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Narttaya Chaiwiang, Juthamanee Koo-akarakul Department of Optometry, Ramkhamhaeng University, Bangkok, ThailandCorrespondence: Juthamanee Koo-akarakul, Department of Optometry, Ramkhamhaeng University, Bangkok, 10240, Thailand, Email juthamanee.k@rumail.ru.ac.thPurpose: To determine the factors associated with eyestrain in esports athletes in Bangkok compared with controls.Patients and Methods: A cross-sectional descriptive study was conducted between April and June 2023, involving 160 male participants (aged 20– 35 years) who used digital devices, consisting of esports athletes and a control group. Data were collected using a general information questionnaire, Computer Vision Syndrome Questionnaire (CVS-Q), and Depression anxiety stress scale-21 (DASS-21). Ophthalmic instruments were used for the eye examinations by an optometrist.Results: Seventy-six esports athletes showed significantly lower visual performance than controls in logMAR visual acuity (p < 0.020), phoria (p < 0.001), negative fusional vergence (blur, break, and recovery) (p < 0.012, p < 0.004 and p < 0.039), positive fusional vergence (blur, break, and recovery) (p < 0.005, p < 0.001 and p < 0.005), monocular estimation method (p < 0.001), monocular and binocular accommodative facility (p < 0.001), and vergence facility (p < 0.001). A study on risk factors for CVS found that esports athletes were significantly more likely to have CVS (p < 0.001). Work environments with high-intensity lighting significantly increase the risk of CVS compared to low-intensity lighting (p < 0.001). The use of a digital device for > 4 h/day, having a history of alcohol consumption, and stress significantly increased the risk of CVS (p < 0.001, p < 0.023, p < 0.048).Conclusion: This study found that esports athletes experienced vision health problems, indicating the need to prevent eyestrain caused by the use of digital devices.Keywords: esports athlete, eyestrain, CVS-Q, digital devices, visual performance

Purpose: Asthenopia is related to near vision activities or visual tasks that dissociate accommodation from vergence. Since the results of previous studies using objective measures to diagnose asthenopia are inconsistent, this study compared optometric tests and objective metrics of accommodation in non‐asthenopic and asthenopic young adults before and after a visual fatigue task. Methods: The accommodative response was recorded objectively for 6 min at a 3.33 D accommodative demand using an autorefractor, before and after a 5‐min non‐congruent visual task. Accommodation was disassociated from vergence with a ±2.00 D accommodative flipper while reading at the same distance. Optometric tests and subjective evaluations of asthenopia were performed before and after the task. Twenty‐six non‐presbyopic adults (23.15 ± 2.56 years) were included and identified as asthenopic (n = 14) or non‐asthenopic (n = 12) based on their score on the Computer Vision Syndrome Questionnaire. Results: A mixed ANOVA found no significant difference between the groups for objective (accommodative response) or subjective metrics (feeling of fatigue, optometric tests), although all participants reported greater visual fatigue after the task. A significant effect of time (before and after the non‐congruent task) was identified for the overall sample for mean accommodative lag (+0.10 D, p = 0.01), subjective visual fatigue (+1.18, p < 0.01), negative relative accommodation (−0.20 D, p = 0.02) and near negative fusional reserve (blur: +2.46Δ, p < 0.01; break: +1.89Δ, p < 0.01; recovery: +3.34Δ, p = 0.02). Conclusions: The task‐induced asthenopia, measured both objectively and subjectively, was accompanied by a change in accommodative lag, greater visual fatigue and a decrease in negative relative accommodation. Conversely, near negative fusional reserves seem to adapt to the task. No significant differences were found between the two groups with respect to accommodative metrics (objective) or subjective and optometric tests. [ABSTRACT FROM AUTHOR]

AIM: To compare and analyse the diagnostic efficacy of the College of Optometrists Vision Development Quality of Life Questionnaire (COVD-QOL) and the Convergence Insufficiency Symptom Survey (CISS) in detecting convergence insufficiency and to compare their diagnostic value in clinical applications. METHODS: Using the diagnostic test method, 62 adult patients with convergence insufficiency (age: 24.74±3.75y) and 62 normal participants (age: 23.61±3.13y) who visited the Optometry Clinic of West China Hospital of Sichuan University from April 2021 to January 2023 were included. All subjects completed the CISS and COVD-QOL. Statistical analysis of the sensitivity and specificity of the CISS and COVD-QOL and comparison and joint experimental analysis of their diagnostic efficacy were performed. RESULTS: The sensitivity of the CISS and COVD-QOL for convergence insufficiency was 64.5% and 71.0%, respectively, while the specificity was 96.8% and 67.7%, respectively. Compared to the CISS alone, the combination of the CISS and COVD-QOL demonstrated lower sensitivity and specificity. The areas under the receiver operating characteristic curve of CISS, COVD-QOL and CISS combined with COVD-QOL were 0.806, 0.694 and 0.782, respectively. CONCLUSION: Considering the low sensitivity of the CISS and the low specificity of the COVD-QOL, it is recommended to supplement these questionnaires with other screening tests for the detection of convergence insufficiency.

Introduction: Digital visual syndrome or digital visual fatigue is a disease caused by the ocular fatigue provoked by spending much time in front of a screen. Objective: To diagnose the digital visual syndrome in patients under 35 years assisted in the refraction service. Methods: A prospective descriptive and cross-sectional study of patients assisted in the refraction service of the Specialties Polyclinic in Saturnino Lora Teaching Clinical Surgical Provincial Hospital, was carried out from April to June, 2022. Results: There was a prevalence of patients aged 26 and 35 and female sex; the most frequent symptoms were visual fatigue, ocular burning, dry eye sensation, closely blurred vision, red eye and headache after visual effort. The most used digital devices were the cellphone and the computer with a time of use from one to three hours, with emphasis in the last one with more than 4 hours. The refractive defects constituted the main cause of visual limitations. The patients with digital visual syndrome and some type of ametropia without correction were those with more symptoms, followed by the patients inadequately corrected. Conclusions: This syndrome affects the youngest population to a great extent. The appropriate interrogation and the incorporation of correct procedures in the daily optometric study allowed the diagnosis of such a syndrome in the assisted patients and the pertinent optic correction. [ABSTRACT FROM AUTHOR]

The diffusion of virtual reality urges to solve the problem of vergence-accommodation conflict arising when viewing stereoscopic displays, which causes visual stress. We addressed this issue with an approach based on reducing ocular convergence effort. In virtual environments, vergence can be controlled by manipulating the binocular separation of the virtual cameras. Using this technique, we implemented two quasi-3D conditions characterized by binocular image separations intermediate between 3D (stereoscopic) and 2D (monoscopic). In a first experiment, focused on perceptual aspects, ten participants performed a visuo-manual pursuit task while wearing a head-mounted display (HMD) in head-constrained (non-immersive) condition for an overall exposure time of ~ 7 min. Passing from 3D to quasi-3D and 2D conditions, progressively resulted in a decrease of vergence eye movements—both mean convergence angle (static vergence) and vergence excursion (dynamic vergence)—and an increase of hand pursuit spatial error, with the target perceived further from the observer and larger. Decreased static and dynamic vergence predicted decreases in asthenopia trial-wise. In a second experiment, focused on tolerance aspects, fourteen participants performed a detection task in near-vision while wearing an HMD in head-free (immersive) condition for an overall exposure time of ~ 20 min. Passing from 3D to quasi-3D and 2D conditions, there was a general decrease of both subjective and objective visual stress indicators (ocular convergence discomfort ratings, cyber-sickness symptoms and skin conductance level). Decreased static and dynamic vergence predicted the decrease in these indicators. Remarkably, skin conductance level predicted all subjective symptoms, both trial-wise and session-wise, suggesting that it could become an objective replacement of visual stress self-reports. We conclude that relieving convergence effort by reducing binocular image separation in virtual environments can be a simple and effective way to decrease visual stress caused by stereoscopic HMDs. The negative side-effect—worsening of spatial vision—arguably would become unnoticed or compensated over time. This initial proof-of-concept study should be extended by future large-scale studies testing additional environments, tasks, displays, users, and exposure times. [ABSTRACT FROM AUTHOR]

AIMS: This study aims to evaluate the relationship between somatic sensations, impaired vision, and cognitive performance using the factor structure convergence insufficiency symptoms survey questionnaire in university undergraduate and post-graduate students. SETTINGS AND DESIGN: Centre-based and questionnaire-based. SUBJECTS AND METHODS: Subjects were recruited from a university. First, an e-Survey was conducted with the help of Google form and distributed through WhatsApp and Gmail to carry out the survey. The age group of participants was ranged from 18 to 30 years. A total number of 561 responses was received during the data collection period. As per the exclusion criteria, 230 responses were excluded from the study. Out of 331 students, 154 were male while 177 were female. Out of 331 participants, 213 were undergraduates and 118 were postgraduate's students. RESULTS: A total of 331 participants took part in the study. The minimum age was 18 years and the maximum age was 30 years. The mean age of the participants was 23.40 ± 2.42. Among all students, 23.81% had somatic sensations followed by 10.49% had impaired vision, and 16.31% had a poor cognitive function. The correlation between somatic sensations-impaired visions was a moderate positive correlation and a strong positive correlation between somatic sensations-cognitive performance and impaired vision-cognitive performance. CONCLUSIONS: A significant relationship between somatic sensations, impaired vision, and cognitive performance was found in the study. The students had more somatic sensations than impaired vision and cognitive performance.

OBJECTIVES: To determine the impact of screen time with digital eye strain (DES), visual acuity, and near point of accommodation (NPA). METHODS: This cross-sectional study was conducted at Khyber Medical College Peshawar, Pakistan. This study included 244 students of 3rd year to 5th year MBBS, who consented to participate. A Snellen chart and Royal Air Force (RAF) rule were used to assess the visual acuity, and NPA. Chi-Square, Pearson Correlation, and multiple regression analyses were conducted using SPSS software. RESULTS: Out of 244 participants, 181 (74.1%) reported at least one symptom of digital eye strain. Headache (n=87; 35.6%) and eye pain (n=64; 26.22%) were the most common reported symptoms. Refractive error was reported in 98 (40.16%) students, including myopia (n=86; 35.25%), hyperopia (n=12; 4.92%), and astigmatism (n=12; 4.92%). Mobile (n=244; 100%) and Laptop (n=212; 86.90%) were the main electronic gadgets used by participants. Headache, eye pain, tearing of the eyes, eye redness, and itching of the eyes were significantly associated with screen time (p

Abstract Background Computer Vision Syndrome (CVS) is a complex of eye and visual problems that arise while using a computer or other Video Display Terminal (DVT). With the advent of the COVID-19 pandemic, the use of these DVTs has become indispensable in the lives of students and teachers. This study aims to identify the prevalence of CVS and associated factors in students and teachers at Lúrio University, in Nampula, during the pandemic period. Methods This is a cross-sectional study, carried out between November 2020 and March 2021. The validated CVS questionnaire (CVS-Q) and another semi-structured questionnaire on ergonomic risk factors were applied. Odds ratios (OR) and adjusted odds ratios (aOR) were calculated to measure the association between CVS and computer use conditions. Results The prevalence of CVS was 76.6%, and the female gender, age ≤ 20 years, levels I, II, III of course, lack of knowledge about ergonomics, use the computer to study, use more than 6 hours daily, absence of anti-reflex treatment, use of other devices and sitting in an inappropriate chair were risk factors for the occurrence of CVS, while being a teacher was a protective factor. Conclusion The prevalence of CVS found in this study was high, due to several factors, especially not using ergonomic principles when using computers and other DVTs. There is a need to adopt intervention strategies focused on the most vulnerable groups such as women, age group ≤20 years and students, especially at the first year level, right after entering the University.

Purpose: To assess the therapeutic efficacy and safety of Mingmu nourishing cream in asthenopia. Methods: This study retrospectively analyzed data from 124 patients who were treated for asthenopia in the Affiliated Hospital of Shanxi University of Traditional Chinese Medicine, China from January 2015 to January 2018. Patients were divided into control group (n = 63; received conventional eye drops) and study group (n = 61; received Mingmu nourishing cream in addition to control group treatment). The ocular symptom scores and tear secretion test (Schirmer's I test (SIT)) were compared between the two groups before and after treatment. Furthermore, the clinical efficacy of Mingmu nourishing cream in the treatment of asthenopia was evaluated. Results: The differences in SIT, conjunctival congestion classification and ocular symptoms between the two groups after treatment were statistically significant (p < 0.05). Moreover, the rate of total therapeutic efficacy in the study group was 86.9 % (53/61), which was significantly higher than the control group (p < 0.05). Conclusion: Mingmu nourishing cream significantly improves symptoms and exhibits favourable tolerability profile. Multi-center large sample study is needed for further verifications of the findings of this study. [ABSTRACT FROM AUTHOR]

AIMS: This study aims to evaluate the relationship between somatic sensations, impaired vision, and cognitive performance using the factor structure convergence insufficiency symptoms survey questionnaire in university undergraduate and post-graduate students. SETTINGS AND DESIGN: Centre-based and questionnaire-based. SUBJECTS AND METHODS: Subjects were recruited from a university. First, an e-Survey was conducted with the help of Google form and distributed through WhatsApp and Gmail to carry out the survey. The age group of participants was ranged from 18 to 30 years. A total number of 561 responses was received during the data collection period. As per the exclusion criteria, 230 responses were excluded from the study. Out of 331 students, 154 were male while 177 were female. Out of 331 participants, 213 were undergraduates and 118 were postgraduate's students. RESULTS: A total of 331 participants took part in the study. The minimum age was 18 years and the maximum age was 30 years. The mean age of the participants was 23.40 ± 2.42. Among all students, 23.81% had somatic sensations followed by 10.49% had impaired vision, and 16.31% had a poor cognitive function. The correlation between somatic sensations-impaired visions was a moderate positive correlation and a strong positive correlation between somatic sensations-cognitive performance and impaired vision-cognitive performance. CONCLUSIONS: A significant relationship between somatic sensations, impaired vision, and cognitive performance was found in the study. The students had more somatic sensations than impaired vision and cognitive performance. [ABSTRACT FROM AUTHOR]

Background: Data from WHO shows that asthenopia cases in the world range from 75-90%. Astenopia can result from excessive efforts of the vision system to obtain the quality of vision it should. Excessive online gaming habits have the potential to result in decreased vision quality. This problem needs to be considered because asthenopia is an early symptom sign of more serious visual impairment. This study aimed to discover an overview of the incidence of asthenopia among online game players in Kupang City based on the duration, distance of smartphones, body position, and eye rest while playing online games. Subjects and Method: It was a descriptive study conducted in Kupang City from March to April 2023. With a total of 378 online game players aged 15-24 years selected by purposive sampling. The dependent variable was the incidence of asthenopia. The independent variables were the duration of playing online games, the viewing distance of smartphone, body position, and eye rest. The data collection techniques used was questionnaires. The data were presented descriptively. Results: A total of 367 people (97.1%) complained about symptoms of eyestrain (asthenopia), 251 people (66.4%) played online games with a duration of >2 hours and other 127 people (33.6%) played online games <2 hours. 277 people (73.3%) used smartphones with a distance of <30 cm and other 101 people (26.7%) with a distance of >30 cm. 184 people (48.7%) played online games while lying down and 194 people (51.3%) sitting. 187 people (49.5%) did not do eye rest and as many as 191 people (50.5%) did eye rest consisting of 53 people (14.0%) doing micro break, 55 people (14.6%) doing mini break and 83 people (22.0%) doing maxi break. Conclusion: Different types of asthenopia have been discovered. The most common incidence of asthenopia is experienced by online game players with risky viewing distance of smartphone. [ABSTRACT FROM AUTHOR]

Background: Computer Vision Syndrome (CVS) is a complex of eye and visual problems that arise while using a computer or other Video Display Terminal (DVT). With the advent of the COVID-19 pandemic, the use of these DVTs has become indispensable in the lives of students and teachers. This study aims to identify the prevalence of CVS and associated factors in students and teachers at Lúrio University, in Nampula, during the pandemic period. Methods: This is a cross-sectional study, carried out between November 2020 and March 2021. The validated CVS questionnaire (CVS-Q) and another semi-structured questionnaire on ergonomic risk factors were applied. Odds ratios (OR) and adjusted odds ratios (aOR) were calculated to measure the association between CVS and computer use conditions. Results: The prevalence of CVS was 76.6%, and the female gender, age ≤ 20 years, levels I, II, III of course, lack of knowledge about ergonomics, use the computer to study, use more than 6 hours daily, absence of anti-reflex treatment, use of other devices and sitting in an inappropriate chair were risk factors for the occurrence of CVS, while being a teacher was a protective factor. Conclusion: The prevalence of CVS found in this study was high, due to several factors, especially not using ergonomic principles when using computers and other DVTs. There is a need to adopt intervention strategies focused on the most vulnerable groups such as women, age group ≤20 years and students, especially at the first year level, right after entering the University. [ABSTRACT FROM AUTHOR]

The retina, an important tissue of the eye, is essential in visual transmission and sustaining adequate eyesight. However, oxidative stress and inflammatory reactions can harm retinal structure and function. Recent studies have demonstrated that exposure to light can induce oxidative stress and inflammatory reactions in retinal cells, thereby facilitating the progression of retinal damage–related diseases and asthenopia. Plant bioactive compounds such as anthocyanin, curcumin, resveratrol, lutein, zeaxanthin, epigallocatechin gallate, and quercetin are effective in alleviating retinal damage and asthenopia. Their strong oxidation resistance and unique chemical structure can prevent the retina from producing reactive oxygen species and regulating eye muscle relaxation, thus alleviating retinal damage and asthenopia. Additionally, the combination of these active ingredients produces a stronger antioxidant effect. Consequently, understanding the mechanism of retinal damage caused by light and the regulation mechanism of bioactive compounds can better protect the retina and reduce asthenopia. Light causes retinal damage and asthenopia through oxidative stress, inflammatory reaction, mitochondrial damage, apoptosis, and autophagy. Anthocyanin, curcumin, resveratrol, lutein, zeaxanthin, epigallocatechin gallate, and quercetin can exert antioxidant and anti-inflammatory mechanisms and prevent retinal light damage. In addition, this bioavailability and preventive effect can be improved by embedding bioactive compounds and synergistic effect of bioactive compounds. Abbreviation: ROS, reactive oxygen species. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective: To detect the presence of asthenopia after implantation of Implantable Collamer Lens (ICL). Method: Design: prospective observational case series. Patients with myopia and/or astigmatism who underwent ICL surgeries and completed 3-month follow-up were enrolled. Asthenopia scores, amplitude of accommodation (AA), positive/negative relative accommodation (PRA/NRA), accommodative facility (AF), the ratio of accommodative convergence and accommodation (AC/A), Schirmer test, noninvasive breakup time (NBUT), and HOA were examined before surgeries and at 1 week, 1 month and 3 months postoperatively then statistically analyzed. Results: Symptoms of asthenopia were significantly decreased at 1 week after ICL surgeries than those before surgeries, but increased gradually as time went by, eventually recovered at 3 months postoperatively. AA, AF, AC/A decreased 1 week postoperatively, returned to the baseline at 1 month and were improved at 3 months after surgeries. NBUT at 1 week, 1 month and 3 months after surgeries were significantly decreased and was the lowest at 1 week postoperatively. PRA, NRA, Schiermer values and HOA had no significant change. Correlation analysis showed that the lower AF and NBUT after ICL surgeries, the more severe the asthenopia symptoms. Conclusion: The symptoms of asthenopia aggravated transiently after ICL implantation surgeries, but improved gradually with time. AF and NBUT were important factors affecting the changes of asthenopia. [ABSTRACT FROM AUTHOR]

AIM: To develop the 17-item Asthenopia Survey Questionnaire (ASQ)-17 by Rasch analysis, and to generate a predictiveness score. METHODS: Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective, cross-sectional study. Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options. RESULTS: Phase 1 assessed the original ASQ-19, adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item. Phase 2 deleted the 11th item. Phases 3 and 4 assessed the new ASQ-17. All the evaluation indexes of ASQ-17 were acceptable. The Infit and Outfit MnSq values of items were 0.67-1.48, the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40% and 1.50-1.80 in three dimensions. The curve peaks of scores in each dimension were separated and in the same order. The PSR and PSI values were 2.80 and 0.89, respectively. The mean scores of dimensions A (9.5±4.1 vs 3.5±3.2), B (7.3±3.3 vs 2.5±2.7), C (4.3±2.2 vs 1.4±2.0) and total (21.1±8.1 vs 7.4±7.0) in asthenopia participants were significantly higher than those without asthenopia (all P

OBJECTIVE: To determine the association of presenting clinical features of asthenopia in madrassa students with different refractive errors. METHODS: This cross-sectional study was conducted from September-November 2022 at different Madrassas in Lahore, Pakistan. Study was performed on a sample of 108 patients, who had different refractive difficulties. Informed consent was taken from the patients aging ≥18 years and from parents/ guardians of patients aging 16 years of age. Common asthenopic symptoms included hazy vision (n=106; 98.1%), headache (n=93; 86.1%), discomfort (n=79; 73.1%), pain (n=76; 70.4%) and eye strain (n=72; 66.7%). Common refractive errors were myopia (n=59; 54.6%), hypermetropia (n=25; 23.2%) and astigmatism (n=24; 22.2%). Severity of refractive errors was mild in majority of cases of myopia (n=24/59; and hypermetropia (n= and moderate in astigmatism (n=16; 64%). Headache, eye strain and blurring of vision had significant association with myopia, hypermetropia, and astigmatism. CONCLUSION: Myopia and hypermetropia are the most common refractive errors; hazy vision and headache are the common asthenopic symptoms. There is a strong association between asthenopic symptoms and refractive errors.

IntroductionThe role of ophthalmologists is defined by tasks requiring visual effort, emphasizing the importance of examining their condition within the realm of occupational visual health. Our goal was to explore the occurrence of asthenopia among Chinese ophthalmologists and identify contributing factors through the use of a reliable and validated survey instrument.MethodsA national cross-sectional online survey was carried out in June 2017, involving 6,220 practicing ophthalmologists in China. Utilizing an 11-item Asthenopia Survey Questionnaire with established reliability and validity. Prevalence rates of asthenopia among subgroups categorized by age, gender, hospital classification, physician level, daily near vision activity duration, sleep duration, sleep quality, presbyopia status, and history of eye surgery were determined using the independent t-test, chi-square test and bonferroni test. Multiple logistic regression analysis was employed to pinpoint independent factors linked to asthenopia.ResultsOut of the 5,009 ophthalmologists who completed the survey, a 40.7% prevalence of asthenopia was identified. Multivariate analysis revealed that good sleep quality (OR: 0.24, 95%CI: 0.20–0.30), moderate sleep quality (OR: 0.47, 95%CI: 0.38–0.59), engaging in daily near vision activities for less than 7 h (OR: 0.76, 95%CI: 0.68–0.86), having daily sleep duration exceeding 7 h (OR: 0.87, 95%CI: 0.77–0.98), and working in tertiary hospitals (OR: 0.88, 95%CI: 0.78–0.99) were protective factors against asthenopia. Conversely, presbyopia was identified as a risk factor (OR: 1.33, 95%CI: 1.04–1.70). All calculated p values were below 0.05. Age, gender, physician level, and eye surgery history were not related factors.ConclusionAsthenopia is prevalent among Chinese ophthalmologists, with employment in tertiary hospitals providing a protective effect and presbyopia is a risk factor. Preventive strategies include improving sleep quality, restricting daily near vision activity to under 7 h, and extending daily sleep duration to over 7 h. Further investigation is needed to explore the protective implications of working in tertiary hospitals.

Background/Aim. Vision and health problems associated with the use of computers and other digital devices are known as computer vision syndrome (CVS). Advances in technology have led to increased use of computers, so the prevalence of these symptoms is increasing. The aim of this study was to calculate the overall prevalence of CVS and CVS symptoms using meta-analysis. Methods. The study was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. In July 2021, a systematic search of four electronic databases with article collections was performed: PubMed, Cochrane Library, Web of Science, and Google Scholar. The key search terms were: "computer vision syndrome", "computer users", "digital eyestrain", "headache", "dry eyes", "red eyes", "eyestrain", "neck pain", "back pain", and "shoulder pain". The articles included in the study had to be original articles written in English only, and the criterion that had to be met was that the research included computer users. As a result, the prevalence of CVS or the prevalence of any of the symptoms of CVS had to be measured. Results. A total of 43 articles were fully reviewed, of which 20 were included in the metaanalysis. The total calculated prevalence for all studies was 74.4%, while the prevalence for individual symptoms was: headache - 43%, dry eyes - 24.4%, eyestrain - 29%, red eyes - 20.7%, and neck, back, or shoulder pain - 46.3%. Conclusion. The results obtained are worrying and point to the necessity of a multidisciplinary approach to solving CVS-related problems. [ABSTRACT FROM AUTHOR]

Background: Accommodative convergence to accommodation (AC/A) ratio expresses the quantitative relationship between the convergence and accommodation. Purpose of this study was to assess and compare the effect of red and green filters on high and low AC/A ratio in emmetropes. Materials & Methods: A comparative cross-sectional study was conducted in The University of Faisalabad. Total one hundred (100) emmetropic females from 18 to 25 years of age (20 having low AC/A ratio and 80 with high AC/A ratio) were included in the study through purposive sampling technique after obtaining informed verbal and written consent. Data was collected using self-designed examination based proforma. AC/A ratio was measured with heterophoric method initially without any filters, and then with red and green filters. Data was analyzed using SPSS version 22. Paired t-test was applied to assess the effect of red and green filters on the base line and then independent t-test was applied to compare the effect of red and green filters. Results: Total 100 emmetropic females revealed that red and green filters have decreased high AC/A ratio and improved low AC/A ratio (p <0.001). Moreover, it was observed that red filters have improved low AC/A ratio (p- 0.023) and decreased high AC/A ratio more effectively as compared to the green filters (p <0.05). Conclusion: This study concluded that the red and green filters improved AC/A ratio and thus, can aid in preventing binocular visual anomalies effectively. [ABSTRACT FROM AUTHOR]

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Background: Positive fusional vergence (PFV) is vital in maintaining fusion in critical and continuous near tasks such as reading or performing digital screen tasks. This study investigated how PFV changed under various lighting conditions. Methods: This cross-sectional study recruited 34 participants aged between 21 and 25 years, with best corrected visual acuity (BCVA) 0.0 logMAR and insignificant refractive error. Three different illuminations—low illumination (50 lux), medium lighting (100 lux), and high illumination (150 lux)—were used to examine the ocular parameters PFV (blur, break, and recovery points), contrast sensitivity and pupil diameter. Results: Pupil diameter changed significantly in different room illuminations (p = 0.00). There was no significant difference in contrast sensitivity across the three levels of room illumination (p = 0.368). Mean PFV (SD) (blur) was 14.5 (2.5) in 50 lux, 10.2 (2.2) in 100 lux, and 8.2 (2.1) in 150 lux. Under 50, 100 and 150 lux, respectively, the mean PFV (SD) (break) values were 16.7 (2.4), 13.4 (1.8), and 10.8 (2.2), and the mean PFV (SD) (recovery) values were 13.3 (2.1), 10.7 (2.1), and 7.5 (2.7). With increased illumination levels, PFV blur, break, and recovery values were significantly lower (p < 0.001). Conclusions: PFV values were significantly higher in lower illumination. Clinicians should be aware that room illumination affected the PFV values measured.

To determine the prevalence of ophthalmological findings suggesting an ocular cause for headache or occult neurological disease, among children with headache. Retrospective cross-sectional study on children with headache at a tertiary outpatient ophthalmology clinic. All children underwent sensorimotor, anterior segment, and dilated fundoscopic examinations, with or without cycloplegic refraction. Prevalence of one or more new findings of ocular or occult neurological cause of headache, including glaucoma, uveitis, optic nerve elevation, or possible asthenopia from strabismus or refractive issues. Headache characteristics and associated symptoms were evaluated as risk factors for ocular findings. Among 1,878 children with headache (mean age 10 yrs, range 2–18), 492 (26.1%, 95% CI 24.3–28.2%) children had one or more new ocular findings that could cause headache or indicate intracranial disease: refractive issues (342, 18.2%), strabismus (83, 4.4%), optic nerve elevation (51, 2.7%; 26 with papilledema, 25 with pseudopapilledema), uveitis (6, 0.3%), and glaucoma (2, 0.1%). Shorter headache duration was associated with ocular findings (p =.047), but headache frequency, photophobia, nausea/vomiting, and visual changes were not. In univariable analysis, visual changes (p ≤.001), nausea/vomiting (p ≤.002), and morning headache (p =.02) were associated with optic nerve elevation. An ophthalmologic examination including cycloplegic refraction is indicated in children with headache, as one-quarter have a treatable ocular condition, which may be related to the headache, or sign of intracranial pathology. While nausea, visual changes, or morning headache should raise concern, coincident visual, ocular, or systemic symptoms are not reliable predictors of discovering ocular pathology in a child with headache. [ABSTRACT FROM AUTHOR]

BACKGROUND: Many individuals experience visual symptoms associated with near work. The level of discomfort appears to increase with the amount of digital screen use. OBJECTIVE: To study the eye discomfort with near tasks in university students in the pre-COVID period and in the period of confinement due to the pandemic. METHODS: Two independent samples of students, aged between 18 and 35 years, were used to assess symptomatic behaviour with the Convergence Insufficiency Symptom Survey (CISS) questionnaire. In the pre-COVID period the sample had 342 participants, 64.6% females and in the COVID period 322 students participated, 71.4% females. The study of differences was carried out by the Mann-Whitney U test. The interpretation of the statistical inference was performed for a significance level≤0.05. RESULTS: There was an increase in the number of symptomatic cases in the COVID period without statistical evidence of differences in the frequency of symptoms reported in the two periods. The dimensions "somatic sensations" and "cognitive performance" were the typology of symptoms that most contributed to visual complaints with near vision. There was a significantly different symptomatic behaviour between genders in the period of confinement (p = 0.001), worsening in females and improving in males. CONCLUSION: These findings suggest that females and males exposed to digital environments, over time, may exhibit different symptomatic behaviour. Our results suggest that boys adapt more quickly than girls. Factors that predispose to these changes, aetiology and potential intervention actions still need further study. [ABSTRACT FROM AUTHOR]

Purpose: Increased screen time has been a major concern among the students who have adopted the online curriculum amid the pandemic. The study was conducted to shed light on the changing trends of symptoms pertaining to dry eye disease and digital eyestrain due to the online curriculum and its negative implications on the ocular health of students. Methods: A cross-sectional study was conducted among students of Manipal Academy of Higher Education who are currently following the E-learning curriculum amid the COVID-19 pandemic the participants were surveyed using a pre-validated structured questionnaire. Results: The mean age of study participants was 23.33 ± 4.604 years. In total, 97.9% (321/352) of the respondents experienced at least three symptoms associated with the usage of digital devices. 88.1% of the participants were exposed to an average screen time of more than 4 hours per day. An increased number of hours of digital device usage was found to be associated with higher total symptom scores (P = 0.04). The total symptom scores were found to be considerably higher for those with continuous contact with the screen (P = 0.02). Headache (69.9%, n = 246) is the most commonly reported symptom followed by neck pain (65.3%, n = 230), tearing (44.6%, n = 157), eye pain (40.9%, n = 144), and burning sensation (40.1%, n = 141). Conclusion: This study highlights a tremendous increase in the prevalence of symptoms related to dry eye and digital eyestrain among students attending online classes during the COVID-19 pandemic. Eye care professionals need to be aware of this emerging public health threat and the appropriate measures for its prevention.