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This study examines the association between excessive digital media use and adverse health outcomes, specifically Digital Eye Strain (DES) and Poor Sleep Quality (PSQ), in adolescents. A cross-sectional survey of 512 participants (aged 11-18 years) assessed DES and PSQ using the Computer Vision Syndrome Questionnaire and the Pittsburgh Sleep Quality Index. We found a high prevalence of DES (63.7%) and PSQ (51.2%). Factors associated with DES included using digital media for more than two hours daily, increased post-pandemic digital consumption, shorter breaks, and PSQ. Extended daily digital media use (>4 hours), bedtime usage, older age, female sex, online education and DES were significantly associated with PSQ. These findings highlight the harmful effects of excessive digital media use on adolescent health, especially post-COVID-19. The intricate link between DES and PSQ underscores the need for public health interventions to promote healthy digital habits., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Şambel Aykutlu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Modern workplace requirements in the banking sector require bankers to work on screens for more than 6 h a day, putting much stress and strain on their eyes, which leads to computer vision syndrome. Therefore, this study aimed to assess the prevalence of computer vision syndrome and associated factors among urban and rural bankers in Trinidad and Tobago., Methods and Materials: A cross-sectional design was applied to collect data from 399 bankers between April and June 2023. The collected data was entered into Excel worksheets and later uploaded to SPSS for further analysis. A variable with a P -value of 0.25 in binary logistic regression is a candidate for multi-variable logistic regression analysis. Finally, a variable with a P -value of 0.05 was used to declare statistical significance., Results: A total of 371 participants were enrolled in this study, leading to a response rate of 92.9%. Of the total participants, 277 (74.7%) had computer vision syndrome. Working in rural areas (AOR = 2.69; 95% CI [1.41-5.13]) and using eyesight glasses (AOR = 0.57; 95% CI [0.33-0.97]) was associated with computer vision syndrome., Conclusion: Despite being easily preventable, computer vision syndrome is substantially prevalent among bankers in Trinidad. The use of eye-sight glasses and the working area are significantly associated with computer vision syndrome. Therefore, it is necessary to improve workplace practices by encouraging the use of anti-glare screens and glasses for employees who work long hours on the computer., Competing Interests: The authors declare that they have no competing interests., (© 2024 Ekemiri et al.)

Clinical Relevance: Digital eye strain (DES) is a condition encompassing visual and ocular symptoms that may arise due to the prolonged use of digital devices. The 2023 Tear Film Ocular Surface Lifestyle report defined DESas"the development or exacerbation of recurrent ocular symptoms and / or signs related specifically to digital device screen viewing". Studies vary as to the prevalence of DES with some reporting values as low as 10 % and some reporting values over 90 %, however no study has examined the prevalence of DES in the UK or Ireland (UK&I)., Purpose: To determine the prevalence of DES amongst adults who work with digital devices in UK&I, their symptoms and ameliorative approaches taken by those affected., Methods: A web-based survey of digital device users was conducted. Adults who used a device for at least 1 h per day for work purposes were eligible to participate. The questionnaire was designed to determine the prevalence of DES, daily device usage, musculoskeletal and ocular symptoms, how they manage their symptoms and eye care history., Results: Based on a Computer Vision Syndrome Questionnaire score ≥ 6, the occurrence of DES was high at 62.6 %. The mean number of hours devices were used for was 9.7 h. Musculoskeletal symptoms were reported by 94.3 % of users and ocular symptoms by 89.5 % with symptoms most likely to occur with those working from home. 8.1 % of respondents considered their symptoms significant enough to affect their work., Conclusion: This study provides a valuable insight into DES in digital device users in UK&I and is the first of its kind to be completed. It shows, that while the level of DES is high in device users, at 62.6 %, the actual effect or consequences of it on many does not appear to be significant., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The increased utilization of digital screens is an unavoidable consequence of the technology era. Digital eye strain (DES) is a prevalent health problem among higher education students in Saudi Arabia, especially health sciences students due to the frequent use of digital sources and virtual classes. Thus, this study aimed to assess the severity of digital eye strain syndrome (DESS) symptoms and preventive ergonomic practices among higher education health science students in Saudi Arabia., Methods: A cross-sectional study using multistage cluster sampling in three cities (Dammam, Riyadh, Jeddah) in Saudi Arabia. A convenient sample of 328 health science students was selected using an equal allocation technique. The researchers designed and used an online survey of three sections: personal and digital device use-related data, the DESS questionnaire, and the self-reported preventive ergonomic practices scale., Results: DESS is a widespread problem among 72.0% of health science students, and 58.2% had unsatisfactory ergonomics. The frequently reported symptoms were blurred vision (32.9%) and increased sensitivity to light (33.5%). The severe eye-related symptoms were headache (45.85%), foreign body inside the eye (43.71%), eye burning (40.19%), and dryness (39.76%). Logistic regression analysis revealed that the female sex, years of screen utilization and the number of hours per day, screen use without rest, and frequency of virtual classes per week, eye disease, digital screen utilization for studying, nonuse of protective eye measures, and using numerous digital devices were significant predictors of DESS risk ( P < 0.05)., Conclusions: DESS is a common problem among many health science students, with headaches and foreign body sensations in the eye being the most frequent symptoms. Screen utilization time and eye disease are significant predictors of DESS, while most items' application of ergonomic practices was low. Educational programs are needed to increase student's awareness of ergonomic practices., Competing Interests: The authors declare no competing interests., (© 2024 Gushgari et al.)

Background: The purpose of this study was to identify the possible association between mental status and the risk of self-reported asthenopia among college students in China., Methods: Ten thousand students were randomly assessed in the study using a self-reported asthenopia questionnaire. Their demographic characteristics and mental status were recorded. Univariate analysis was performed to preliminarily select potential risk and protective factors. Then, multivariate logistic regression was used to estimate odds ratios for the selected risk factors of interest., Results: Among the 8370 students who completed the survey, the prevalence of asthenopia was 61.0%. Multivariate analysis revealed a significant relationship between asthenopia and depressive symptoms (OR 1.511 95% CI: 1.350-1.691), obsessive-compulsive symptoms (OR 1.477, 95% CI: 1.338-1.632), gender and study load. The place college students spent their off-hours (OR 0.841, 95% CI: 0.784-0.902) was found to be the strongest factor for decreasing the occurrence of asthenopia complaints., Conclusion: Asthenopia appears common in Chinese college students. In addition to depressive symptoms, we should pay attention to obsessive-compulsive symptoms when considering means of preventing asthenopia. Harmonious social relationships, outdoor off-hour activities and exercising more than three times per week are crucial to relieving visual fatigue. Further study is still needed in this area., Competing Interests: Declarations. Ethical approval: Ethics Committee of Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine (Approval No. 2017KY002). Conflict of interest: All authors declare no conflict of interest in the study., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: To determine the prevalence of digital eye strain or computer vision syndrome (CVS) and its risk factors in a university population (University of Valladolid, Spain)., Methods: An anonymous cross-sectional online survey was conducted in a university population [staff (lecturers and administrative employees) and students (undergraduate, master's, and PhD)], including two validated questionnaires (Ocular Surface Disease Index [OSDI] and the 17-item Computer-Vision Symptom Scale questionnaire [CVSS17]) and questions about sociodemographic data and visual display terminal use. The prevalence and risk factors for CVS (CVSS17≥29) (multivariate logistic regression model) were calculated., Results: One thousand nine participants responded to the survey (35.2±15.2 years; 64.1% women). The mean OSDI and CVSS17 questionnaire scores were 18.9±15.6 and 31.5±6.4, respectively, and 35.4% of the respondents had dry eye symptoms (OSDI>22). The total prevalence of CVS was 65.4% (95% CI 62.1-68.3). Undergraduate students showed the highest CVS prevalence (72.6%; P <0.01), which was significant. In addition, women, participants younger than 36 years old, contact lens wearers, and subjects with dry eye symptoms reported a statistically higher CVSS17 score ( P ≤0.01). In the multivariate model, significant factors associated with the presence of CVS ( P ≤0.03) were female sex (OR=2.10; 95% CI 1.54-2.88), dry eye symptoms (OSDI>22) (OR=16.98; 95% CI 10.36-27.84), VTD use ≥6 hr daily (OR=1.96; 95% CI 1.09-3.52), and being an undergraduate student (OR=2.23; 95% CI 1.54-3.24)., Conclusion: A high prevalence (65.4%) of CVS was found among the Spanish university population, with the undergraduate student group having the highest prevalence (72.6%). Female sex, more than 6 hr/day of visual display terminal use, being an undergraduate student, and dry eye symptoms significantly increased the risk of CVS in the university population., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Contact Lens Association of Ophthalmologists.)

Background: Ever since the start of the coronavirus disease 2019 (COVID-19) pandemic, students have been spending an increasingly longer time staring at electrical devices to take online courses., Objective: This study aimed to investigate the effect of the virtual class environment on eye and musculoskeletal problems in university students during the COVID-19 pandemic., Methods: A total of 365 university students were enrolled in this study. They completed an online survey to examine the effects of online learning on eye and musculoskeletal health during the COVID-19 pandemic. The questionnaires consisted of four sections: demographic and general information, environmental and work factors, device-related factors, and visual display terminal syndrome (VDTS)., Results: Participants have been taking online classes of 14.5 hours per week during the COVID-19 pandemic. They reported the mean daily usage of digital devices of 4.8±2.2 hours before the pandemic but this increased to 8.1±2.9 during the pandemic. Eye fatigue and neck, shoulder, and back pain have also been reported. The mean VDTS score was significantly influenced by gender, obesity, daily exercise, regular breaks, wear of blue light-blocking glasses, daily hours of electronic device use, and illumination of room., Conclusion: The results of this study showed that university students taking online classes suffered more from VDTS, especially in eye fatigue and neck, lower back, and shoulder pain during COVID-19 pandemic than prior. This study suggests that it is necessary to take breaks in online classes and regularly provide appropriate eye exercise and physical activity to prevent VDTS.

Introduction: The 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., Methods: A 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., Results: Out 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., Conclusion: Asthenopia 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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Lin, Zhu, Wu, Yang, Lu and Deng.)

Aim: This study aimed to assess the prevalence of Computer Vision Syndrome (CVS) among children and adolescents in Qatar during the period of remote learning and explore the associated factors and discuss some digital health remedies that might reduce the risk., Methods: We conducted an analytical cross-sectional study between June and August 2022 by collecting data via telephone interviews with parents of selected students utilizing the Computer Vision Syndrome Questionnaire (CVS-Q)., Results: We completed 1,546 interviews. The mean age of the students was (11 ± 2), male: female ratio was almost 1:1. About one quarter (368, 23.8%) of parents reported a previous diagnosis of visual disturbances among their children with over 88% of them wearing eyeglasses or medical contact lenses. The prevalence of CVS in our sample was about 8% (95%CI: 6.8-9.6). Mother's employment, having positive history of visual disturbances, and excess screen time were found to be significant predictors of CVS., Conclusion: Health care providers in collaboration with teachers should provide parents with evidence-based strategies to prevent or minimize the digital eye strain among students. In the landscape of remote learning, the implementation of digital remedies emerges as a proactive approach to mitigate the risk of digital eye strain., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Abed Alah, Abdeen, Selim, AlDahnaim and Bougmiza.)

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: To evaluate the prevalence of computer vision syndrome (CVS)-related symptoms in a presbyopic population using the computer as the main work tool, as well as the relationship of CVS with the electronic device use habits and the ergonomic factors., Methods: A sample of 198 presbyopic participants (aged 45-65 years) who regularly work with a computer completed a customised questionnaire divided into: general demographics, optical correction commonly used and for work, habits of electronic devices use, ergonomic conditions during the working hours and CVS-related symptoms during work performance. A total of 10 CVS-related symptoms were questioned indicating the severity with which they occurred (0-4) and the median total symptom score (MTSS) was calculated as the sum of the symptoms., Results: The MTSS in this presbyopic population is 7 ± 5 symptoms. The most common symptoms reported by participants are dry eyes, tired eyes and difficulties in refocusing. MTSS is higher in women (p < 0.05), in laptop computer users (p < 0.05) and in teleworkers compared to office workers (p < 0.05). Regarding ergonomic conditions, MTSS is higher in participants who do not take breaks while working (p < 0.05), who have an inadequately lighting in the workspace (p < 0.05) and in the participants reporting neck (p < 0.01) or back pain (p < 0.001)., Conclusion: There is a relationship between CVS-related symptoms, the use of electronic devices and the ergonomic factors, which indicates the importance of adapting workplaces, especially for home-based teleworkers, and following basic visual ergonomics rules., (© 2023. The Author(s).)

Purpose: To assess the magnitude severity and determinants of eyestrain and the use of digital devices in a Saudi population during the COVID-19 pandemic lockdown., Methods: This web-based survey was conducted in September 2020 and enrolled only Saudi nationals 15 years or older. Data were collected on demographics, eye strain related symptoms, severity, and the use of optical aids during the COVID-19 lockdown. The frequency and severity of eye strain were calculated. A Computer Vision Syndrome (CVS) score was graded as none/mild moderate and severe, based on the sum of 15-eye strain related signs and symptoms. Correlation analysis was performed for determinants of CVS., Results: The study sample was comprised of 2009 individuals with median age of 20 years. Among those who used digital devices for more than 6 h daily, the main reasons for use were work and social purposes among 68.4%, and 61% of respondents, respectively. The prevalence of knowledge on CVS and the '20-20 rule for using digital devices' was 9.4% and 6.9, respectively. The most common symptoms of eye strain from digital device usage were headache, burning, itching, tearing, and redness of eyes. Six hours of daily usage of digital devices was positively associated to the grade of eye strain severity during the COVID-19 lockdown (P < 0.05))., Conclusion: The Saudi population experienced eye strain during COVID-19 lockdown due to excessive digital devices usage. Longer duration of digital device usage was associated to eye strain. Health care providers should educate the general population on measures to mitigate eye strain due to digital devices. Trial registration ID None applicable., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: The present work style and lifestyle have increased the digital device use. Therefore, an increase in digital eyestrain is to be expected. We undertook a survey during coronavirus disease 2019 (COVID-19) pandemic to investigate the practice of 20/20/20 rule and its association with digital device use and asthenopic symptoms. While this rule is commonly advised, little is known about its validity., Methods: An online survey form was disseminated through social media and emails. The questions for eye-related symptoms were similar to the convergence insufficiency symptom survey (CISS). Participants with age ≥5 years were included, with parents completing the survey for children (≤16 years)., Results: A total of 432 participants (mean ± standard deviation [SD]: 26.06 ± 13.92 years) were enrolled, of which 125 responses were for children. The 20/20/20 rule was practiced only by 34% of the participants either regularly (n = 38) or occasionally (n = 109). Those who had complaints of burning sensation and headache tended to practice this rule. Among adult participants, more females (47%) practiced this rule when compared to males (23%). Also, adult females significantly (P = 0.04) had more symptoms score when compared to males. In children, no such gender difference was found., Conclusion: Only one-third of participants practice the 20/20/20 rule at least occasionally. More number of adult females being symptomatic and practicing in greater number could be due to higher prevalence of dry eye condition in females. While the symptom of burning sensation could be related to dry eye, that of headache could be related to refractive error or binocular vision dysfunctions., Competing Interests: None

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., Competing Interests: None

Introduction: This study explored the impact of online learning during the coronavirus disease 2019 (COVID-19) pandemic on asthenopia and vision impairment in students, with the aim of establishing a theoretical basis for preventive approaches to vision health., Methods: This balanced panel study enrolled students from western rural China. Participant information was collected before and during the COVID-19 pandemic via questionnaires administered at local vision care centres, along with clinical assessments of visual acuity. Paired t tests and fixed-effects models were used to analyse pandemic-related differences in visual status., Results: In total, 128 students were included (mean age before pandemic, 11.82 ± 1.46 years). The mean total screen time was 3.22 ± 2.90 hours per day during the pandemic, whereas it was 1.97 ± 1.90 hours per day in the pre-pandemic period (P<0.001). Asthenopia prevalence was 55% (71/128) during the pandemic, and the mean visual acuity was 0.81 ± 0.30 logarithm of the minimum angle of resolution; these findings indicated increasing vision impairment, compared with the pre-pandemic period (both P<0.001). Notably, asthenopia prevalence increased by two- to three-fold, compared with the pre-pandemic period. An increase in screen time while learning was associated with an increase in asthenopia prevalence (P=0.034)., Conclusion: During the COVID-19 pandemic, students spent more time on online classes, leading to worse visual acuity and vision health. Students in this study reported a significant increase in screen time, which was associated with increasing asthenopia prevalence and worse vision impairment. Further research is needed regarding the link between online classes and vision problems., Competing Interests: As an International Editorial Advisory Board member of the journal, Y Shi was not involved in the peer review process. Other authors have disclosed no conflicts of interest.

Digital device usage has increased significantly in last decade among all age groups, both for educational and recreational purposes. Computer vision syndrome (CVS), also known as digital eye strain (DES), represents a range of ocular, musculoskeletal, and behavioral conditions caused by prolonged use of devices with digital screens. This paper reviews the principal environmental, ocular, and musculoskeletal causes for this condition. Due to the high prevalence of DES and frequent usage of digital devices, it is important that eye care practitioners be able to provide advice and management options based on quality research evidence.

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., (Copyright © 2022 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background Clinical microscopists are at a greater risk of developing binocular vision anomalies and asthenopia. Objective To assess the refractive and binocular vision status and to explore the association between the presence of asthenopic symptoms and microscopy work among clinical microscopists working at medical laboratory department. Method This cross-sectional study involved 37 clinical microscopists working at medical laboratory department of Dhulikhel Hospital, Nepal. The study was conducted from January to December 2013. Only those participants who had been using microscope for at least a year were enrolled in this study. Each participant underwent distance visual acuity (VA) assessment, refractions, and orthoptic evaluation, including measurement of distance and near phoria, near point of convergence (NPC), near point of accommodation (NPA), positive fusional vergence (PFV), adduction, and calculation of accommodation convergence/accommodation (AC/A) ratio. The tear test was also carried out in each subject. Information about use of glasses, microscopy work (duration, and time spent per day in microscope), and visual symptoms associated with the use of microscope such as eye strain, headache, double vision, and near vision were collected. Result The mean age of the clinical microscopists was 29 ± 5.7 years. The prevalence of refractive error was 56.76% and the mean spherical equivalent (SE) refractive error was -0.77 ± 0.86 D. Refractive error had neither correlation with microscopy work and asthenopic symptoms associated with it, and nor with binocular vision parametersNPC, AA and AC/A ratio. However, there was a positive association between asthenopic symptoms and microscopy work. There was statistically significant difference between symptomatic and asymptomatic subjects for binocular vision parameters, including NPC, AA and positive fusional vergence (PFV) for near. Conclusion Microscopy work has an impact on near binocular vision. Asthenopic symptoms bear a positive association with microscopy work. Refractive error has no significant correlation with either microscopy works or associated asthenopic symptoms.

Objectives. This study aimed to describe the prevalence of ergonomic factors associated with computer vision syndrome (CVS), and knowledge and practices of computer usage among bank workers in the Cape Coast Metropolis, Ghana. Methods. A comprehensive eye examination was performed for 139 bankers in the Cape Coast Metropolis. Measurements of ergonomic practices at workstations were carried out and self-administered questionnaires were used to collect socio-demographic data, symptoms of CVS and associated factors as well as knowledge, attitudes and practices of the bankers on CVS. Descriptive statistics and logistic regression were carried out to compute the different proportions and relevant associations. Results . Headaches (73.4%), eyestrain (65.5%) and itching (63.3%) were the most common reported symptoms. The prevalence of CVS in the study population was 71.2% with a high level of poor ergonomic practices (78.4%) at computer workstations. With regard to knowledge, attitudes and practices of the participants on CVS, 68.3% of the participants had low levels of knowledge on CVS, while 90.6% had negative attitudes towards CVS and 46.0% of the participants had poor practices. Conclusion. Bankers had a high prevalence of CVS. Ergonomic practices, females and computer usage were all associated significantly with the presence of CVS.

Objectives. Nearly 60 million people suffer from computer vision syndrome (CVS) globally, resulting in reduced work productivity. This study aimed to determine the prevalence of CVS, describe the working conditions, visualize ergonomic factors and determine preventive measures application among university staff members. Methods . A cross-sectional study was conducted with university medical staff members using a semi-structured questionnaire that included a validated CVS questionnaire. Results. CVS prevalence was 81.2%. Dryness, headache, feeling that sight is worsening and difficulty in focusing on near vision were the most experienced symptoms. Prevalence of CVS was significantly higher among females (52.3%), those having a higher mean work duration (21.65 ± 7.55 years), those who frequently use a smartphone (84.9%) and those spending most of their screen time during both day and night (87.1%). Visual ergonomics and preventive measures application, such as correct screen level, regular cleaning of the screen, appropriate illumination and use of eye drops, were significantly associated with negative CVS. Conclusions. These results raised attention to the essential need for visual assessment of university staff members for early and proper diagnosis of CVS to minimize its impact on working performance. Accordingly, it is recommended to organize university-based awareness programs regarding CVS for working personnel.

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 <20 cm (p = 0.023), presence of glare or reflection on screen (p < 0.001), low screen brightness (p = 0.045), sleep duration (p = 0.030), inadequate break time between classes (p < 0.001) and increased screen time usage during online study (p < 0.001). Recommendations to prevent CVS based on the adjustable factors might reduce the burden of online study.

Competing Interests: None

Purpose: This study was undertaken to identify the prevalence of symptoms related to the use of display devices and contributing factors in children engaged in distance learning during the COVID-19 pandemic., Methods: An online electronic survey form was prepared using Google Forms (Alphabet Co., Mountain View, CA) and sent to parents of children under the age of 18 years engaged in distance learning during the COVID-19 pandemic. The types of display devices children use, how often such devices are used, the symptoms of digital eye strain, and the severity and frequency of the symptoms were recorded, and the associations between the factors were analyzed., Results: A total of 692 participants were included. The mean age of the children was 9.72±3.02 years. The most common display devices used were personal computers (n=435, 61.7%) for online classes and smartphones (n=400, 57.8%) for nonacademic purposes. The mean duration of display device use was 71.1±36.02 min without a break and 7.02±4.55 h per day. The most common reported symptom was headache (n=361, 52.2%). Of the participants, 48.2% (n=332) reported experiencing 3 or more symptoms. The multivariate analysis detected that being male (P=0.005) and older age (P=0.001) were independent risk factors for experiencing 3 or more symptoms., Conclusion: The increasing use of digital devices by children is exacerbating the problem of digital eye strain in children as a side effect of online learning. Public awareness should be improved., Competing Interests: None

The digital revolution, which has been underway since the 1980's, is disrupting our daily routines with an exponential increase in the use of screens, which has not been without consequence to our visual system. Digital eye strain (DES), or computer vision syndrome (CVS), includes all the visual symptoms secondary to the use of digital devices. DES is present in at least 50% of regular users of digital media and is defined by blurred vision, difficulty focusing, ocular irritation or burning, dry eye, visual fatigue, headaches and increased sensitivity to light. Exposure time, age, female gender, and work environment are the main factors increasing its prevalence. Its pathophysiology, still poorly understood, is felt to be multifactorial and includes disturbances in the accommodative-convergence balance and changes in the ocular surface. Regarding accommodation and convergence, the studies are mostly old and their results heterogeneous. Conversely, many studies have shown an increase in the prevalence of dry eye in screen users. Although the retinal toxicity of blue light has been proven in in vitro models, the low level of evidence in the available studies does not allow it to be clearly correlated with the symptoms of DES. The objective of this review is to condense the knowledge available in the literature on the symptoms, prevalence, pathophysiology and management of DES., (Copyright © 2021. Published by Elsevier Masson SAS.)

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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Li, Zhang, Chen, Li, Chu, Jiang, Liu, Zhang, Shi, Wang, Zhu, Chen, Xun and Zhou.)

Objective: The aim of this study is to examine the interactive effects of display curvature radius and display size on visual search accuracy, visual search speed, and visual fatigue., Background: Although the advantages of curved displays have been reported, little is known about the interactive effects of display curvature radius and size., Method: Twenty-seven individuals performed visual search tasks at a viewing distance of 50 cm using eight configurations involving four display curvature radii (400R, 600R, 1200R, and flat) and two display sizes (33″ and 50″). To simulate curved screens, five flat display panels were horizontally arranged with their centers concentrically repositioned following each display curvature radius., Results: For accuracy, speed, and fatigue, 33″-600R and 50″-600R provided the best or comparable-to-best results, whereas 50″-flat provided the worst results. For accuracy and fatigue, 33″-flat was the second worst. The changes in the horizontal field of view and viewing angle due to display curvature as well as the association between effective display curvature radii and empirical horopter (loci of perceived equidistance) can explain these results., Conclusion: The interactive effects of display curvature radius and size were evident for visual search performance and fatigue. Beneficial effects of curved displays were maintained across 33″ and 50″, whereas increasing flat display size from 33″ to 50″ was detrimental., Application: For visual search tasks at a viewing distance of 50 cm, 33″-600R and 50″ 600R displays are recommended, as opposed to 33″ and 50″ flat displays. Wide flat displays must be carefully considered for visual display terminal tasks.

Purpose : There has been an enormous increase in the use of gadgets for online classes and entertainment during the COVID-19 pandemic. This study aimed to estimate the prevalence of digital eye strain (DES), describe the pattern of gadget usage, and analyse the risk factors for DES. Methods : This online survey analysed 941 responses from students of online classes (688), teachers of online classes (45), and general population (208). A pre-validated questionnaire was used to calculate the DES score. Non-parametric tests of medians were used to compare the median DES score, Chi-square test to compare categorical variables, and binary logistic regression to find the predictors of DES. Results : The prevalence of eye strain was higher among students taking online classes compared to the general public (50.6% vs 33.2%; χ 2  = 22.5, df = 1, p < .0001). There was an increase in screen time during the pandemic compared to pre-pandemic time. The DES score was highest among students attending online classes ( p < .0001), in those with eye diseases ( p = .001), greater screen time ( p = <0.0001), screen distance <20 cm ( p = .002), those who used gadgets in dark ( p = .017) and those who took infrequent/no breaks ( p = .018). The DES scores were proportional to the increase in the number of hours of gadget usage during the pandemic. Conclusion : There is a need to educate people about limiting overall screen exposure and ergonomic methods of screen viewing. Efforts from policymakers to reduce the duration of online classes for students and online work hours for professionals are warranted to control this epidemic of eye strain.

Clinical Relevance: Home-isolation and social distancing during the COVID-19 pandemic caused increased use of digital devices, posing a greater risk of developing digital eye strain-related symptoms. Eye-care professionals should educate patients about limiting screen time and managing digital eye strain symptoms., Background: This study aimed to evaluate the COVID-19 isolation's impact on digital device use by comparing hours spent on digital devices before and during the 24-hour curfew in Saudi Arabia, while assessing the symptoms associated with digital eye strain., Methods: A self-reported questionnaire was used to compare the total hours per day, either continuous or intermittent, spent on digital devices during and before curfew, and the association of these durations with digital eye strain., Results: A total of 1,939 participants, (mean ± SD: 33 ± 12.2 years and 72% women) were recruited. Results showed a significant difference between usage duration before and during curfew. Digital eye strain incidence was 78% during the curfew. Chi-squared analysis indicated most symptoms are associated with usage duration and employment status. Multivariate analysis revealed significant associations between digital eye strain and the following factors: using more than one device (odds ratio 1.208, 95% confidence interval: 1.068-1.3661), age, optical correction, employment status, gender, using rewetting drops, and usage duration., Conclusions: In this population, prolonged use of digital devices significantly increased during home-isolation. Digital eye strain incidence increased during curfew. Regular eye exams should be encouraged to ensure the use of optimum prescription use and meet the specific visual demands required for the use of digital devices. Eye-health strategies and awareness campaigns should be employed on the importance of regular eye exams, decreasing screen time, practising the 20-20-20 rule, and the use of rewetting drops to help reduce the symptoms of digital eye strain during this period.

Digital eye strain (DES) is a growing occupational and public health problem and one of the most frequent reasons for seeking medical care. The objectives of this study are to identify the prevalence and to study some associated personal, ergonomic, and environmental factors of DES among information technology (IT) professionals at Tanta University, Egypt. An interview questionnaire was used to collect data related to socio-demographic, job, ergonomic and environmental characteristics. Computer vision syndrome questionnaire (CVS-Q) was used for the assessment of DES. It was used to measure ocular and visual symptoms related to computer use. CVS-Q includes 16 symptoms that are scored using two rating scales, one for frequency and the other for intensity. A total of 108 IT professionals were included. Prevalence of DES was 82.41%. The most common symptoms were headache (81.5%), burning of the eye (75.9%), and blurred vision (70.4%). Significant predictors of DES were female gender (OR = 2.845), age ≥ 35 years (OR = 1.112), daily computer use more than 6 h (OR = 1.351), duration of work more than 10 years (OR = 1.793), wearing corrective glasses (OR = 5.009), distance from the monitor less than 20 in. (OR = 4.389), not using antiglare screen (OR = 0.214), no brightness adjustment of screen (OR = 0.015), not taking break time during computer work (OR = 0.007), exposure to air pollution (OR = 5.667), use of the air conditioner (OR = 23.021), and exposure to windy environments (OR = 3.588). Prevalence of DES was found to be high among IT professionals. Significant predictors of DES were female gender, older age, wearing eyeglasses, long duration of computer use, unadjusted ergonomic workstation, and dry environment. DES is a problem that can be prevented by increasing knowledge and awareness about DES by providing computer users with eye health education, periodic training on a proper ergonomic computer workstation, and adjustment of the suitable comfortable workplace environment.

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

Background: To date there have been few systematic attempts to establish the general prevalence of asthenopia in unselected populations of school-aged children. Thus, the aim of this study was to determine whether the incorporation of Borsting et al's 2003 Revised Convergence-Insufficiency Symptom Survey (CISS) into a general school vision screening could aid in the identification of children with visual discomfort and indicate the need for further investigation., Methods: Vision screening of an unselected middle school population investigated and analysed the incidence of self-reported nearwork-related visual discomfort via the CISS along with distance and near visual acuities plus non-cycloplegic autorefraction using a Shin-Nippon NVision-K 5001., Results: Of the 384 unselected students approached in Grades 6-9, 353 participated (92.2%, mean 13.2 ± 1.4 years). The mean CISS score for the population without amblyopia and/or strabismus (96.0% of all students) was 16.8 ± 0.6, i.e., 45% of students in this cohort had CISS scores greater than one standard deviation above the mean found by Borsting et al. in 2003 during their validation study of the CISS on 9 to 18 year old children without binocular anomalies. Regression analyses indicated significantly higher (p < 0.001) mean CISS scores for the 3.2% who were hyperopes ≥ + 2.00D by non-cycloplegic autorefraction (27.7 ± 14.7) and for those who were amblyopic (24.3 ± 6.6) or strabismic (34.0 ± 9.8). The mean CISS score of 31.6 ± 9.0 for non-amblyopic/strabismic students having near vision poorer than 0.1 LogMAR was significantly higher (p < 0.001) than for those with good acuity., Conclusion: The most important finding of this study was the high incidence of asthenopia in an unselected population and that refractive status per se was not a major contributor to CISS scores. The results highlight the usefulness of the CISS questionnaire for assessment of visual discomfort in school vision screenings and the need for future exploration of near binocular vision status as a potential driver of asthenopia in school students, especially given current trends for frequent daily use of computers and handheld devices and necessarily prolonged accommodative-convergence effort at near, both at school and at home.

Purpose: To determine the prevalence of symptoms of computer vision syndrome and to identify its associated factors. The secondary objective was to assess knowledge and practices related to preventing computer vision syndrome symptoms., Methods: The data for this cross-sectional study were collected through a self-administered questionnaire distributed to 713 female undergraduates studying business and medicine in Saudi Arabia. The questionnaire included computer vision syndrome validated symptoms and factors associated with computer vision syndrome development., Results: The most common symptom due to prolonged computer use was neck or shoulder pain, reported by 82.2% of the subjects. Overall, 66.5% of the subjects suffered from headache and 51.5% from dry eyes, in mild, moderate, or severe form. Business students were 1.6 times as likely as medical students to suffer from computer vision syndrome (odds ratio = 1.65; 95% confidence interval: 1.22, 2.24). The use of electronic devices for more than 5 h (odds ratio = 1.52; 95% confidence interval: 1.07, 2.16) was also associated with experiencing computer vision syndrome symptoms. Regarding computer vision syndrome prevention, factors such as hours of use, screen distance, screen brightness, and room illumination showed statistically significant difference between the two groups (p < 0.0001)., Conclusion: The prevalence of computer vision syndrome symptoms was significantly higher among business students, who reported lower awareness and poor practice measures of computer use recommendations. Relevant awareness campaigns focusing on the appropriate use of computers are highly recommended.

Computers have become to play an important role in people's lives throughout the world thus increasing the number of patients with ocular complaints. Also known as computer vision syndrome, accommodative asthenopia might be considered as a neglected occupational condition, but there is no consensus regarding diagnostic criteria, which leads to under-recognition and under-reporting. The aim of the study was to investigate the prevalence, early symptoms and specific preventive measures of accommodative asthenopia among computer-using medical students ( n  = 420), in a cross-sectional study. The most common early symptoms were: tired eyes/eye strain (86.1%), burning eyes (46.8%), migraines/headaches (46.8%), red-swollen eyes (43%), photophobia (41.8%), temporary blurred vision (35.4%), and eyelid spasms (32.9%). Our study identifies the most frequent early symptoms of accommodative asthenopia as a possible occupational disease, which might serve as a fundament for a future consensus strategy.

Background: Sixty-four to 90% of computer users experience symptoms of computer vision syndrome (CVS). People with CVS symptoms experience neck pain (NP), and people with NP can have visual symptoms., Objectives: (1) To examine differences in CVS symptoms in computer users with and without persistent NP. (2) To determine relationships between visual ergonomics, demographics, and CVS in those with and without persistent NP DESIGN: Comparative cross-sectional observational study METHOD: An online survey consisting of multiple questionnaires including the Computer Vision Syndrome Questionnaire (CVS-Q), Visual Symptoms Survey (VSS), and Convergence Insufficiency Symptoms Survey (CISS) was completed by 167 participants., Results: The persistent NP group had significantly higher CVS-Q, VSS, and CISS scores (p <0.01) compared to controls. No relationships were found between visual ergonomics, demographics, and visual symptoms in both groups., Conclusions: People with persitent NP are more likely to present with CVS than controls. Clinicians should consider assessing visual symptoms in people presenting with persisting NP., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

To examine the effects of prolonged visual display terminal (VDT) working hours and exercise frequency on VDT-related symptoms, we recruited 944 Chinese internet staff for the study. A self-administered questionnaire survey was used to obtain the hours of daily VDT work, exercise frequency, and the physical and mental health of the participants. The daily VDT working time of participants was 8.7 hours. Musculoskeletal pain and eye complaints were prevalent, and the participants had poor mental health status. When daily VDT operation time was more than 11 hours, VDT-related symptoms, including backache (odds ratios (OR) = 3.59), wrist pain (OR = 1.88), hip pain (OR = 2.42), dry eyes (OR = 2.22), and ocular soreness (OR = 2.16) were more likely to occur, and an increased risk of serious occupational stress (OR = 6.75) and job burnout (OR = 2.66) was found in internet workers. Compared with those who never exercised, appropriate exercise frequency (three times per week) was helpful to relieve pain in the shoulders (OR = 0.28), neck (OR = 0.45), back (OR = 0.30), lower back (OR = 0.25), and wrists (OR = 0.38), as well as to prevent vision loss (OR = 0.33) and job burnout (OR = 0.42). Therefore, avoiding excessive VDT exposure and performing moderate exercise could protect the physical and mental health of internet staff from the adverse effects of VDT.

Purpose: The purpose of this study was to investigate the use of handheld digital devices and the prevalence of self-reported asthenopia among college students in China and their potential relationship., Methods: Five thousand students were randomly assessed using a self-reported asthenopia questionnaire. The students' demographic characteristics and habits regarding digital device use were recorded. Univariate analysis was performed to select potential risk factors, and multivariate logistic regression was used to estimate the odds ratios for the selected risk factors of interest., Results: Among the 4786 students who completed the survey, the prevalence of asthenopia was 53.3%. Multivariate analysis revealed significant relationships between asthenopia and each of the following: level of digital reliance (OR 1.350, 95%CI: 1.230-1.481), workload, time spent on computer per day, sex and time spent on handheld digital devices in bed and at desk. Aerobic exercise duration (OR 0.912, 95%CI: 0.839-0.990) was found to be strong predictor of less asthenopia complaints., Conclusion: Asthenopia appears to be common among college students in China. Preventative measures against asthenopia include limiting the amount of time spent using digital devices in bed (<0.5 h), adopting a posture of lying on one's back while doing so and engaging in aerobic exercise for more than one hour per day. Furthermore, studies on this topic are needed., (© 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Introduction: Given the increasing use of electronic devices, and the increasing number of complaints with its use, we intend to evaluate the prevalence of manifestations of dry eye and ocular fatigue in a population of individuals, who use the computer daily to perform all their professional tasks, as well as to correlate these complaints with the number of hours of digital use as well as their possible improvement with behavioural measures and use of tear drops., Material and Methods: A total of 77 individuals (154 eyes) were evaluated on two separate days with a 1-month interval. They completed two questionnaires: OSDI and PEG Eye Fatigue. An objective ocular surface assessment was performed: Schirmer test without anesthetic, DR-1a Dry Eye Monitor™, hyperemia evaluation, lacrimal break up, presence of keratitis and lesions in the conjunctiva, as well as near accommodation point and near convergence point. After the first evaluation, the subjects were divided into two groups: group A (< 2 hours of computer working) and group B (> 2 hours of computer working). Some environmental measures to reduce complaints and recommendation of use of artificial tears were explained to the latter., Results: There was a statistically significant difference in the majority of the parameters evaluated in the group B, in relation to the morning period (group A) - tear film (p = 0.032), hyperemia (p < 0.001), BUT (p < 0.001), keratitis (p < 0.001), conjunctival lesion (p = 0.002) and accommodation point (p < 0.001). In the evaluation - one month later - there were no statistically significant differences in any of the parameters analysed in the group A, and in group B there was a decrease in most parameters at the end of that period - Schirmer test (p = 0.005), lacrimal film (p = 0.022), keratitis (p < 0.001), conjunctival lesion (p = 0.005) and fatigue score (p < 0.001)., Discussion: It was thus possible to show the appearance of ocular fatigue and ocular surface changes with prolonged use of computers (> 2 hours) as well as a significant improvement in symptomatology (subjective assessment) as well as of ocular surface changes (objective evaluation) with the implementation of postural measures, regular breaks and use of lubricants. This is the first study, to the best of our knowledge, of digital asthenopia in which, in addition to the subjective evaluation, the presence of ocular surface modifications (objective assessment) were evaluated and the respective improvement with the aforementioned ergophthalmological measures were evaluated., Conclusion: This survey highlights the increased overall level of awareness that we need to have to face the rapid and wide-scale changes driven by the emergence of digital technology and, more particularly, its impact on user's vision and posture. We concluded that the longer we use the electronic devices (more than two hours) the more severe the complaints and rates of ocular surface changes are. Environmental and ocular strategies can attenuate or even eliminate the discomfort caused by this syndrome, and increase professional performance and quality of life.

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.

Eye fatigue is a common health problem across all age groups. Herein, we explored the correlation between eye fatigue and thickness of the retinal nerve fiber layer (NFL). Included in the NFL are intrinsically photosensitive retinal ganglion cells (ipRGCs), which are associated with trigeminal pain. This retrospective cross-sectional study included outpatients with best-corrected visual acuity above 20/30 in both eyes and without dry eye, glaucoma, or retinal disease. A total of 1981 patients were initially enrolled and 377 patients were declared as eligible for the study analysis. We tested subjects for the presence of major ocular symptoms and measured thickness of ganglion cell complex (GCC) using optical coherence tomography. A total of 377 outpatients (46.4% men, mean age of 57.1 years) were enrolled for analysis, based on the interview-reported prevalence of six eye symptom, as follows: 31.5% for eye fatigue, 19.2% for blurring, 18.6% for dryness, 15.7% for photophobia, 13.5% for irritation, and 4.6% for pain. The macular GCC was significantly thicker in subjects with eye fatigue compared to the group not reporting eye fatigue (103.8  μ m versus 100.3  μ m, P = 0.014). Regression analysis identified eye fatigue ( P = 0.026, β =0.122, adjusted for age and sex) and dryness ( P =0.024, β =0.130) as significantly correlated with the macular GCC thickness, while the full macular thickness showed no significant correlation. In conclusions, eye fatigue and dryness were positively associated with thickness of the macular GCC. Nonvisual symptoms might therefore play a role in the development of eye fatigue.

Background: Globally, computer is one of the common office tools used in various institutions. Using computer for prolonged time led to the users at greater health risk of computer vision syndrome (CVS). Computer vision syndrome is the leading occupational health problem of the twenty-first century. About 70 percent of computer users are suffered from CVS. Besides the health problems, CVS causes inefficiency at workplace and deteriorate quality of work. The problem of CVS and its risk factors are not well known in Ethiopia., Method: A cross-sectional study was conducted to assess the prevalence of CVS and associated factors among computer user government employees in Debre Tabor town from February to March, 2016. Multistage random sampling method was applied to select 607 study participants, and the data were collected by using a structured questionnaire. Computer vision syndrome was measured by self-reported method. Bivariate and multivariable binary logistic regression analyses were performed using SPSS version 20. Significance level was obtained at 95% CI and p value < 0.05., Results: The prevalence of CVS was 422 (69.5%) with 95% CI of 65.60, 73.0%. Blurred vision, eyestrain, and eye irritation were the commonest reported symptoms of CVS with proportion of 62.60%, 47.63%, and 47.40%, respectively. Occupation: officer (adjusted odds ratio (AOR) = 4.74) and secretary (AOR = 9.17), daily computer usage (AOR: 2.29), and preexisting eye disease (AOR = 3.19) were risk factors for CVS. However, computer users with high payment, who took regular health break, and with good knowledge on computer safety measures were less impacted by CVS., Conclusion: The prevalence of computer vision syndrome was found to be higher in Debre Tabor town. Monthly income, occupation, daily computer usage, regular health break, knowledge, and preexisting eye disease were predictor variables for CVS. Optimizing exposure time, improving awareness on safety measures, and management support are important to tackle CVS.

Aim: To determine the prevalence of computer vision syndrome (CVS) and ergonomic practices among students in the Faculty of Medical Sciences at The University of the West Indies (UWI), Jamaica., Method: A cross-sectional study was done with a self-administered questionnaire., Results: Four hundred and nine students participated; 78% were females. The mean age was 21.6 years. Neck pain (75.1%), eye strain (67%), shoulder pain (65.5%) and eye burn (61.9%) were the most common CVS symptoms. Dry eyes (26.2%), double vision (28.9%) and blurred vision (51.6%) were the least commonly experienced symptoms. Eye burning (P = .001), eye strain (P = .041) and neck pain (P = .023) were significantly related to level of viewing. Moderate eye burning (55.1%) and double vision (56%) occurred in those who used handheld devices (P = .001 and .007, respectively). Moderate blurred vision was reported in 52% who looked down at the device compared with 14.8% who held it at an angle. Severe eye strain occurred in 63% of those who looked down at a device compared with 21% who kept the device at eye level. Shoulder pain was not related to pattern of use., Conclusion: Ocular symptoms and neck pain were less likely if the device was held just below eye level. There is a high prevalence of Symptoms of CVS amongst university students which could be reduced, in particular neck pain and eye strain and burning, with improved ergonomic practices., (© 2017 John Wiley & Sons Ltd.)

Advanced manufacturing has resulted in significant changes on the shop-floor, influencing work demands and the working environment. The corresponding safety-related effects, including fatigue, have not been captured on an industry-wide scale. This paper presents results of a survey of U.S. manufacturing workers for the: prevalence of fatigue, its root causes and significant factors, and adopted individual fatigue coping methods. The responses from 451 manufacturing employees were analyzed using descriptive data analysis, bivariate analysis and Market Basket Analysis. 57.9% of respondents indicated that they were somewhat fatigued during the past week. They reported the ankles/feet, lower back and eyes were frequently affected body parts and a lack of sleep, work stress and shift schedule were top selected root causes for fatigue. In order to respond to fatigue when it is present, respondents reported coping by drinking caffeinated drinks, stretching/doing exercises and talking with coworkers. Frequent combinations of fatigue causes and individual coping methods were identified. These results may inform the design of fatigue monitoring and mitigation strategies and future research related to fatigue development., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Introduction: The individual and combined effect of occupational noise and vibration exposures, on workers' health has not been thoroughly investigated. In order to find better ways to prevent and manage workers' headache, this study aimed to investigate the effects of occupational noise and vibration exposure on headache/eyestrain., Methods: We used data from the fourth Korean Working Condition Survey (2014). After applying inclusion and exclusion criteria, 25,751 workers were included. Occupational noise and vibration exposure and the prevalence of headache/eyestrain were investigated by self-reported survey. Chi-square tests were used to compare differences in baseline characteristics between the group with headache/eyestrain and the group without. Odds ratios and 95% confidence intervals were estimated using a logistic regression model adjusted for several covariates. Area under the receiver operating characteristics curve (AUROC) analysis was used to evaluate the effect of occupational noise and/or vibration exposure., Results: Among the 25,751 study subjects, 4,903 had experienced headache/eyestrain in the preceding year. There were significant differences in age, education level, household income, occupational classification, shift work, occupational vibration exposure, and occupational noise exposure between the two groups (all p<0.05). The odds ratios between each exposure and headache/eyestrain increased proportionally with the level of exposure, increasing from 1.08 to 1.26 with increasing vibration exposure, and from 1.25 to 1.41 with increasing noise exposure. According to the AUROC analysis, the predictive power of each exposure was significant, and increased when the two exposures were considered in combination., Discussion: The findings of this study show that both occupational noise and vibration exposures are associated with headache/eyestrain; noise exposure more strongly so. However, when the two exposures are considered in combination, the explanatory power for headache/eyestrain is increased. Therefore, efforts aimed at reducing and managing occupational noise and vibration exposure are crucial to maintaining workers' health.

Background: With the increasing prevalence of electronic readers (e-readers) for vocational and professional uses, it is important to discover if there are visual consequences in the use of these products. There are no studies in the literature quantifying the incidence or severity of eyestrain, nor are there clinical characteristics that may predispose to these symptoms with e-reader use., Purpose: The primary objective of this pilot study was to assess the degree of eyestrain associated with e-reader use compared to traditional paper format. The secondary outcomes of this study were to assess the rate of eyestrain associated with e-reader use and identify any clinical characteristics that may be associated with the development of eyestrain., Methods: Forty-four students were randomly assigned to study (e-reader iPAD) and control (print) groups. Participant posture, luminosity of the room, and reading distance from reading device were measured during a 1-h session for both groups. At the end of the session, questionnaires were administered to determine symptoms., Results: Significantly higher rates of eyestrain (p = 0.008) and irritation (p = 0.011) were found among the iPAD study group as compared to the print 'control' group. The study group was also 4.9 times more likely to report severe eyestrain (95 % CI [1.4, 16.9]). No clinical characteristics predisposing to eyestrain could be identified., Conclusions: These findings conclude that reading on e-readers may induce increased levels of irritation and eyestrain. Predisposing factors, etiology, and potential remedial interventions remain to be determined.

Objectives: The impact of wearing lenses on visual and musculoskeletal complaints in VDU workers is currently unknown. The goal of this study was 1) to evaluate the impact of wearing VDU lenses on visual fatigue and self-reported neck pain and disability, compared to progressive lenses, and 2) to measure the effect of both lenses on head inclination and pressure pain thresholds during the performance of a VDU task., Methods: Thirty-five eligible subjects were randomly assigned to wear progressive VDU lenses (VDU group) (n = 18) or progressive lenses (P group) (n = 17). They were enquired about visual complaints (VFQ), self-perceived pain (NRS) and disability (NDI) at baseline (with old lenses), and 1 week, 3 months and 6 months after wearing their new lenses. In addition, Forward Head Angle (FHA) and PPTs were assessed during and after a VDU task before and 6 months after wearing the new lenses. A short questionnaire concerning the satisfaction about the study lenses was completed at the end of the study., Results: In both groups, visual fatigue and neck pain was decreased at 3 and 6 months follow up, compared to baseline. All PPTs were higher during the second VDU task, independent of the type of lenses. The VDU group reported a significantly higher suitability of the lenses for VDU work., Conclusion: It can be concluded that there is little difference in effect of the different lenses on visual and musculoskeletal comfort. Lenses should be adjusted to the task-specific needs and habits of the participant.

Objective: The aim of this study was to determine the relationship between vibration and noise exposure in the workplace and certain nervous system related symptoms (NSRS) among Korean workers., Methods: Using data from the fourth Korean Working Conditions Survey, we investigated the influence of vibration and noise with three categories; none, mild, and severe, on sleep disturbance, overall fatigue, and headache/eye strain using logistic regression analysis with stratification by personal protective equipment (PPE) wearing status., Results: Severe noise/vibration exposure was associated in a dose-response fashion with NSRS; the odds ratios (ORs) for sleep disturbance, headache/eyestrain, and overall fatigue were 1.48/1.06, 1.46/1.26, and 1.56/1.28 for severe and mild noise/vibration exposure, respectively, compared with no exposure. Workers who did not wear PPEs were the most affected., Conclusions: Occupational exposures to vibration and noise are associated with NSRS. Additional longitudinal studies and tightened education and safety measures are warranted.

Background: Computer vision syndrome (CVS) is a group of visual symptoms experienced in relation to the use of computers. Nearly 60 million people suffer from CVS globally, resulting in reduced productivity at work and reduced quality of life of the computer worker. The present study aims to describe the prevalence of CVS and its associated factors among a nationally-representative sample of Sri Lankan computer workers., Methods: Two thousand five hundred computer office workers were invited for the study from all nine provinces of Sri Lanka between May and December 2009. A self-administered questionnaire was used to collect socio-demographic data, symptoms of CVS and its associated factors. A binary logistic regression analysis was performed in all patients with 'presence of CVS' as the dichotomous dependent variable and age, gender, duration of occupation, daily computer usage, pre-existing eye disease, not using a visual display terminal (VDT) filter, adjusting brightness of screen, use of contact lenses, angle of gaze and ergonomic practices knowledge as the continuous/dichotomous independent variables. A similar binary logistic regression analysis was performed in all patients with 'severity of CVS' as the dichotomous dependent variable and other continuous/dichotomous independent variables., Results: Sample size was 2210 (response rate-88.4%). Mean age was 30.8 ± 8.1 years and 50.8% of the sample were males. The 1-year prevalence of CVS in the study population was 67.4%. Female gender (OR: 1.28), duration of occupation (OR: 1.07), daily computer usage (1.10), pre-existing eye disease (OR: 4.49), not using a VDT filter (OR: 1.02), use of contact lenses (OR: 3.21) and ergonomics practices knowledge (OR: 1.24) all were associated with significantly presence of CVS. The duration of occupation (OR: 1.04) and presence of pre-existing eye disease (OR: 1.54) were significantly associated with the presence of 'severe CVS'., Conclusions: Sri Lankan computer workers had a high prevalence of CVS. Female gender, longer duration of occupation, higher daily computer usage, pre-existing eye disease, not using a VDT filter, use of contact lenses and higher ergonomics practices knowledge all were associated with significantly with the presence of CVS. The factors associated with the severity of CVS were the duration of occupation and presence of pre-existing eye disease.