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Introduction: Because of COVID's impact on social behavior, students have become more reliant on computer-facilitated communication to continue their studies and interact with friends. While it is known that the association between screen exposure and psychological well-being is both harmful and stronger among adolescents than younger children, what is less studied are the causal factors that may mediate the relationship., Objectives: The objectives of this study were to analyze the relationship between screen exposure and two psychological outcomes, sleep quality and loneliness, using digital eye strain as a mediating factor. Eye strain is expected to have a direct and harmful influence on psychological well-being., Materials and Methods: A structured and validated questionnaire was transcribed and administered online. A nonrepresentative sample of 497 female college students in a North Indian city participated in the study. Digital eye strain, quality of sleep, and feeling of loneliness scores were assessed using latent class analysis., Results: The selected latent model suggested that Class 2 had a high percentage of students with network issues, the problem with space and noise, and various financial hardships, which had almost doubled the rate of loneliness (53.28%) and sleep-wake difficulties (75.41%) among the students affected with computer vision syndrome (89.75%)., Conclusion: There is an urgent need to examine the implications of digital exposure across gender and age to prevent future complications. Further, awareness for improving holistic well-being in the digital era should be promoted through various platforms., (Copyright © 2023 Copyright: © 2023 Indian Journal of Public Health.)

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 = <0.0001). 36.9% (n = 80) were using digital devices >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., Competing Interests: None

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., Competing Interests: None

Purpose: To evaluate the use of digital devices, reading habits and the prevalence of eyestrain among urban Indian school children, aged 11-17 years., Methods: The study included 576 adolescents attending urban schools who were surveyed regarding their electronic device usage. Additional information on the factors that may have an effect on ocular symptoms was collected., Results: Twenty percent of students aged 11 in the study population use digital devices on a daily basis, in comparison with 50% of students aged 17. In addition to using these devices as homework aids, one third of study participants reported using digital devices for reading instead of conventional textbooks. The majority of students preferred sitting on a chair while reading (77%; 445 students), with only 21% (123 students) preferring to lie on the bed and 8 students alternating between chair and bed. There was a significant association between the students who preferred to lie down and those who experienced eyestrain, as reported by a little over one fourth of the student population (27%). Out of 576 students, 18% (103) experienced eyestrain at the end of the day after working on digital devices., Conclusions: The increased use of digital devices by adolescents brings a new challenge of digital eyestrain at an early age. Our study reports the patterns of electronic device usage by school children, evaluates factors associated with eyestrain and highlights the need for further investigation of these issues.

Objective: This cross-sectional study was done to find the prevalence of eye strain and other ocular morbidities among students in Udupi, Karnataka., Methods: The study protocol included interview, visual acuity examination using Snellen chart, and measuring classroom illumination through lux meter., Results: 26% students had visual morbidity and the most prevalent symptoms of eyestrain were headache (38.6%), watering of eyes (25.7%), pain around eyes (15.6%) and blurred vision (11.9%). 55.5% classrooms and 88.4% blackboards did not have proper illumination., Conclusion: Low classroom illumination levels may be a possible factor for development of visual morbidity.

Children of footwear making units are working in the soling process. The process includes fixing of upper part with the sole of the footwear. The adhesives contain a mix of organic solvents, which are released in the working environment and cause irritation and lacrimation of eyes. In addition poor illumination and ventilation further aggravates the eyestrain. The present study was carried out to find out the prevalence and the associated factors of eyestrain in working children of footwear making units. The study included 139 exposed and 160 comparison group subjects. Self-reported eyestrain was recorded through personal interview. The prevalence of eyestrain in child laborers was 25.9%, which was significantly more than the 12.4% prevalence in comparison group subjects (P=0.01). Working children of footwear making units were at 2.4 times higher risk of developing eyestrain as compared to comparison group subjects, though statistically non significant. Significantly higher proportion of eyestrain was reported in those aged >12 years, males and those working daily for >4 hours. The higher prevalence of eyestrain in the working children of footwear units may be attributed to exposure to workplace factors.

Working children of gem-polishing units are exposed to poor illumination and improper workstations. Also processes require lot of visual and mental concentration for precision. This may result in eyestrain. The study included 432 exposed and 569 comparison group subjects. Self-reported eyestrain was recorded through personal interview. Eyestrain included symptoms like itching, burning, or irritated eyes; tired or heavy eyes; difficulty seeing clearly (including blurred or double vision); and headache. The study variables included age, gender, daily working hours, and duration of exposure. The prevalence of eyestrain in child labourers was 32.2%, which was significantly more than the comparison group subjects. Also, the working children of gem-polishing units were at 1.4 times higher risk of developing eyestrain. Age (3)14 years and female gender were significantly associated with the eyestrain. The prevalence of eyestrain in child labourers was 32.2% and was associated with age (3)14 years and female gender.

Context: There is growing body of evidence that use of computers can adversely affect the visual health. Considering the rising number of computer users in India, computer-related asthenopia might take an epidemic form. In view of that, this study was undertaken to find out the magnitude of asthenopia in computer operators and its relationship with various personal and workplace factors., Aims: To study the prevalence of asthenopia among computer operators and its association with various epidemiological factors., Settings and Design: Community-based cross-sectional study of 419 subjects who work on computer for varying period of time., Materials and Methods: Four hundred forty computer operators working in different institutes were selected randomly. Twenty-one did not participate in the study, making the nonresponse rate 4.8%. Rest of the subjects (n = 419) were asked to fill a pre-tested questionnaire, after obtaining their verbal consent. Other relevant information was obtained by personal interview and inspection of workstation., Statistical Analysis Used: Simple proportions and Chi-square test., Results: Among the 419 subjects studied, 194 (46.3%) suffered from asthenopia during or after work on computer. Marginally higher proportion of asthenopia was noted in females compared to males. Occurrence of asthenopia was significantly associated with age of starting use of computer, presence of refractive error, viewing distance, level of top of the computer screen with respect to eyes, use of antiglare screen and adjustment of contrast and brightness of monitor screen., Conclusions: Prevalence of asthenopia was noted to be quite high among computer operators, particularly in those who started its use at an early age. Individual as well as work-related factors were found to be predictive of asthenopia.

Purpose: To study the knowledge, attitude and practices (KAP) towards computer vision syndrome prevalent in Indian ophthalmologists and to assess whether 'computer use by practitioners' had any bearing on the knowledge and practices in computer vision syndrome (CVS)., Materials and Methods: A random KAP survey was carried out on 300 Indian ophthalmologists using a 34-point spot-questionnaire in January 2005., Results: All the doctors who responded were aware of CVS. The chief presenting symptoms were eyestrain (97.8%), headache (82.1%), tiredness and burning sensation (79.1%), watering (66.4%) and redness (61.2%). Ophthalmologists using computers reported that focusing from distance to near and vice versa (P =0.006, chi2 test), blurred vision at a distance (P =0.016, chi2 test) and blepharospasm (P =0.026, chi2 test) formed part of the syndrome. The main mode of treatment used was tear substitutes. Half of ophthalmologists (50.7%) were not prescribing any spectacles. They did not have any preference for any special type of glasses (68.7%) or spectral filters. Computer-users were more likely to prescribe sedatives/anxiolytics (P = 0.04, chi2 test), spectacles (P = 0.02, chi2 test) and conscious frequent blinking (P = 0.003, chi2 test) than the non-computer-users., Conclusions: All respondents were aware of CVS. Confusion regarding treatment guidelines was observed in both groups. Computer-using ophthalmologists were more informed of symptoms and diagnostic signs but were misinformed about treatment modalities.