selected by stratified random sampling method from July to October 2016. By asking the medical history and basic personal information of the subjects, the naked eye visual acuity, the best corrected visual acuity, slit lamp examination including: eyelid, eyelid margin, meibomian gland changes, cornea and conjunctiva signs of ocular surface damage, and corneal fluorescein staining to determine the tear breakup time(BUT). The Ocular Surface Disease Analysis Scale(OSDI)and ocular fatigue questionnaire were filled in, the incidence and severity of ocular fatigue were counted, and the risk factors of ocular fatigue were analyzed.RESULTS: Totally 63.0%(235)of the crew members had different degrees of visual fatigue. There was no correlation between asthenopia and gender, age and previous corneal refractive surgery(P>0.05); Dry eyes and exposure time of electronic screen were the risk factors(P

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.

The present study seeks to correlate the use of face mask and electronic devices in the COVID-19 era with the emergence or worsening of dry eye disease. Online databases were used to identify articles published in 2020 and 2021, using the descriptors “dry eye syndromes”, “covid-19”, “diagnosis” and “asthenopia” found in MeSH (Medical Subject Headings), associated with the Boolean operator AND. After reading the titles, abstracts and texts in full, seventeen articles were selected to compose the work. In addition, at the recommendation of an expert, the world's largest study on dry eye disease, TFOS DEWS II, published in the Ocular Surface Journal in July 2017, was also added to this review. The average duration of use of electronic devices has been found to triple in the COVID era, and just two continuous hours develop digital eye fatigue, as diminished and incomplete blinking leads to ocular surface compromise and asthenopic symptoms. In addition, inadequate mask seals dissipate air around the eyes, causing rapid tear film evaporation and corneal exposure. In view of the studies, it can be concluded that the correlation between the factors presented and dry eye disease really exists. In addition, the ocular manifestation proved to be heterogeneous and affects not only aspects of physical health but also emotional health and negatively impacts the patient's quality of life. El presente estudio busca correlacionar el uso de mascarillas y dispositivos electrónicos en la era del COVID-19 con la aparición o el empeoramiento de la enfermedad del ojo seco. Se utilizaron bases de datos en línea para identificar artículos publicados en 2020 y 2021, utilizando los descriptores “síndromes del ojo seco”, “covid-19”, “diagnóstico” y “astenopía” que se encuentran en MeSH (Medical Subject Headings), asociados al operador booleano AND . Después de la lectura completa de los títulos, resúmenes y textos, se seleccionaron diecisiete artículos para componer el trabajo. Además, por recomendación de un experto, también se agregó a esta revisión el estudio más grande del mundo sobre la enfermedad del ojo seco, TFOS DEWS II, publicado en el Ocular Surface Journal en julio de 2017. Se ha descubierto que la duración promedio del uso de dispositivos electrónicos se triplica en la era COVID, y solo dos horas continuas desarrollan fatiga ocular digital, ya que el parpadeo disminuido e incompleto conduce al compromiso de la superficie ocular y síntomas astenópicos. Además, los sellos inadecuados de las máscaras disipan el aire alrededor de los ojos, provocando una rápida evaporación de la película lagrimal y exposición de la córnea. A la vista de los estudios, se puede concluir que la correlación entre los factores presentados y la enfermedad del ojo seco realmente existe. Además, la manifestación ocular resultó ser heterogénea y afecta no solo aspectos de la salud física sino también emocional e impacta negativamente en la calidad de vida del paciente. O presente estudo busca correlacionar o uso da máscara facial e dispositivos eletrônicos na era COVID-19 com o surgimento ou agravamento da doença do olho seco. Bancos de dados online foram usados para identificar artigos publicados em 2020 e 2021, através dos descritores “dry eye syndromes”, “covid-19”, “diagnosis” e “asthenopia” encontrados no MeSH (Medical Subject Headings), associados ao operador booleano AND. Após a leitura dos títulos, resumos e textos na íntegra, dezessete artigos foram selecionados para compor o trabalho. Além disso, por indicação de especialista, o maior estudo mundial sobre doença do olho seco, TFOS DEWS II, publicado no Ocular Surface Journal em julho de 2017, também foi somado a esta revisão. Foi constatado que a duração média de uso dos dispositivos eletrônicos triplicou na era COVID, e apenas duas horas contínuas desenvolvem fadiga ocular digital, pois piscadas diminuídas e incompletas levam ao comprometimento da superfície ocular e sintomas astenópicos. Além disso, a vedação inadequada da máscara dissipa o ar ao redor dos olhos, causando rápida evaporação do filme lacrimal e exposição da córnea. Diante dos estudos, pode-se concluir que a correlação entre os fatores apresentados e a doença do olho seco realmente existe. Além disso, a manifestação ocular mostrou-se heterogênea e afeta não somente aspectos da saúde física como também da saúde emocional e impacta negativamente a qualidade de vida do paciente.

BACKGROUND: Social distancing was implemented worldwide due to the coronavirus (COVID-19) pandemic. This impacted physical activity levels and increased the time spent in sedentary behaviors which may contributed to the emergence of increased musculoskeletal complaints. OBJECTIVE: To assess the consequences of social distancing for the increase in perceived pain of students and professors from higher education institutions. METHODS: One thousand two hundred and fifty-four participants responded to an online survey containing sociodemographic information and questions related to daily habits, physical activity profile, and musculoskeletal pain before and during the pandemic. Levels of concentration, nervousness, productivity, and visual fatigue were also assessed. The primary outcome was presence of perceived pain before and during the pandemic, dichotomized between those with and without increased pain during the pandemic. RESULTS: Perceived pain increased during the pandemic (p 6 hours (p = 0.041; PR = 1.44; 95% CI = 1.02–2.06). Nervousness (p = 0.001) and visual fatigue (p = 0.001) increased, whereas concentration (p = 0.001) and productivity (p = 0.001) reduced during the pandemic. CONCLUSIONS: Reduced physical activity practice and increased time in sedentary behavior and electronic device usage during the pandemic were associated with increased musculoskeletal pain in students and professors from higher education institutions. Decreased concentration and productivity and increased nervousness and visual fatigue were also observed during the pandemic.

IntroductionDigital eye strain, which is often ignored by the public, has emerged as a “Shadow Pandemic” in the era of the COVID-19 pandemic.AimThe current paper is aimed at discussing the ill effect of digital screens on eyes in the wake of the COVID-19 pandemic.MethodologyA literature search was done using “PubMed,” “Google scholar”, and “Scopus” using key terms like “Digital Eye Strain,” “Eyestrain,” or “Computer Vision Syndrome.” Relevant articles were identified and included to support the argument for this narrative review.ResultsStudies conducted in the UK reported that 68% of children extensively use computers, while 54% undertake online activities after the age of 3. Similar studies estimated 4 h and 45 min per day of screen exposure time among adults in the UK. Indian studies reveal that the prevalence of DES is 69% in adults and 50% in children respectively. Indian ophthalmologists found that computer-using and specialized ophthalmologists were more informed of symptoms and diagnostic signs but were misinformed about treatment modalities. The use of social media and multitasking is particularly prominent among younger adults, with 87% of individuals aged 20–29 years reporting the use of two or more digital devices simultaneously. It has been observed that the use of computer glasses corrects refractive errors and helps in the reduction of symptoms, while precision spectral filters help in reducing symptoms of micro-fluctuation of accommodation.ConclusionWe concluded that DES is emerging globally as a “Shadow Pandemic” and it is high time to respond. Community ophthalmologists, public health authorities, and educational sectors especially should be involved to prevent this.

Intelligent mines require much more mental effort from visual display terminal (VDT) operators. Long periods of mental effort can easily result in operator fatigue, which further increases the possibility of operation error. Therefore, research into how brain fatigue affects the sustained attention of VDT operators in intelligent mines is important. The research methods were as follows: (1) Recruit 17 intelligent mine VDT operators as subjects. Select objective physiological indicators, such as reaction time, error rate, task duration, flicker fusion frequency, heart rate, electrodermal activity, and blink frequency, and combine these with the subjective Karolinska Sleepiness Scale to build a comprehensive brain fatigue evaluation system. (2) According to the fatigue-inducing experiment requirements, subjects are required to carry out mathematical operations in accordance with the rules during the presentation time, determine whether the results of the operations fall within the [7, 13] interval, and continue for 120 min to induce brain fatigue. (3) Perform the standard stimulus button response experiment of the sustained attention to response task, before and after brain fatigue, and compare each result. The results show that: (1) When the standard stimulus appeared in the EEG experiment, the amplitude of the early N100 component before and after brain fatigue was significantly different. When the bias stimulus appeared, the average amplitudes of the P200 component and the late positive component, before and after brain fatigue, were significantly different, suggesting that the brain fatigue of VDT workers in coal mines would reduce sustained attention; (2) After the 120 min of the continuous operation task, the subjects showed obvious brain fatigue. The objective brain fatigue was followed by an increase in reaction time, an increase in error rate, a decrease in flicker fusion frequency, an increase in heart rate, an increase in electrodermal current, an increase in the number of blinks, and a larger pupil diameter, and both the subjective and objective data indicated more significant changes in the subjects’ brain fatigue at the 45th and 90th min. The results of the study could provide insight into the reduction in operational efficiency and safety of VDT operators in intelligent mines due to brain fatigue and further enrich the research in the area of brain fatigue in VDT operations.

Purpose To investigate if blue-blocking lenses are effective in reducing the ocular signs and symptoms of eye strain associated with computer use. Design Double-masked, randomized controlled trial. Methods A total of 120 symptomatic computer users were randomly assigned (1:1) into a “positive” or “negative” advocacy arm (ie, a clinician either advocating or not advocating for the intervention via a prerecorded video). Participants were further sub-randomized (1:1) to receive either clear (placebo) or blue-blocking spectacles. All participants were led to believe they had received an active intervention. Participants performed a 2-hour computer task while wearing their assigned spectacle intervention. The prespecified primary outcome measures were the mean change (post- minus pre-computer task) in eye strain symptom score and critical flicker-fusion frequency (CFF, an objective measure of eye strain). The study also investigated whether clinician advocacy of the intervention (in a positive or negative light) modulated clinical outcomes. Results All participants completed the study. In the primary analysis, for CFF, no significant effect was found for advocacy type (positive or negative, p = .164) and spectacle intervention type (blue-blocking or clear lens, p = .304). Likewise, for eye strain symptom score, no differences were found for advocacy (p = .410) or spectacle lens types (p = .394). No adverse events were documented. Conclusions Blue-blocking lenses did not alter signs or symptoms of eye strain with computer use relative to standard clear lenses. Clinician advocacy type had no bearing on clinical outcomes.

AIM: To discuss the efficacy of fresnel prism in different types of binocular diplopia patients.METHODS: This retrospective study reviewed 20 patients who received fresnel prism treatment between June 2018 and November 2020 in Jiangmen Central Hospital. Eight of them were diagnosed as acute acquired comitant esotropia, five patients were thyroid-associated ophthalmopathy, and seven patients were eye misalignment caused by cranial nerve palsies. The outcome measures were deviation, near stereoacuity, asthenopia and driving ability at pre-treatment and post-treatment.RESULTS: The deviations were decreased after treatment. There were significant differences between pre-treatment and post-treatment(P0.05). Thirteen patients recovered in the driving ability while fifteen patients were cured of asthenopia. There were significant differences between before and after treatment(all P

Purpose: The aim of this study was to determine prevalence, symptoms frequency and associated risk factors of digital eye strain (DES) among children attending online classes during COVID-19 pandemic. Methods: The online electronic survey form was prepared on the Google app. Children/parents were asked to indicate the total duration of digital device use before and during COVID era. The symptoms of DES, its severity and frequency were recorded & measured with the Computer Vision Syndrome Questionnaire. Results: Two hundred and sixty one parents responded to the questionnaire, of these 217 were complete. Mean age of children was 13 ± 2.45 years. Mean duration of digital device used during COVID era was 3.9 ± 1.9 h which is more than pre COVID era (1.9 ± 1.1 h, P = 5 h in COVID era as compared to 1.8% (n = 4) before COVID era. The most common digital device used were smartphones (n = 134, 61.7%). One hundred and eight children (49.8%) were attending online classes for >2 h per day. Prevalence of DES in our cohort is 50.23% (109/217). Of these 26.3% were mild, 12.9% moderate and 11.1% of severe grade. Most common symptoms were itching and headache (n = 117, 53.9%). Multivariate analysis revealed age >14 years (P = 0.04), male gender (P = 0.0004), smartphone use (P = 0.003), use of device >5 h (P = 0.0007) and mobile games >1 h/day (P = 0.0001) as independent risk factors for DES in children. Conclusion: There is an increased prevalence of DES among children in COVID era. Parents should be considerate about duration, type and distance of digital device use to avoid DES symptoms in children.

Background and Objective of the Study: The COVID-19 pandemic has increased the use of online platforms for education. This may lead to digital eye strain (DES) in the student community. The objective of this study was to assess the pattern of digital device use, the prevalence of DES symptoms and assess the awareness of DES among undergraduate medical students. Materials and Methods: This was a cross-sectional study and was conducted among undergraduate medical students of a medical college in Kerala using a structured, self-administered online questionnaire. Results: Two-hundred and twenty-seven students responded to this questionnaire. Of these respondents, 90.3% (205 students) reported experiencing the ocular and extra-ocular symptoms of DES. Neck pain, headache, and watering of eyes were the most frequent symptoms. Continuous use of devices without breaks, the predominant activity on devices, the presence of refractive errors, and inappropriate control of glare on digital devices had a statistically significant association with DES. Although 79.4% of students were aware that using digital devices can cause eye strain

To compare the clinical efficacy betweenForty-six cases (92 eyes) with presbyopia complicated with visual fatigue of liver depression and spleen deficiency were randomly divided into an observation group (23 cases) and a control group (23 cases, 2 cases dropped off). The cases in the observation group were treated withCompared before treatment, the visual fatigue core symptoms scores in the two groups were decreased after 1-week and 2-week treatment (

The use of digital devices affects eye health; this can influence the performance of workers. To assess this impact, validated patient-reported outcome questionnaires are needed. The purpose of this study was to validate the psychometric properties of the Italian version of the Computer Vision Syndrome Questionnaire (CVS-Q©) using Rasch analysis. Two hundred and forty-one Italian workers completed an ad hoc questionnaire on anamnesis and exposure to digital devices, and the Italian version of the CVS-Q©. Subsequently, a battery involving three clinical ocular surface and tear tests was performed. The reliability and validity of the scale was assessed using the Andrich Rating Scale Model, and the prevalence of computer vision syndrome (CVS) was calculated. A good fit of both items and persons to the predictions of the Rasch model was observed, with acceptable reliability, unidimensionality, and no or minimal severe differences as a function of gender or age; moreover, good test–retest repeatability, adequate values of sensitivity, reliability, and area under the curve, and adequate construct validity based on clinical tests were obtained. Workers with a questionnaire score ≥ 7 were found to present with CVS. The prevalence of CVS was 76.6%. The CVS-Q IT© is a valid and reliable scale to assess CVS in Italian workers who use digital devices.

Objectives Advances in dental operative microscopes (DOMs) enable examination of root canal morphology or detection of root fractures otherwise not visible to the naked eye. However, dental therapy involving prolonged use of DOMs requires precision within a limited visual field, resulting in eye strain among users. This study examined the effects of halogen and light-emitting diode (LED) light sources on asthenopia and visual function following use of DOMs. Methods The study used halogen and LED light sources in DOMs. The first experiment was conducted on 6 participants with corrected visual acuity without any organic eye disease. General visual function test (calculation ability test, hand grip strength test, and ophthalmic examination) and subjective symptom questionnaire were used to evaluate the degree of fatigue before and after DOM use. The second experiment was conducted on 9 participants with spherical equivalents within ±4 diopters (D) and astigmatism of 1 D or less. Accommodative function tests (precise test for asthenopia) and a subjective symptom questionnaire (asthenopia) were used before and after use of DOM. Results No significant changes were noted in the degree of fatigue and ophthalmological parameters before and after the procedure with either light source or in between light sources. The tear firm breakup time was shortened after therapy, and a tendency toward dry eyes was observed while using the LED light source. Conclusions The halogen and LED light sources used for DOM therapy had similar effects on asthenopia of the operators, with no significant changes in visual function.

Background: The eye and vision related problems that results from continuous use of computers and other visual display terminals for extended period of time leads to computer vision syndrome. Due to rapid digitalization in human life, the risk of developing it has also increased in many folds. So, with an aim of determining the prevalence and level of awareness of computer vision syndrome among computer users along with their attitude and practices to prevent it, this study was conducted in the office employees who use computer for a considerable period of time. Materials and Methods: A hospital based observational descriptive study was conducted in the out-patient department of Ophthalmology in Nobel Medical College and Teaching Hospital, Biratnagar, where 105 employees working in different work stations of same institution were enrolled. A questionnaire and the clinical findings were used to collect data. Results: About 80% of the employees were using computer for about (8-11) hours per day. Prevalence of computer vision syndrome noted was (92.4%) with low level of knowledge (85.7%) about it. About 45% of them wore glasses for their refractive errors but attitude and practices in work place to prevent the bad effects of using visual display terminals were found to be lacking (53.3%). Burning sensation in the eye, headache, ocular irritation and itching and neck, shoulder or back pain were the common symptoms. Around (60-70)% of the eyes tested positive for dry eye. Conclusion: Lack of awareness of computer vision syndrome and lack of personal protective measures were associated with its high level of prevalence.

Objective: Compared to standard spectacle lenses, do +0.40 EyeZenTM lenses reduce symptoms of asthenopia induced by computer? Methods: A prospective clinical study was carried out with 39 volunteers who spent more than 4 hours a day using a computer (age, 27.31±4.24; male: female =13:26). Asthenopia and visual comfort were assessed using a questionnaires. All participants completed the asthenopia questionnaire with updated regular lenses (baseline). After 4 weeks of +0.40 Eyezen™ lenses wearing all subjects answered the asthenopia questionnaire and a second questionnaire to establish their level of satisfaction with these lenses. Statistical analysis was performed usind the Shapiro-Wilk test and Wilcoxon test, and p-values less than 0.05 were considered statistically significant. Results: Compared to standard spectacle lenses (baseline), +0.40 EyeZenTM lenses wearing reduced the total asthenopia score from17.44 ± 5.51 to 13.18 ± 10.22 (p < 0.001). Regarding the perception of the visual comfort levels with these lenses in the management of digital devices, more than 90% of subjects said they were entirely or delighted with their visual comfort.. Conclusions: Digital asthenopia induced by computer was significantly reduced by +0.40 EyeZen lenses wearing. Resumo Objetivo: Comparadas com lentes oftálmicas regulares, as lentes de visão simples com +0,40D de poder adicicional de perto reduzem os sintomas de astenopia induzida por computador? Métodos: Foi realizado um estudo clínico prospectivo com 39 voluntários que passavam mais de 4h diárias utilizando computador (idade: 27,31±4,24 anos; masculino:feminino = 26:13). A astenopia e a percepção do conforto visual foram avaliadas com questionários. Todos os participantes respoderam ao questionário de astenopia com lentes regulares atualizadas (baseline). Após 4 semanas de uso das lentes +0.40 Eyezen™ os participantes responderam aos questionários de astenopia e de conforto visual. A análise estatística foi feita com os testes de Shapiro-Wilk e Wilcoxon. Valores de p

Purpose To investigate the effects of watching ultra-high-definition television (UHD TV) on subjective ocular fatigue and objective ocular surface indices. Methods A total of 76 volunteers were recruited for this study. Subjects watched UHD TV for 10 minutes at a viewing distance of 110 cm. Best-corrected visual acuity, refractive errors, tear break-up time, corneal staining grading, conjunctival redness grading by slit-lamp examination, tear meniscus measurement by anterior segment optical coherence tomography, and ocular symptom scores were obtained before and immediately after watching UHD TV. Subgroup analyses were conducted according to participant age (old age group >50 years vs. young age group ≤50 years) and dry-eye syndrome (presence vs. absence). The relationship between subjective and objective indices was evaluated. Results The mean age of subjects was 39.6 ± 12.4 years. Watching UHD TV induced a decrease in tear break-up time in the non-dry-eye group (p < 0.001) but not in the dry-eye group (p = 0.726). Corneal staining grades increased in all subgroups, and the changes were particularly larger in the older group (p = 0.038). The increase in ocular symptom scores was larger in the dry-eye group (p = 0.08) and in the older group (p = 0.016). The decrease in tear break-up time and ocular symptom scores after watching UHD TV was significantly correlated with tear break-up time. Conclusions Tear break-up time significantly decreased in non-dry-eye subjects after watching UHD TV. Subjective ocular discomfort increased significantly in subjects over the age of 50 and in participants with dry-eye syndrome.

Jameel Rizwana Hussaindeen,1,2 Amirthaa Murali2 1Binocular Vision Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai 600006, India; 2Elite School of Optometry (in Collaboration with SASTRA Deemed University), Unit of Medical Research Foundation, Sankara Nethralaya, Chennai 600016, IndiaCorrespondence: Jameel Rizwana HussaindeenBinocular Vision Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Sankara Nethralaya, 18, College Road, Nungambakkam, Chennai 600006, IndiaTel +91-44-42271626Fax +91-44-28254180Email rizwana@snmail.orgPurpose: Accommodative insufficiency (AI), defined as the inability to stimulate accommodation in pre-presbyopic individuals, has gained much attention over recent years. Despite the enormity of the available information, there is a significant lack of clarity regarding the criteria for definition, methodology adopted for testing and diagnosis, and the varied prevalence across the globe. This review aims to gather evidence that is pertinent to the prevalence, impact and efficacy of available treatment options for AI.Methods: PubMed, Google Scholar and Cochrane Collaboration search engines were used with the keywords prevalence, accommodative insufficiency, symptoms, plus lens, vision therapy and treatment. Peer-reviewed articles published between 1992 and 2019 were included in the review. After reviewing the studies for study methodology and robustness, 83 articles were chosen for this literature review.Results: The prevalence of AI ranges between < 1.00% and 61.6% across studies. The prevalence shows considerable variation across ethnicities and age groups. There is significant variation in the study methodology, diagnostic criteria and number of tests performed to arrive at the diagnosis. Not many studies have explored the prevalence beyond 20 years of age. The prevalence of AI is high among children with special needs. There is no high-quality evidence regarding the standard treatment protocol for AI. Both vision therapy and low plus lenses have shown efficacy in independent studies, and no studies have compared these two treatment options.Conclusion: The understanding of AI prevalence is currently limited owing to the lack of a standard set of diagnostic criteria and wide variations in the study methodology. There is a lack of high-quality evidence suggesting the best possible treatment for AI. The current gaps in the literature have been identified and future scope for exploration is elucidated.Keywords: accommodation insufficiency, amplitude of accommodation, lag of accommodation, asthenopia, vision therapy, binocular vision, accommodative facility, plus lens

Purpose Accommodative insufficiency (AI), defined as the inability to stimulate accommodation in pre-presbyopic individuals, has gained much attention over recent years. Despite the enormity of the available information, there is a significant lack of clarity regarding the criteria for definition, methodology adopted for testing and diagnosis, and the varied prevalence across the globe. This review aims to gather evidence that is pertinent to the prevalence, impact and efficacy of available treatment options for AI. Methods PubMed, Google Scholar and Cochrane Collaboration search engines were used with the keywords prevalence, accommodative insufficiency, symptoms, plus lens, vision therapy and treatment. Peer-reviewed articles published between 1992 and 2019 were included in the review. After reviewing the studies for study methodology and robustness, 83 articles were chosen for this literature review. Results The prevalence of AI ranges between

Background: Three-dimensional (3D) laparoscopic surgery in pediatrics is still uncommon and few studies assessed in clinical practice advantages and disadvantages. Applicability and effectiveness o...

Asthenopic and related symptoms are a major problem in school-going children. With the inception of computers and other gadgets for near work, the unseen problems arising out of constant and continuous near work, are on the rise. Parents wander from pillar to post, seeking respite from their child's constant complaints from near work; but despite best spectacle correction and avoidance of excessive near work, the complaints continue. Studies have shown that the majority of these problems arise from defects in accommodation, even in a young child. Therefore, various aspects of accommodation deficiencies have to be studied clinically, detected, and treated to ameliorate the symptoms.

Background Many ophthalmic lens manufacturers are currently marketing blue-blocking filters, which they claim will reduce symptoms of Digital Eye Strain (DES). However, there is limited evidence to support the proposal that DES results from the blue light emitted by electronic screens. Objective This investigation compared the effect of blue-blocking filters on DES symptoms with a no-filter lens, using a double-blind methodology. Methods Twenty-four subjects were required to perform a 20-minute reading task from a tablet computer. They wore either lenses containing a blue-blocking filter (TheraBlue 1.67 or TheraBlue polycarbonate) or a CR-39 control lens which did not include a filter. Immediately following each session, subjects completed a questionnaire to quantify symptoms of DES. Results While a significant increase in symptoms was observed immediately following the near vision task (p = 0.00001), no significant difference in symptoms was found between the 3 lens conditions (p = 0.74). Conclusions There is little evidence at this time to support the use of blue-blocking filters as a clinical treatment for DES. Management of other ocular factors, as well as the creation of an optimal environment for screen viewing, are more likely to provide greater success in minimizing symptoms.

Background: Comfortable working at near and intermediate tasks depend on the efficiency as well as coordination of accommodation and vergence systems. At present, the need for near and intermediate visual tasks has been dramatically increased, requiring prolonged computer- and gazette-related works. It demands excessive working of the extraocular and ciliary muscles. It may cause eye fatigue and other associated asthenopic symptoms. Globally, eye fatigue is one of the most commonly reported conditions in nonpresbyopic population with asthenopic symptoms. It is necessary to get relief from eye fatigue for better near and intermediate tasks. Materials and Methods: Thirty-two undergraduate optometry students who were symptomatic based on a validated eye fatigue questionnaire were included after a baseline comprehensive eye examination. Based on the eye fatigue symptoms score, they were equally assigned to a control group and an exercise group with sixteen participants in each. The exercise group performed yoga ocular exercises for up to 6 weeks after which the eye fatigue symptoms were reassessed in both groups. Results: In the exercise group, there was a statistically significant reduction in eye fatigue scores (P = 0.003), whereas the eye fatigue scores showed significant increment in the control group after 6 weeks (P = 0.044). Conclusions: Yoga ocular exercises reduce the eye fatigue symptoms score by increasing the efficiency of extraocular muscles. Hence, it could be considered as a therapeutic and nonpharmacologic intervention for reducing the eye fatigue and associated asthenopic symptoms.

During the COVID-19 pandemic, computer vision syndrome (CVS) related to online classrooms were unavoidable. This cross-sectional study aimed to explore the prevalence, characteristics and associated factors of CVS. A total of 527 students who were currently studying in a virtual classroom (70.40% female, mean (standard deviation; SD) age of 20.04 (2.17) years) were included. The prevalence of CVS assessed by an online CVS-Questionnaire was 81.0% (427/527). Comparing with those in the period before the online study, an increase in screen time (interquartile range) in students with and without CVS was 3 (0–3) and 2 (1–5) h, respectively. Overall, 516 students (97.9%) experienced at least one symptom. The most frequent symptom in CVS subjects was eye pain (96.5%). The most intense symptoms were the feeling of worsening eyesight (15.9%). The factors associated with CVS were female (p < 0.001), age (p = 0.010), atopic diseases (p = 0.020), prior ocular symptoms (p < 0.001), astigmatism (p = 0.033), distance from display

Although microprisms have become an important medical means of strabismus treatment, related research concerning the design, fabrication, and testing of microprismatic glasses for preventing eyestrain has rarely been reported. In this study, the structure of microprismatic glasses for preventing eyestrain related to using electronic monitors, including computers and mobile phones, is introduced. A designing theory of anti-fatigue glasses with microprisms is developed. The fabrication technique and the process are described, and the performances of the fabricated microprisms are characterized. Finally, a compact testing system for the measurement of prismatic diopter is designed and constructed. This measuring system can be used not only for Fresnel microprisms, but also for other types of prisms. The measured results agree with our calculations. Although this study is focused on optimizing the objective prismatic diopter for anti-fatigue microprismatic glasses, 2.0–3.0 prismatic diopters (Δ) for each eye in the anti-fatigue glasses are suggested according to our experience on strabismus treatments. The clinical research for patients using the developed anti-fatigue glasses will be fully implemented in our further research to confirm the optimal subjective prismatic value.

Blur is the subjective awareness that the edges of a high contrast image are indistinct. The concept of blur is fundamental to the understanding of vision, accommodation, refractive error, concomitant strabismus, and asthenopia. It is easy for clinicians to believe that blur always needs to be avoided or resolved, or that everyone responds to blur similarly. This narrative review outlines the literature on blur and the accommodation to resolve it, and relates it to current clinical practice. Laboratory studies have traditionally been highly controlled, using expert observers, but more recent research using naïve participants suggests that variability and tolerance of blur are common and more widespread than often thought, especially in children and clinical groups. Objective and subjective responses can differ widely, and it cannot be assumed that because we expect accommodation to have occurred, that it always has. A deeper understanding of the role of blur and objective accommodation in vision, refractive error and strabismus may help us understand the variability that exists in clinical practice. We may use blur to help investigation and treatment but also be relaxed about what is normal. Many patients are led to believe that they should always achieve constant clear vision, when this is unrealistic. Although pathological blur must be identified and treated, normal everyday blur may become medicalized into "a problem" by well-meaning professionals.

Stereoscopic viewing has an impact on ocular dynamics, but its effects on accommodative functions are not fully understood, especially for autostereoscopic viewing. This study aimed to investigate the changes in dynamic accommodative response, accommodative amplitude, and accommodative facility of myopes after autostereoscopic visual training.We enrolled 46 adults (men = 22 and women = 24; age = 21.5 ± 2.5 [range = 18-25] years, spherical equivalent: -4.52 ± 1.89 [-8.88 to -1.75] diopters [D]) who visited the EyeENT Hospital of Fudan University. The study population was randomly divided into three-dimensional (3D) and two-dimensional (2D) viewing groups to watch an 11-minute training video displayed in 3D or 2D mode. Dynamic accommodative response, accommodative facility, and accommodative amplitude were measured before, during, and immediately after the training. Accommodative lag and the variability of accommodation were also analyzed. Visual fatigue was evaluated subjectively using a questionnaire.Accommodative lag decreased from 0.54 ± 0.29 D to 0.42 ± 0.32 D (P = 0.004), whereas accommodative facility increased from 10.83 ± 4.55 cycles per minute (cpm) to 13.15 ± 5.25 cpm (P0.001) in the 3D group. In the 2D group, there was no significant change in the accommodative lag (P = 0.163) or facility (P = 0.975), but a decrease in accommodative amplitude was observed (from 13.88 ± 3.17 D to 12.71 ± 2.23 D, P = 0.013). In the 3D group, the accommodative response changed with the simulated target distance. Visual fatigue was relatively mild in both groups.The immediate impact of autostereoscopic training included a decrease in the accommodative lag and an increase in the accommodative facility. However, the long-term effects of autostereoscopic training require further exploration.

Although the high prevalence of digital eyestrain has been well established, to date, there is no objective measurement of this condition. Previous studies have suggested that digital eyestrain may be associated with decreased critical fusion frequency, but the published evidence to support this association is sparse.This study sought to determine whether symptoms of digital eyestrain after a sustained computer task are indeed associated with changes in critical fusion frequency.The experiment was performed on 30 young visual-normal subjects. They attended two sessions, during which they undertook a 20-minute reading task. This comprised either reading random words from a tablet computer or a story from a printed children's book. Critical fusion frequency was measured both before and immediately after each of the reading tasks. In addition, the level of digital eyestrain was assessed by subjects completing a questionnaire regarding ocular and visual symptoms experienced during each of the reading trials.The mean increase in digital eyestrain symptoms after the digital and printed conditions was 11.37 (standard error of the mean [SEM], 2.23) and 4.40 (SEM, 1.34), respectively. Both the post-task symptom change (P.001) and the difference between the two reading conditions (P = .004) were significant. The mean change in critical fusion frequency after the digital and printed conditions was -0.42 (SEM, 0.25) and -0.72 (SEM, 0.26), respectively. Neither the post-task change nor the difference between the two reading conditions was significant. In addition, when considering the digital condition only, no significant correlation was observed between the changes in critical fusion frequency and reported symptoms.These results do not support the proposal that changes in critical fusion frequency can be used as an objective measure of eyestrain or other symptoms of digital eyestrain.

Purposes: This study discussed the accommodative response and pupil size of myopic adults using a double-mirror system (DMS). The viewing distance could be extended to 2.285 m by using a DMS, which resulted in a reduction and increase in the accommodative response and pupil size, respectively. By using a DMS, the reduction of the accommodative response could improve eye fatigue with near work. Method: Sixty subjects aged between 18 and 22 years old were recruited in this study, and the average age was 20.67 ± 1.09. There were two main steps in the experimental process. In the first step, we examined the subjects’ refraction state and visual function, and then fitted disposable contact lenses with a corresponding refractive error. In the second step, the subjects gazed at an object from a viewing distance of 0.4 m and at a virtual image through a DMS, respectively, and the accommodative response and pupil size were measured using an open field autorefractor. Results: When the subjects gazed at the object from a distance of 0.4 m, or gazed at the virtual image through a DMS, the mean value of the accommodative response was 1.74 ± 0.43 or 0.16 ± 0.47 D, and the pupil size was 3.98 ± 0.06 mm or 4.18 ± 0.58 mm, respectively. With an increase in the viewing distance from 0.4 m to 2.285 m, the accommodative response and pupil size were significantly reduced about 1.58 D and enlarged about 0.2 mm, respectively. For three asterisk targets of different sizes (1 cm × 1 cm, 2 cm × 2 cm, and 3 cm × 3 cm), the mean accommodative response and pupil size through the DMS was 0.19 ± 0.16, 0.27 ± 0.24, 0.26 ± 0.19 D; and 4.20 ± 1.02, 3.94 ± 0.73, 4.21 ± 0.57 mm, respectively. The changes of the accommodative response and pupil size were not significant with the size of the targets (p > 0.05). In the low or high myopia group, the accommodative response of 0.4 m and 2.285 m was 1.68 ± 0.42 D and 0.21 ± 0.48 D; and 1.88 ± 0.25 D and 0.05 ± 0.40 D, respectively. The accommodative response was significantly reduced by 1.47 D and 1.83 D for these two groups. The accommodative microfluctuations (AMFs) were stable when a DMS was used; on the contrary, the AMFs were unstable at a viewing distance of 0.4 m. Conclusions: In this study, the imaging through a DMS extended the viewing distance and enlarged the image, and resulted in a reduction in the accommodative response and an increase in the pupil size. For the low myopia group and the high myopia group, the accommodative response and pupil size were statistically significantly different before and after the use of the DMS. The reduction of the accommodative response could be applied for the improvement of asthenopia.

Background. To validate the 17-item Computer Vision Symptom Scale questionnaire (CVSS17) in Italian. Methods. Cross-sectional validation study on video terminal (VDT) users and a reference sample of subjects not working at a VDT (control group), cognitively able to respond to a health status interview. The Italian self-administered version of the CVSS17 questionnaire was administered to all participants. The reliability and validity of the Italian translation of the CVSS17 were tested using standard statistical methods for questionnaire validation. The Rasch analysis was performed as well. Results. A total of 216 subjects were enrolled. Concerning the reliability, the Cronbach’s alpha coefficient was 0.925 (from 0.917 to 0.924), and the test–retest stability was 0.91 (

Einleitung: Die genaue Differenzierung zwischen zwei sehr ähnlichen Krankheitsbildern, stellt eine wichtige Aufgabe und Herausforderung für Orthoptist*innen im Alltag dar, wie auch der Strabismus divergens intermittens und die dekompensierende Exophorie. Das Erkennen und Diagnostizieren dieser beiden Krankheitsbilder ist in der Praxis für das therapeutische Vorgehen und die Prognose der Erkrankung wichtig. Methodik: Für die folgende Arbeit hat sich eine Literaturrecherche als geeignete Methode erwiesen. Die Suche nach Literatur fand sowohl in bekannten Datenbanken wie z.B. Medline und Pubmed, als auch in der elektronischen Zeitschriftenbibliothek bzw. Suchmaschine der Bibliothek und Mediathek der FH Campus Wien statt. Ergebnisse: In diesem Kapitel werden alle Ergebnisse aus der Literaturrecherche bzw. Interpretation aller Ergebnisse in Bezug auf die Fragestellungen erläutert. Außerdem werden hier alle Forschungsfragen beantwortet und die beiden Krankheitsbilder gegenübergestellt in Hinblick auf die Diagnostik und Therapie. Diskussion: Hier werden alle Ergebnisse von den Studien mit der Literatur verglichen und die Meinungen der Autor*innen kritisch hinterfragt. Zusätzlich erfolgt in diesem Kapitel eine kritische Reflexion hinsichtlich des Schreibprozesses. Zusammenfassung: In dem Kapitel erfolgt eine Zusammenfassung der wesentlichen Aspekte und Ergebnisse der gesamten Arbeit und die Beantwortung der Forschungsfragen. Introduction: Knowing the difference between two similar clinical picture is an important task and challenge for orthoptists in everyday life, as well as the intermittent Exotropia and the decompensating Exophoria. The recognition and diagnosis of these two clinical pictures appears to be important in practice for the therapeutic approach and for the prognosis of the disease. Methods: A literature search has proven to be a suitable method for the following chapter. The search for literature was performed in databases such as Medline and Pubmed as well as in the electronic journal library and the search engine of the library and media center of the FH Campus Wien. Results: In this chapter all the results from the literature research and the interpretation of all these results in relation to the questions are explained. In addition, all research questions are answered and the two clinical pictures are compared with regard to diagnostic and therapy. Discussion: Here, all the results of the studies are recorded with the literature and the opinions of the authors are critically questioned. This chapter also includes a critical reflection on the writing process. Summary: This chapter summarizes the main aspects and results of the entire work and answers the research questions.

Objetivo: Analizar la prevalencia y la evolución del síndrome visual informático en estudiantes de secundaria y bachillerato mediante el CVS-Q© adaptado y validado para adolescentes, según empleen libros en papel o en soporte digital. Método: Se adaptará el CVS-Q© mediante un pilotaje en adolescentes y un grupo nominal compuesto por especialistas en salud visual, profesorado y padres/madres. Se evaluarán la calidad y la aplicabilidad de la versión resultante (CVS-Q teen©) y se realizará un estudio de validación con pruebas visuales, retest y análisis psicométrico. Posteriormente, se realizará un estudio prospectivo longitudinal con cuatro medidas repetidas en adolescentes de dos institutos de San Juan de Alicante (uno ha sustituido libros por tabletas). Se medirá el síndrome visual informático mediante el CVS-Q teen© con tres seguimientos. Se analizará la prevalencia de síndrome visual informático según factores sociodemográficos, visuales y de uso de dispositivos digitales. Se realizarán modelos de regresión logística con efecto aleatorio por estudiante y tiempo de uso. Objective: To analyse the prevalence and progression of computer vision syndrome in secondary and high school students with the CVS-Q© adapted and validated for adolescents, depending on whether they use textbooks or digital books. Method: The CVS-Q© will be adapted by a pilot study in adolescents and a nominal group of visual health specialists, teachers and parents. The resulting version (CVS-Q teen©) will be tested to confirm its quality and applicability and a validation study will be done with visual tests, retest and psychometric analysis. Subsequently, a prospective longitudinal study with four repeated measures will be carried out in adolescents from two secondary schools of San Juan de Alicante (one has replaced textbooks by tablets). Computer vision syndrome will be measured by the CVS-Q teen© with three follow-ups. The prevalence of computer vision syndrome will be analysed according to sociodemographic, visual and digital device use variables. Logistic regression models will be performed, with random effect by student and time of use. Los autores agradecen al Vicerrectorado de Investigación de la Universidad de Alicante por el contrato de formación predoctoral de la segunda autora (UAFPU2019-08). El presente proyecto ha sido financiado por la convocatoria «Proyectos de Investigación en Salud», Fondo de Investigación en Salud del Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación y Unión Europea, a través de los Fondos Europeos de Desarrollo Regional (FEDER) «Una manera de hacer Europa», con la referencia PI20/01629.

Purpose. The contributory factors and symptoms for presbyopia progression have not been fully determined. The purpose of the study was to compare presbyopia progression in subjects with short and normal tear breakup time and to explore the severity of common ocular symptoms associated with presbyopia progression. Method. We conducted a clinic-based, retrospective, cross-sectional study. Inclusion criteria were bilateral phakic patients aged 40–69 years with best-corrected distance visual acuity better than 20/30, and exclusion criteria were the use of glaucoma eye drops, any disease affecting vision, or history of ocular surgery. We measured the binocular near add power and compared the results using Kaplan-Meier analysis. Association between near add power and ocular symptoms was explored. Results. There were 1411 participants (mean age of 50.1 years). There were no significant differences in age, intraocular pressure, spherical equivalent, astigmatism, or anisometropia between the sexes. Kaplan-Meier analysis indicated that women with short tear breakup time reached the endpoint (near add power of +3.00 D) significantly earlier than those with normal tear breakup time ( P = 0.043 ; Cox-Mantel test). Eye fatigue was most severe in the group with an add power of 1.25-2.00 D. Near add power was correlated with hyperopia, astigmatic errors, and anisometropia. Conclusions. This study suggests an exacerbation of presbyopia progression in women with short tear breakup time. Eye fatigue was most severe in those with an add power of 1.25-2.00 D.

Purpose Evaluate blue-violet light filter and additional power of +0.40 D in the near zone ophthalmic lenses, on convergence, accommodative functions, and symptoms of digital asthenopia (DA). Methods Randomized study in cross-over design conducted on 49 volunteers (age, 29 ± 5.5 years; male: female, 18:31). Each subject wore test (+0.40 D in the near zone) and control lenses (regular single vision) for 4 weeks in randomized order. Both lenses had a selective blue-violet light filter. A baseline measurement was taken with the subjects’ current updated glasses. Accommodation amplitude (AA) and near point of convergence (NPC) were measured binocularly with the RAF ruler. DA was evaluated by a questionnaire. Results No significant difference (p=.52) was found for AA comparing baseline (11.50±1.88 D), test (11.61± 1.62 D), and control SV lenses (11.88±1.50 D). No significant difference was found for NPC (p=.94), between baseline (6.50 ± 2.89cm), test (6.71± 3.49) and control SV lenses (6.82± 3.50 cm). No significant difference was found comparing test and control SV lenses in symptoms of DA (p=0.20). Conclusions The +0.40 D lenses have no negative impact on convergence or loss of accommodation power. The +0.40 D and control SV lenses had a similar impact on attenuating symptoms of DA.

Steady-state visual evoked potential (SSVEP)-based brain-computer interface (BCI) systems suffer from low SSVEP response intensity and visual fatigue, resulting in lower accuracy when operating the system for continuous commands, such as an electric wheelchair control. This study proposes two SSVEP improvements to create a practical BCI for communication and control in disabled people. The first is flicker pattern modification for increasing SSVEP response through mixing (1) fundamental and first harmonic frequencies, and (2) two fundamental frequencies for an additional number of commands. The second method utilizes a quick response (QR) code for visual stimulus patterns to increase the SSVEP response and reduce visual fatigue. Eight different stimulus patterns from three flickering frequencies (7, 13, and 17 Hz) were presented to twelve participants for the test and score levels of visual fatigue. Two popular SSVEP methods, i.e., power spectral density (PSD) with Welch periodogram and canonical correlation analysis (CCA) with overlapping sliding window, are used to detect SSVEP intensity and response, compared to the checkerboard pattern. The results suggest that the QR code patterns can yield higher accuracy than checkerboard patterns for both PSD and CCA methods. Moreover, a QR code pattern with low frequency can reduce visual fatigue; however, visual fatigue can be easily affected by high flickering frequency. The findings can be used in the future to implement a real-time, SSVEP-based BCI for verifying user and system performance in actual environments.

The aims of the study were to investigate the ability and effectiveness of an oral intake of a fixed combination of zinc, L-carnitine, elderberry extract, black currant and Eleutherococcus extract in controlling the symptoms of eyestrain in videoterminal (VDT) users and to record its effects on contrast sensitivity. A single-center, phase II, observational, case-control, 1-month study in VDT workers without dry eye disease was carried out. Demographics and number of actual hours at VDT/day were taken into account. All subjects underwent a complete ophthalmic examination, including assessment of contrast sensitivity, and completed the computer vision symptom scale questionnaire at baseline and one month later. A total of 30 Caucasian subjects adhered to the required inclusion criteria and completed the study; 15 subjects were treated (T) and 15 were controls (C). All clinical data at baseline were similar in both groups (p > 0.05): after one month, all subjects had stable visual acuity, refractive defect and intraocular pressure (IOP); screen exposure time was unchanged. Regarding symptoms, at randomization, the groups had a similar score: 33.1 ± 3.3 in T and 32.8 ± 5.6 in C. One month later, the computer vision symptom scale (CVSS) questionnaire score decreased by −14.1 ± 3, 1 (p = 0.000) and −2.3 ± 1.8 (p = 0.568), respectively. Regarding contrast sensitivity, in group C the values of spatial frequencies remained unchanged, while they improved in almost all the cycles per degree stimuli in the treated group. Oral intake of a fixed combination of zinc, L-carnitine, elderberry extract, black currant and eleutherococcus extract can significantly improve contrast sensitivity and symptoms in VDT workers with no signs of dry eye disease.

Objectives: During the coronavirus disease 2019 (COVID-19) self-quarantine period, the transition to online-course has profoundly changed the learning modes of millions of school-aged children and put them at an increased risk of asthenopia. Therefore, we aimed to determine associations of the total screen/online-course time with asthenopia prevalence among that children during the COVID-19 pandemic, and whether the associations were mediated by psychological stress.Methods: Asthenopia was defined according to a validated computer vision syndrome questionnaire (CVS-Q). We used CVS-Q to collect the frequency and intensity of 16 asthenopia-related eye symptoms of 25,781 children. Demographic features, eye care habits, visual disorders, lifestyle, psychological and environmental factors, were also collected.Results: The overall asthenopia prevalence was 12.1%, varying from 5.4 to 18.2% across grade/gender-classified subgroups. A 100-h increment of total screen/online-course time were associated with an increased risk of asthenopia by 9% [odds ratio (OR) = 1.09] and 11% (OR = 1.11), respectively. Mediation analysis showed that the proportions of total effects mediated by psychological stress were 23.5 and 38.1%, respectively. Age, female gender, having myopia or astigmatism, bad habits when watching screens were also risk factors. Conversely, keeping 34–65 cm between eyes and screen, increased rest time between classes, and increased eye exercise were all associated with a decreased risk.Conclusion: Our study indicated that the influence of long total screen or online-course time on psychological stress increases asthenopia risk. The findings of this study have provided a new avenue for intervening screen-related asthenopia in addition to incorporating a reasonable schedule of online courses into educational policy.

This study evaluates the progression of visual fatigue induced by visual display terminal (VDT) using automatically detected blink features. A total of 23 subjects were recruited to participate in a VDT task, during which they were required to watch a 120-min video on a laptop and answer a questionnaire every 30 min. Face video recordings were captured by a camera. The blinking and incomplete blinking images were recognized by automatic detection of the parameters of the eyes. Then, the blink features were extracted including blink number (BN), mean blink interval (Mean_BI), mean blink duration (Mean_BD), group blink number (GBN), mean group blink interval (Mean_GBI), incomplete blink number (IBN), and mean incomplete blink interval (Mean_IBI). The results showed that BN and GBN increased significantly, and that Mean_BI and Mean_GBI decreased significantly over time. Mean_BD and Mean_IBI increased and IBN decreased significantly only in the last 30 min. The blink features automatically detected in this study can be used to evaluate the progression of visual fatigue.

Purpose: Accommodative support (AS) lenses are a low add progressive addition spectacle lens designed to ease symptoms in computer vision syndrome (CVS). The study aims to investigate if (1) AS lenses improve CVS symptoms; (2) binocular/accommodative functions predict a benefit from AS lenses and (3) wearing AS lenses for six months impacts on binocular/accommodative functions. Methods: Pre-presbyopic adults with symptoms of CVS (Computer Vision Syndrome Questionnaire, CVS-Q©, score ≥ 6) were randomly allocated to wear AS lenses or control single vision (SV) lenses. The CVS-Q© and a battery of optometric tests were applied at baseline and after three and six months. Participants and researchers were masked to participant group. After six months, the SV group were unmasked and changed to AS lenses and one week later asked to choose which they preferred. Results: The change in CVS-Q© scores from baseline to six months did not differ significantly in the two groups. At the end of the one week period, when the control group wore the AS lenses, control group participants were significantly more likely to prefer AS lenses to SV lenses. No optometric functions correlated with the benefit from AS lenses. AS lenses did not have any adverse effects on binocular or accommodative function. Conclusions: In pre-presbyopic adults, there was no greater improvement in CVS-Q© scores in the group wearing AS lenses than in the control group. No adverse effects on optometric function (including accommodation) are associated with wearing AS lenses. Funded by Hoya Holdings NV.

To evaluate the efficacy and safety of interventions for treating eye strain related to computer use relative to placebo or no treatment.Computer use is pervasive and often associated with eye strain, referred to as computer vision syndrome (CVS). Currently, no clinical guidelines exist to help practitioners provide evidence-based advice about CVS treatments, many of which are marketed directly to patients. This systematic review and meta-analysis was designed to help inform best practice for eye care providers.Eligible randomized controlled trials (RCTs) were identified in Ovid MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and trial registries, searched from inception through November 23, 2021. Eligible studies were appraised for risk of bias and were synthesized. The certainty of the body of evidence was judged using the Grading of Recommendations, Assessment, Development, and Evaluation system. Standardized mean differences (SMDs) were used when differently scaled measures were combined.Forty-five RCTs, involving 4497 participants, were included. Multifocal lenses did not improve visual fatigue scores compared with single-vision lenses (3 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 (3 RCTs), with evidence judged of low certainty. Relative to placebo, oral berry extract supplementation did not improve visual fatigue (7 RCTs; SMD, -0.27; 95% CI, -0.70 to 0.16; P = 0.22) or dry eye symptoms (4 RCTs; SMD, -0.10; 95% CI, -0.54 to 0.33; P = 0.65). Likewise, berry extract supplementation had no significant effects on critical flicker-fusion frequency (CFF) or accommodative amplitude. Oral omega-3 supplementation for 45 days to 3 months improved dry eye symptoms (2 RCTs; mean difference [MD], -3.36; 95% CI, -3.63 to -3.10 on an 18 unit scale; P0.00001) relative to placebo. Oral carotenoid supplementation improved CFF (2 RCTs; MD, 1.55 Hz; 95% CI, 0.42 to 2.67 Hz; P = 0.007) relative to placebo, although the clinical significance of this finding is unclear.We did not identify high-certainty evidence supporting the use of any of the therapies analyzed. Low-certainty evidence suggested that oral omega-3 supplementation reduces dry eye symptoms in symptomatic computer users.