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• Ergonomic considerations can be unintentionally neglected and underutilized in the modern diagnostic radiology practice. • Repetitive stress injuries affecting multiple musculoskeletal systems can negatively impact the practice of diagnostic radiology, and can contribute to reduced productivity and reduced career longevity. • Suboptimal workplace reading station ergonomics can also negatively impact the oculo-neural axis and can contribute to digital eye strain and migraines, among other entities. • By taking into consideration a combination of multiple ergonomic tools and implementing certain behavioral modifications, diagnostic radiologists can mitigate the risks of musculoskeletal injuries, digital eye strain, and other afflictions attributed to prolonged PACS reading station use. The average post-pandemic modern radiology practice is experiencing an ever-increasing workload volume with overall relatively similar staffing levels, regardless of practice setting. This has resulted in an increased workload demand for the average diagnostic radiologist, which in many cases translates to longer working hours. It is now more important than ever to be cognizant of various work-related injuries, including repetitive-stress injuries and vision-related ailments as examples, in relation to the working conditions of the radiologist. This article will discuss commonly occurring conditions and ergonomic considerations that the radiologist can employ to reduce the risk of work-related injuries. [ABSTRACT FROM AUTHOR]

Andrew D Pucker,1 Aaron M Kerr,2 Jennifer Sanderson,2 Chris Lievens2 1Clinical and Medical Sciences, Lexitas Pharma Services, Durham, NC, USA; 2Southern College of Optometry, Memphis, TN, USACorrespondence: Andrew D Pucker, Clinical and Medical Sciences, Lexitas Pharma Services, 5425 Page Road, Suite 410, Durham, NC, 27703, USA, Tel +1 (920)579-2900, Email andrewpucker@hotmail.comPurpose: Digital eye strain (DES) is a growing worldwide concern because digital devices are prevalent in both our work and home lives. The purpose of this review was to summarize clinically relevant and evolving key topics related to DES.Methods: A PubMed.gov search was conducted on or before June 8, 2024. No date restrictions were used during the primary search. The search was aimed at detecting all articles related to DES; thus, the search terms only included “digital eye strain” or “computer vision syndrome”.Results: The two most used, validated DES questionnaires are the Computer Vision Syndrome Questionnaire (CVS-Q) and Computer Vision Symptom Scale (CVSS17). The world-wide prevalence of DES ranges from 8.2% to 100% depending upon the subjects evaluated and the method used to evaluate them. The most common DES symptoms include headache, eye strain, eye redness, eye itching, tearing, photophobia, burning sensation, blurred vision, eye pain, neck and shoulder pain, and eye dryness. Ocular surface symptoms in DES are integrally tied to decreased blink frequency, which causes ocular surface desiccation, increased osmolarity, and dry eye-like symptoms. The most studied DES-specific treatments are improving subjects’ environment, artificial tears, blinking exercises, and near work breaks.Conclusion: DES is a highly prevalent condition that should be regularly screened for in clinic with a validated diagnosis instrument. While there are several treatment options, the community’s treatment approach is evolving and primarily focused on treating the visual and dry eye-like symptoms associated with the condition.Keywords: digital eye strain, computer vision syndrome, prevalence, digital device, symptoms

Saif Khuzaim Al-Dossary Ophthalmology Consultant, King Faisal University, Al-Ahsa, Saudi ArabiaCorrespondence: Saif Khuzaim Al-Dossary, Email Saldossari@kfu.edu.saObjective: This cross-sectional study aimed to investigate the associations between environmental and occupational factors and the prevalence of dry eye symptoms among participants from the Ahsa region of Saudi Arabia.Methods: Participants from urban, rural, and suburban areas seeking medical care at primary health centers were recruited through systematic random sampling. Data on demographics, exposures, and ocular health were captured using a structured questionnaire. Dry eye symptoms were evaluated using the Ocular Surface Disease Index (OSDI), Impact of Dry Eye on Everyday Life (IDEEL), and Symptom Assessment in Dry Eye (SANDE) questionnaires. Logistic regression analysis examined the relationships between environmental/occupational factors and the prevalence of dry eye symptoms.Results: Key exposures included particulate matter (PM) (60%), low humidity (55%), wind/dust (50%), prolonged computer use (65%), and chemical irritants (45%). These factors were significantly associated with an increased prevalence of dry eye symptoms, with the following odds ratios (ORs): PM (1.85, 95% CI: 1.35– 2.52), low humidity (1.45, 95% CI: 1.05– 2.00), wind and dust (1.60, 95% CI: 1.20– 2.14), prolonged computer use (2.10, 95% CI: 1.55– 2.85), and chemical irritants (1.75, 95% CI: 1.30– 2.35). All associations were statistically significant (p < 0.05). The use of protective equipment was associated with reduced odds of dry eye symptoms (OR 0.60, 95% CI: 0.42– 0.85, p = 0.03).Conclusion: This study identifies significant associations between specific environmental and occupational exposures and the prevalence of dry eye symptoms. Reducing modifiable exposures through policy, workplace enhancements, and clinical preventative strategies is essential to mitigate the burden of dry eye symptoms related to modern lifestyles and technology.Keywords: ocular surface disease, air pollution, low humidity, digital eye strain, occupational hazard

Aim: Digital device usage, especially during the pandemic, has catapulted into a new age problem, the computer vision syndrome. This study aimed to quantify the prevalence and determinants of digital eye strain (DES). Subject and Methods: A total of 345 university students in India were surveyed in June–July 2022, by a validated tool, the Computer Vision Syndrome Questionnaire (CVS-Q) © in this cross-sectional study. According to American Optometric Association, digital eye strain and computer vision syndrome are synonyms. Non-parametric tests of medians were used to compare the median DES scores, Chi square test to compare categorical variables, and binary logistic regression to find the determinants of DES. Results: The average age of the study participants was 21.0 ± 2.2 years, ranging between 18–26 years with 52.8% females and 47.2% males. The prevalence of DES was 45.5% (CI 95% = 40.2%–50.8%). Any existing eye disease (p-value = 0.000, OR = 0.41, 95% CI = 0.26–0.65), average daily screen time (p-value = 0.001, OR = 1.61, 95% CI = 1.22–2.13) and using gadgets in the dark (p-value = 0.000, OR = 0.37, 95% CI = 0.23–0.61) were significant determinants of the same. Conclusion: Framing guidelines limiting the hours allotted for online classes for university students are imperative, with promotion of ergonomic practices for digital device usage such as blue light filters and night mode on devices. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluates the recent trends in ocular morbidities and vision-related practices in "out-of-school" children in urban slums of Gurugram in North India. Methods: In this observational study, a validated questionnaire was administered to 161 students from two nonformal slum schools. Sociocultural, demographic data, vision-related practices, and visual acuity with subjective refraction of the children were recorded. Results: A total of 80 boys and 81 girls (9.17 ± 2.58 years) participated in this study. About 40% of the children were from lower socioeconomic status. The visual acuity recorded for all the children, except three children, was 6/6 in both eyes. One child had a pre-phthisical eye with no light perception, following a childhood trauma, with the other eye having 6/6 vision. Two children had refractive errors (myopia and compound myopic astigmatism), with a best corrected visual acuity (BCVA) of 6/6. Thirteen children (8%) had Bitot's spots and 67 (35.4%) had allergic conjunctivitis. Eight (5%) children complained of dry eye- related symptoms like redness and watering of eyes, while 19 (11.8%) had diffuse headache. Average number of years spent in school for these children was less than 1.7 years (range: 1 month-6 years). Only 10.5% of the children gave the history of watching television more than 30 h/week. Significant association was found between the income of father and use of digital devices in children below 10 years (P = 0.003) and children playing outdoors (P = 0.001). There was a significant association noted for age and use of digital devices (P = 0.037). Conclusion: The prevalence of refractive errors in "out-of-school" children of urban slum was much less than the national average. Almost one in three children suffered from eye allergies, while 8% children had Bitot's spots. The data about the prevalence of ocular comorbidities in underserved areas like urban slums can be used to update and strategize eye health-care delivery models for out-of-school children. [ABSTRACT FROM AUTHOR]

Purpose: It is often stated that digital eye strain can impact productivity and/or work accuracy, but the relationship between symptoms, productivity, and work accuracy has been unclear. Hence this study tracked the development of visuo-ocular symptoms during prolonged digital tasks and to explore the impact of higher and lower cognitive load levels on visuo-ocular symptoms, productivity, and work accuracy. Methods: Thirty-five participants (23.2 ± 4.0 years) who had digital eye strain (diagnosed with the Computer Vision Syndrome Questionnaire) undertook an uninterrupted laptop adapted Eriksen Flanker task for 60 min on two separate days, once with a high cognitive load in randomised sequence. Symptoms were assessed at baseline and every 10 min throughout the task. Results: All visuo-ocular symptom scores significantly worsened (F = 87.783, p

Introduction: Exposure to blue light throughout the day plays a key role in maintaining the balance of our biological functions. It has a profound impact on our physical and mental state, including the visual system, and contributes to the regulation of behavior and circadian rhythms. The relationship between light emitted by digital devices, the biological rhythm of the retina and the development of refractive errors has been the subject of research in recent years. Aim of Study: This manuscript aims to investigate the implications of light exposure from digital devices on the visual system and circadian rhytms, with a focus on understanding the associated risks, such as digital eye strain and myopia progression. Additionally, the study evaluates the efficacy of blue light-filtering lenses in mitigating these effects. Material and Methods: The present study is based on literature available in scientific databases such as PubMed, Corchane Library and Google Scholar, using the following keywords ,,Digital devices”; ,, Blue light” ; Digital eye strain” ; Visual system”; ,,Circadian rhythms” Results and conclusions: Despite the prevalent use of blue light-filtering lenses, existing evidence indicates that their effectiveness in improving visual performance or preventing retinal damage is limited. Consequently, the implementation of protective strategies, such as the 20-20-20 rule, combined with appropriate ergonomic practices, is critical in alleviating the ocular strain induced by extended screen exposure.

Purpose: to assess the state of the wavefront in children with myopia, who have various manifestations of digital eye strain and symptoms of ocular surface disorders, and to evaluate the diagnostic significance of wavefront criteria for assessing the state of the ocular surface.Patients and methods. The study involved 76 children (152 eyes) with myopia aged 8 to 18 years who used gadgets and computers for more than 2 hours a day. All patients used glasses as a method of optical correction and were constantly worn. The patients were divided into 2 groups: 1st with symptoms of ocular surface disorder, 2nd — comparison group. Subjective signs were studied using the online questionnaire “State of the ocular surface”. Using the “Keratograph 5M Oculus” the following parameters were assessed: non­invasive tear film breakup time (NTBR), including the first tear film breakup time, average tear film breakup time, breakup time gradient and maximum tear film breakup zone, the same device was used to perform infrared meibography and study of the lipid layer of the tear film. All patients underwent wavefront aberrometry in a darkened room without cycloplegia.Results. It was found that in the group of patients with the presence of subjective phenomena of disturbance of the state of the ocular surface, identified using the online questionnaire “State of the ocular surface”, rotor aberrations were statistically significantly higher than in the comparison group. At the same time, the indicators of higher­order corneal aberrations have comparable values. Correlation analysis between indicators of the state of the ocular surface and parameters of the wavefront in the group of children with disturbances of the state of the ocular surface showed that a higher level of corneal aberrations corresponds to a higher number of points on the questionnaire of disturbances of the ocular surface and the state of visual comfort, in turn, when comparing data on non­invasive tear film breakup time, a negative correlation was established, which means that with a higher number of points on the questionnaire, and therefore, with a more significant degree of impairment of the ocular surface, the tear film breakup time was shorter.Conclusion. The structure of the wavefront in children with myopia against the background of a disorder of the ocular surface in combination with CVS and digital eye strain is significantly different from the structure of the wavefront in the comparison group.

Purpose: To assess the impact of computer use on the ocular surface of individuals after laser in situ keratomileusis (LASIK). Methods: The dry eye symptoms and ocular surface of 18 post‐LASIK young individuals and 18 controls were evaluated before and after performing a 30‐min task on a computer without (Visit 1) and with (Visit 2) initial instillation of artificial tears. Symptoms were assessed using the Ocular Surface Disease Index (OSDI), Symptom Assessment in Dry Eye questionnaire version two (SANDE II) and Computer Vision Syndrome Questionnaire (CVS‐Q). The ocular surface was assessed by measuring corneal higher order aberrations, tear meniscus height (TMH), conjunctival redness, blink rate and incomplete blinking, lipid layer thickness (LLT) and non‐invasive keratograph break‐up time (NIKBUT). Results: SANDE II scores were >0 after the computer task in both groups (p ≤ 0.01). SANDE II and CVS‐Q scores did not differ between LASIK and controls (p ≥ 0.43). Greater bulbar–temporal conjunctival redness, TMH and LLT and shorter NIKBUT were found after computer use in the LASIK group (p ≤ 0.04), whereas no changes were observed in the controls (p ≥ 0.20). Lower SANDE II and CVS‐Q scores were reported at Visit 2 compared with Visit 1 in both groups (p ≤ 0.01). Likewise, no worsening of dry eye signs was observed at Visit 2 (p ≥ 0.11). Conclusions: Ocular symptoms reported during computer use were comparable between the groups. However, a worsening of dry eye signs was mostly observed in post‐LASIK individuals. The instillation of artificial tears was effective in preventing the effects of computer use on the ocular surface in post‐LASIK patients. [ABSTRACT FROM AUTHOR]

Background: Internet Gaming Disorder (IGD) has been associated with symptoms of Digital Eye Strain (DES) and poor academic performance among adolescent students. The purpose of this study is to assess whether a student’s achievement of a specific academic goal within a short period of time can be directly predicted by symptoms of IGD and DES. Methods: This is a cross-sectional survey of 140 high school graduates who received an examination of visual acuity as a pre-requisite for entering the written admission examinations of law enforcement and military academies. The students completed the Digital Eye Strain Questionnaire (DESQ) and the Ten-Item Internet Gaming Disorder Test (IGDT-10) and stated their own evaluation of their chances for success. They were contacted following their admission examinations, and their success or failure to be admitted was recorded. Results: The students with IGD symptomatology were more likely to present with symptoms of DES. They were also more pessimistic about their chances of success in the subsequent written admission examinations; none succeeded, while the rest of the students recorded an expected rate of success. A combination of IGD and complaints related to the prolonged fixation of the upper body in a specific viewing position was the best predictor variable set for future success in admission examinations. Conclusions: IGD is associated with a failure to achieve academic success. Combining a factor for physical discomfort during prolonged sessions of gaming with the typical criteria for IGD may expand the predictive validity of the construct of gaming disorder.

Background: Internet Gaming Disorder (IGD) has been associated with symptoms of Digital Eye Strain (DES) and poor academic performance among adolescent students. The purpose of this study is to assess whether a student's achievement of a specific academic goal within a short period of time can be directly predicted by symptoms of IGD and DES. Methods: This is a cross-sectional survey of 140 high school graduates who received an examination of visual acuity as a pre-requisite for entering the written admission examinations of law enforcement and military academies. The students completed the Digital Eye Strain Questionnaire (DESQ) and the Ten-Item Internet Gaming Disorder Test (IGDT-10) and stated their own evaluation of their chances for success. They were contacted following their admission examinations, and their success or failure to be admitted was recorded. Results: The students with IGD symptomatology were more likely to present with symptoms of DES. They were also more pessimistic about their chances of success in the subsequent written admission examinations; none succeeded, while the rest of the students recorded an expected rate of success. A combination of IGD and complaints related to the prolonged fixation of the upper body in a specific viewing position was the best predictor variable set for future success in admission examinations. Conclusions: IGD is associated with a failure to achieve academic success. Combining a factor for physical discomfort during prolonged sessions of gaming with the typical criteria for IGD may expand the predictive validity of the construct of gaming disorder. [ABSTRACT FROM AUTHOR]

Background: Digital Eye Strain (DES) has enhanced one of the crucial well-being matters with the expanded utilization of digitalized gadgets with optical revealing. Common digital eye strain manifestations include eye strain, headaches, blurred vision, and neck or shoulder pain, which typically get worse the more video display terminals (VDT)users use them. Very little investigation has been done to show how digital use affects Indian users' physical health, particularly among college undergraduate. Purpose: To find the effect of specific eye care exercise combined with 20-20-20 vision rule in managing computer vision syndrome among computer users. Methods: Seventy-four participants were selected for inclusion and exclusion criteria. They were divided into two groups: 20-20-20 Vision Rule Group (37) and conventional group (37). The pre and post-test values will be measured by computer vision syndrome - questionnaire. Group-A received 20-20-20-vision rule along with eye exercise and group-B received specific eye exercise. Both programs were given for 2 weeks, weekly 6 days. Results: Using Computer vision syndrome-questionnaire, 20-20-20 vision rule group's post-test mean was 25.51 and whereas conventional group's was 29.35. This demonstrates that the conventional group received a higher score of digital eye strain symptom positive than the 20-20-20 vision rule group. Conclusion: Specific eye care exercise combined with 20-20-20 vision rule in managing Digital Eye Strain among digital users was found to be more successful than specific eye exercise in reducing manifestation of Digital Eye Strain. [ABSTRACT FROM AUTHOR]

Context: Digital eye strain (DES) is a visible growing condition that has increased dramatically during the lockdown period, resulting in early visual impairments. Aims: The purpose of this study was to use a standardized computer vision syndrome questionnaire (CVS-Q) to assess the effect of the Bates method and Tibetan Eye Chart Exercise on DES among students. Settings and Design: A randomized clinical trial study was conducted at the health-care institution in Belagavi which included students aged between 19 and 25 years. Subjects and Methods: A total of 44 students with DES aged between 19 and 25 years were randomly allocated into Groups A and B. Group A was intervened with Bates method, whereas Group B was intervened with Tibetan Eye Chart Exercises for the duration of 3 weeks, 5 days per week followed by postevaluation using Computer Vision Syndrome Questionnaire. Statistical Analysis Used: The statistical analysis for within-group pre- and posttest for Bates method and Tibetan eye chart exercise was done using the Wilcoxon test. Results: In Group A, a statistical significant change was observed in components such as burning (P = 0.011), itching (P = 0.002), excessive blinking (P = 0.002), eye pain (P = 0.001), heavy eyelids (P = 0.011), increased sensitivity to light (P = 0.030), and headache (P = 0.001), whereas in Group B, only headache component has shown statistically significant improvement (P = 0.002). In between-group analysis for CVS-Q, both the groups showed statistically significant change with P = 0.001 for Group A and 0.003 for Group B. Conclusion: According to the results of this study, the Bates method is more beneficial in reducing DES as compared to Tibetan Eye Chart Exercise. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the impact of the COVID-19 pandemic on ocular health related to digital device usage among university students in Lebanon. Design: A cross-sectional design was utilized to examine the association between the pandemic and ocular health. Participants: A total of 255 university students in Lebanon participated in the study, selected based on their enrollment during the pandemic. Methods: An online survey assessed participants' digital device usage, awareness of digital eye strain, and experienced symptoms. The study addressed the relationship between symptom frequency and screen time, especially in their connection to the pandemic and online learning. Results: Prior to the pandemic, the majority of participants (73.0 %) were unaware of digital eye strain. Following the transition to online learning, nearly half of the participants (47.0 %) reported using digital devices for 12 or more hours. The majority (92.0 %) experienced a substantial increase in daily digital device usage for learning, with an average increase of 3–5 h. Symptoms of digital eye strain, including headache, burning of eyes, blurry vision, sensitivity to light, worsening of vision and dryness of the eyes intensified in both frequency and severity during the pandemic and online learning period. Conclusions: The study emphasizes the importance of promoting healthy habits and implementing preventive measures to reduce the prevalence of digital eye strain symptoms among university students. Healthcare professionals and public health authorities should educate individuals on strategies to alleviate digital eye strain, considering the persistent reliance on digital devices beyond the pandemic.

Kirandeep Kaur,1 Janani Muralikrishnan,2 Jameel Rizwana Hussaindeen,3 Nilutparna Deori,4 Bharat Gurnani5 1Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India; 2Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Chennai, India; 3Department of Optometry, Rivoli Vision Academy, Rivoli Groups LLC, Dubai, United Arab Emirates; 4Department of Pediatric Ophthalmology and Strabismus, Sri Sankaradeva Nethralaya, Guwahati, Assam, India; 5Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, IndiaCorrespondence: Bharat Gurnani, Department of Cornea and Refractive services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, 485334, India, Tel +919080523059, Email drgurnanibharat25@gmail.comAbstract: The COVID-19 pandemic came with many new challenges that forced personal and professional lifestyle modifications. Medical facilities were in scarcity against this new unknown enemy and were challenged with the overloaded patient flow, scarcity of healthcare staff, and evolving treatment modalities with a better understanding of the virus each day. Ophthalmology as a “branch of medicine” suffered challenges initially because of a lack of guidelines for patient management, close working distance during routine examinations, and halt of major surgeries, including cataracts. Pediatric ophthalmology had major implications, as reduced outpatient visits would mean deeper amblyopia, and changed lifestyles, including online classes and home refinement, predisposing children to myopia, digital eye strain, and worsening of strabismus. COVID-19 also unveiled underlying accommodation and convergence anomalies that predisposed pediatric and adolescent patients to an increased prevalence of headache and acute onset esotropia. Teleophthalmology and other innovative solutions, including the use of prism glasses, safe slit-lamp shields, alternative ways of school screening with the use of photoscreeners, performing retinoscopy only when needed, and using autorefractors were among the few guidelines or modifications adopted which helped in the efficient and safe management of pediatric patients. Many pediatric ophthalmologists also suffered in terms of financial constraints due to loss of salary or even closure of private practices. School screening and retinopathy of prematurity screening suffered a great setback and costed a lot of vision years, data of which remains under-reported. Important implications and learnings from the pandemic to mitigate future similar situations include using teleophthalmology and virtual platforms for the triage of patients, managing non-emergency conditions without physical consultations, and utilizing home-based vision assessment techniques customized for different age groups. Though this pandemic had a lot of negative implications, the innovations, modifications, and other important learnings helped pediatric ophthalmologists in navigating safely.Keywords: pediatric ophthalmology, COVID-19, digital eye strain, myopia, amblyopia

Amani M AlQarni,1 Assim M AlAbdulKader,1 Asma N Alghamdi,2 Jumana Altayeb,2 Raghad Jabaan,2 Lujain Assaf,3 Rawan A Alanazi1 1Family and Community Medicine Department, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia; 2Medical Intern, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia; 3Epidemiology Senior Specialist, Clinical Leadership, Center for National Health Insurance, Riyadh, Saudi ArabiaCorrespondence: Rawan A Alanazi, Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman bin Faisal University, P.O. Box 77134, Khobar, 31952, Saudi Arabia, Tel +966556999190, Email Raalanazi@iau.edu.saIntroduction: The prolonged use of digital devices is a major risk factor for digital eye strain (DES) syndrome.Aim: To estimate the prevalence of DES symptoms among students at Imam Abdulrahman University who use digital devices for virtual learning and leisure activities.Methods: This was a retrospective cross-sectional study conducted by asking medical students of Imam Abdulrahman bin Faisal University to complete a self-administered online questionnaire. The questionnaire was used to determine the effect of the hours spent on digital devices and other factors, such as screen distance and not using artificial tears, on the development of DES. The severity (moderate or severe) and frequency (occasionally, always, or never) of 16 eye strain-related symptoms, including eye pain, headache, and itching, were evaluated by using the Computer Vision Syndrome Questionnaire.Results: The overall prevalence of DES in the sample was found to be 68.53%. The largest proportion of students were found to have mild DES (43.20%), and only 11% had severe DES. The most common symptoms reported in our sample were headache, dryness, and burning. Female gender, using smartphones for online classes, and not using eye lubricants were significantly associated with increased severity of DES.Conclusion: In the wake of the COVID-19 pandemic, virtual learning has become an integral part of education, leading to increased use of digital technology. The aim of this study was to investigate the impact of virtual learning on eye strain and to determine the prevalence and effects of DES. A questionnaire was administered to participants, and the findings revealed a DES prevalence of 68.53%. The use of eye drops for lubrication and smartphones for classes was significantly associated with DES. Furthermore, females were found to be more susceptible to severe DES symptoms than males. The development of a tool such as the Computer Vision Syndrome Questionnaire to predict DES prevalence could reduce clinic time and resources by minimizing unnecessary follow-up and ophthalmology referrals.Keywords: digital eye strain, digital devices, computer vision syndrome, virtual learning

Catherine Wang,1 Katherine A Joltikov,1,2 Sasha Kravets,2,3 Deepak P Edward2,4 1University of Illinois at Chicago College of Medicine, Chicago, IL, USA; 2Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA; 3Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA; 4Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USACorrespondence: Deepak P Edward, Illinois Eye and Ear Infirmary, 1009 S Wood St, Chicago, IL, 60612, USA, Tel +1 312 996 6590, Fax +1 312 996 4255, Email deepedwa@uic.eduPurpose: The purpose of this study was to evaluate Computer Vision Syndrome (CVS) in undergraduate and medical students since transitioning to online learning during the COVID-19 pandemic.Patients and Methods: This was a cross-sectional single center survey-based study using a validated CVS questionnaire (CVS-Q). The survey was distributed to 20,080 undergraduate students and 680 medical students at the University of Illinois at Chicago. The primary outcome measures were prevalence of CVS (based on CVS severity score of 6 or more), frequency of CVS and intensity of CVS symptoms.Results: The survey was completed by 2300 undergraduate students (11.4% response rate) and 154 medical students (22.6% response rate). The prevalence of CVS was 77.1% in undergraduate students and 69.1% in medical students. CVS-Q severity scores were highest for headaches and eye dryness, with over half of students reporting worsening of symptoms since March 2020. Increased time spent on online learning (undergraduate: P < 0.001, medical: P = 0.018), blue light glasses usage (undergraduate: P < 0.001, medical: P = 0.0015), and increased number of device usage were associated with higher CVS severity scores (undergraduate: P < 0.001, medical: P = 0.0032).Conclusion: CVS among undergraduate and medical students has increased since the start of the COVID-19 pandemic. More focus should be placed on the management of CVS for students in higher education. Physicians should be cognizant of the consequences of online learning and be proactive about providing advice regarding preventative measures.Keywords: digital eye strain, screen time

Purpose: This study evaluates the recent trends in ocular morbidities and vision-related practices in “out-of-school” children in urban slums of Gurugram in North India. Methods: In this observational study, a validated questionnaire was administered to 161 students from two nonformal slum schools. Sociocultural, demographic data, vision-related practices, and visual acuity with subjective refraction of the children were recorded. Results: A total of 80 boys and 81 girls (9.17 ± 2.58 years) participated in this study. About 40% of the children were from lower socioeconomic status. The visual acuity recorded for all the children, except three children, was 6/6 in both eyes. One child had a pre-phthisical eye with no light perception, following a childhood trauma, with the other eye having 6/6 vision. Two children had refractive errors (myopia and compound myopic astigmatism), with a best corrected visual acuity (BCVA) of 6/6. Thirteen children (8%) had Bitot’s spots and 67 (35.4%) had allergic conjunctivitis. Eight (5%) children complained of dry eye–related symptoms like redness and watering of eyes, while 19 (11.8%) had diffuse headache. Average number of years spent in school for these children was less than 1.7 years (range: 1 month–6 years). Only 10.5% of the children gave the history of watching television more than 30 h/week. Significant association was found between the income of father and use of digital devices in children below 10 years (P = 0.003) and children playing outdoors (P = 0.001). There was a significant association noted for age and use of digital devices (P = 0.037). Conclusion: The prevalence of refractive errors in “out-of-school” children of urban slum was much less than the national average. Almost one in three children suffered from eye allergies, while 8% children had Bitot’s spots. The data about the prevalence of ocular comorbidities in underserved areas like urban slums can be used to update and strategize eye health-care delivery models for out-of-school children.

AimThis 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.MethodsWe 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).ResultsWe 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.ConclusionHealth 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.

Purpose: To assess changes in visual function and optical and tear film quality in computer users. Methods: Forty computer workers and 40 controls were evaluated at the beginning and end of a working day. Symptoms were assessed using the Quality of Vision questionnaire (QoV), 5‐item Dry Eye Questionnaire (DEQ‐5) and Symptom Assessment in Dry Eye version II (SANDE II). Tear film quality was evaluated using the Medmont E300 dynamic corneal topography tool to measure the tear film surface quality (TFSQ), TFSQ area and auto tear break‐up time (TBUT). Optical quality was assessed by measuring high, low and total ocular aberrations with a Hartmann–Shack wavefront sensor. Visual performance was assessed by measuring photopic and mesopic visual acuity, photopic and mesopic contrast sensitivity and light disturbance. Results: Poorer DEQ‐5, QoV and SANDE II scores were obtained in computer workers at the end of the working day compared with controls (p ≤ 0.02). Computer workers exhibited a higher (worse) TFSQ and TFSQ area at visit 2 compared with visit 1 (p ≤ 0.04), while no significant differences in TBUT (p = 0.19) or ocular aberrations were observed (p ≥ 0.09). Additionally, both light disturbance (p ≤ 0.04) and mesopic and photopic contrast sensitivity worsened at several spatial frequencies (p ≤ 0.04) throughout the working day in computer workers, while visual acuity remained unchanged (p ≥ 0.07). In contrast, control subjects exhibited no decrease in any variable during the day. Conclusions: While visual acuity remained unchanged, several aspects of visual function and quality of vision decreased over a day of computer use. These changes were accompanied by greater dry eye symptoms and tear film changes, which are likely to have played a fundamental role. The present study provides insight into new metrics to assess digital eye strain. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the knowledge, attitude, and practice towards digital eye strain (DES) among Northern Border University (NBU) students in Arar city. A total of 389 students from all nine NBU colleges willingly participated in this population-based cross-sectional study. The majority of the participants (65.6%) were in the age group 18-22 and females (76.3%), while 67.6% of the participants belonged to health-related colleges. Around 60% of students were familiar with the terms like DES and computer vision syndrome. More than fifty people (55.5%) had sufficient knowledge about DES. The most commonly used digital devices were IPads (56.6%). A significant difference in the knowledge in relation to the ages, faculty type, and academic year existed. A positive attitude regarding adjustment of brightness, appropriate seating position and viewing distance was demonstrated by 74%, 73.8%, and 81% of participants respectively. Regarding the duration, 61.2% of participants above six hours of total digital exposure per day. The symptoms associated with digital devices were fatigue of the eyes, foreign body sensation, and also non-ocular symptoms like shoulder or neck pain. The commonest source of participants’ information about digital eye strain was an awareness campaign. Sufficient knowledge about DES was demonstrated above half of the studied population. The current study highlights the need to reduce the digital exposure hours among university students and also to strengthen awareness about DES and its methods of prevention with a target to reach out to the community at large. [ABSTRACT FROM AUTHOR]

The last two years have seen a rapid rise in the duration of time that both adults and children spend on screens, driven by the recent COVID-19 health pandemic. A key adverse effect is digital eye strain (DES). Recent trends in human-computer interaction and user experience have proposed voice or gesture-guided designs that present more effective and less intrusive automated solutions. These approaches inspired the design of a solution that uses facial expression recognition (FER) techniques to detect DES and autonomously adapt the application to enhance the user’s experience. This study sourced and adapted popular open FER datasets for DES studies, trained convolutional neural network models for DES expression recognition, and designed a self-adaptive solution as a proof of concept. Initial experimental results yielded a model with an accuracy of 77% and resulted in the adaptation of the user application based on the FER classification results. We also provide the developed application, model source code, and adapted dataset used for further improvements in the area. Future work should focus on detecting posture, ergonomics, or distance from the screen.

Andrew D Pucker,1 Chris Lievens,2 Gerald McGwin Jr,1 Quentin X Franklin,1 Amy Logan,1 Gregory S Wolfe2,3 1University of Alabama at Birmingham, Birmingham, AL, USA; 2Southern College of Optometry, Memphis, TN, USA; 3Center for Eye and Health Outcomes, Memphis, TN, USACorrespondence: Andrew D Pucker, University of Alabama at Birmingham, School of Optometry, 1716 University Blvd, Birmingham, AL, 35233, Tel +1 (920) 579-2900, Email apucker@uab.eduPurpose: To understand the impact of Systane Hydration PF on dryness symptoms and quality of life in digital device users and to determine if participants prefer either the unit-dose or multi-dose dispensing system of Systane Hydration PF.Materials and Methods: This 2-week, three visit study recruited regular digital device users. Participants were required to score ≤ 80 on the Impact of Dry Eye on Everyday Life (IDEEL) Quality of Life (QoL) Work domain and between 13 and 32 on the Ocular Surface Disease Index (OSDI) questionnaire. Participants were randomized to either Systane Hydration PF unit-dose or multi-dose for 1 week and switched to the alternative dosing system for the second week. Participations were evaluated by completing the full IDEEL-QoL module and OSDI questionnaire at each visit. Likert surveys were completed to probe dispensing system preferences.Results: Thirty participants with a mean ± SD age of 28.6 ± 12.0 years (70% female) were recruited. Participants had significant improvements in all three IDEEL-QoL domains as well as in OSDI scores (all p < 0.0001). Participants had similar preferences for the two dispensing systems, though they were more likely to indicate that they thought that the multi-dose bottle was more environmentally friendly than the unit-dose vials.Conclusion: Digital device users with dry eye symptoms had meaningful improvements in eye comfort and quality of life scores after being treated with Systane Hydration PF for 2 weeks. Participants did not have a clear dispensing system preference suggesting that the best dispensing system may depend on the patient.Keywords: artificial tears, digital eye strain, dry eye disease, symptoms, Systane Hydration PF

Ioanna Mylona,1 Mikes N Glynatsis,2 Georgios D Floros,3 Stylianos Kandarakis4 1Department of Ophthalmology, General Hospital of Katerini, Katerini, Greece; 2Department of Ophthalmology, ‘Hippokration’, General Hospital of Thessaloniki, Thessaloniki, Greece; 3 2nd Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece; 4 1st Department of Ophthalmology, General Hospital “G. Gennimatas”, National and Kapodistrian University of Athens, Athens, GreeceCorrespondence: Ioanna Mylona, Ophthalmology Department, General Hospital of Serres, Serres, 62210, Greece, Tel +306941406978, Email milona_ioanna@windowslive.comAbstract: Digital Eye Strain (DES) is a clinical syndrome manifested with visual disturbances and/or ophthalmic dysfunction related to the usage of screen-enabled digital equipment. This term is gradually replacing the older term computer vision syndrome (CVS) that focused on the same symptoms found on personal computer users. DES is encountered more frequently during the past years due to the explosive increase in the usage of digital devices and subsequent increase in time in front of any screens. It presents with a series of atypical symptoms and signs stemming from asthenopia, dry eye syndrome, preexisting untreated vision issues and poor screen ergonomics. This review summarizes research data to date to determine whether the concept of DES has been conclusively defined and demarcated as a separate entity and if sufficient guidance is offered on professionals and the lay public. The maturity of the field, grouping of symptoms, examination techniques, treatment and prevention modalities are summarily presented.Keywords: digital eye strain, computer vision syndrome, classification, management

Purpose: The spectrum of symptoms that arise from prolonged hours of computer work has been the focus of interest since computers became the center of the modern workplace. This study focuses on engineers and aims at identifying the departments that are most susceptible to the effects of computer vision syndrome (CVS), their awareness about the entity, and identify lacunae in the existing eye health education provided to them. Materials and Methods: A cross-sectional study was conducted through an open online survey that was circulated among engineering college students belonging to colleges in Southern India and working professionals in the Information Technology (IT) and non-IT sector from the Southern States of India. Responses were collected over a period of 5 weeks spanning over 2 months and analyzed using the SPSS software version 25. Results: A total of 449 usable responses were received. The professionals in the non-IT sector logged a daily average work-related computer usage of 3.9 ± 3.1 h/day, while the IT sector professionals logged 4.3 ± 3.2 h/day of work-related computer usage. Among the participants, 57% of the study population were unaware of an entity called CVS, and 74.6% believed that blue light filters prevented damage caused by prolonged screen time. The data showed that 18% of the study population have never undergone an ophthalmic evaluation. Conclusion: It is evident that no health education is available to engineers at any stage of their professional career that helps them deal with ocular effects of prolonged screen time. We would like to recommend an ophthalmic screening and eye-heath awareness program to be conducted at the time of recruitment, with refresher courses at timely intervals.

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.

Purpose: To know the magnitude and determinants of dry eye syndrome among health professionals and to study the correlation of computer vision syndrome with dry eye disease. Methods: In total, 501 participants took part in the study, which included history followed by baseline ocular examination, which included visual acuity using Snellen's chart and anterior segment examination using a slit lamp. Later, a questionnaire was administered to health professionals to be filled out for analysis in the present study. Results: The symptoms reported occasionally were burning (35.5%), itching (34.5%), foreign body sensation 22.6%, and tearing (35.3%). The majority of participants used mobiles and laptops (56.1%) as a display. Also, 53.3% of participants have heard about dry eye syndrome, and the source of information was from friends and doctors in 17% of participants. One hundred twenty-one participants (24.2%) had taken the consultation for ocular symptoms. Eighty-six participants had mild, 29 participants had moderate, and 6 participants had severe dry eye disease, respectively. Conclusion: The pandemic effect, and the drastic shift of educational media from the classroom to the digital platform have increased the use of mobiles, laptops, or other digital pads for learning. This has increased the risk for health professionals.

BACKGROUND: To analyze the impact of online classes on eye health of children and young adults during the COVID-19 pandemic. MATERIALS AND METHODS: An observational study with a written questionnaire and comprehensive ophthalmic evaluation at a tertiary eye care center in South India, during the COVID-19 pandemic. RESULTS: Of the 496 patients, most were 5–10 years old, attending online classes 1–2 h/day with majority (84.7%) having

Mohammed Iqbal,1 Ashraf Soliman,2 Ola Ibrahim,2 Ahmed Gad1 1Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt; 2Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, EgyptCorrespondence: Mohammed Iqbal, Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, 82425, Egypt, Tel +2 01068559840, Fax +2 093 2159080, Email dr_m_iqbal@yahoo.comPurpose: To analyze the outcomes of screen-time reduction on the foveal responses that associates computer vision syndrome (CVS) using multifocal electroretinogram (mfERG) examination.Methods: This prospective multicenter cohort comparative study included 49 eyes of 49 medical students divided into two groups. Group A (control group) included 25 eyes with no CVS diagnosis while group B (CVS group) included 24 eyes with CVS diagnosis. All students responded to the valid and reliable CVS-Form 3 (CVS-F3) questionnaire and underwent complete ophthalmic and mfERG examinations twice at the time recruitment in the study and four weeks after strict reduction of the daily screen-hours to ≤ 1 screen-hour daily to document associated foveal responses.Results: We documented statistically significant reduction in foveal responses in CVS versus control groups in mean mfERG Rings 1, 2, and 5 with Quadrants 1, 2, and 4 (P=< 0.0001, 0.0001, 0.0003, 0.001, 0.002, and 0.006, respectively). Following the screen-time reduction, the second mfERG examination revealed significant post-reduction improvements in foveal responses in CVS group particularly in mean mfERG Rings 1, 2, 3, and 5 with Quadrants 1 and 4 (P=< 0.0001, < 0.0001, 0.0005, 0.02, < 0.0001, and 0.04, respectively).Conclusion: This study documented the screen-induced foveal dysfunction that associates CVS using mfERG examination, which revealed remarkable significant improvements in foveal responses in the 4 weeks following strict screen-time reduction. These improvements were also associated with corresponding improvements in the visual performances. We suggest that the potential screen-induced foveal dysfunction outcomes might be reversible with strict screen-time reduction. We also recommend that educational institutional policies should limit online education-hours and redesign the mandated computer system use program to guard against visual sequelae of CVS.Clinical Trials Registration: ClinicalTrials.gov (ID: NCT04405648).Keywords: computer vision syndrome, digital eye strain, multifocal electroretinogram, screen-induced foveal dysfunction

Alexandre Uwimana,&ast; Cong Ma,&ast; Xiang Ma Department of Ophthalmology, the First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiang Ma, Department of Ophthalmology, the First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116044, People’s Republic of China, Tel +8618098876399, Fax +8641183622844, Email xma9467@vip.sina.comPurpose: Students spend extended hours using electronic devices due to online teaching. Digital eye strain (DES) and dry eye disease (DED) symptoms are both associated with prolonged screen exposure time and may co-occur. This study aimed to evaluate the correlation between DES and DED symptoms and determine the prevalence of DED according to the severity of DES.Patients and Methods: This cross-sectional study was conducted among international students in Chinese universities. The survey was built using Wenjuan Mini Program and distributed using the WeChat platform. The questionnaire assessed participants’ screen exposure, the 20-20-20 rule, ED practices, and DED awareness. Computer Vision Syndrome Questionnaire (CVS-Q) and Dry Eye Questionnaire (DEQ-5) were used to diagnose DES and DED symptoms, respectively.Results: 498 students completed the survey, but 452 were considered for the study. Predictors of DES and DED symptoms were conjunctivitis, eye allergy, glares, tired eye, neck pain, back pain, PhD students, and daily spending > 9h on screen (P < 0.05 for all). We observed that an increase in DES scores also exponentially increases DED scores. Among students diagnosed with DES symptoms, 26.5% had mild to moderate DED symptoms, and 8.2% had severe DED symptoms. In contrast, only 8.4% and 0.9% of those with asymptomatic DES had mild to moderate and severe DED symptoms, respectively (P < 0.000). A strong and significant positive correlation (r = 0.695, P < 0.000) between DES and DED scores was found.Conclusion: We found an extremely high prevalence of DES and DED symptoms compared to the previous studies with a similar population group. We believe that the prevalence of DED may be underestimated in the young population. Training about proper ED practices is mandatory to prevent these deleterious ocular surface conditions.Keywords: COVID-19 pandemic, digital eye strain, dry eye disease, electronic device, online study, university students

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: 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. [ABSTRACT FROM AUTHOR]

The last two years have seen a rapid rise in the duration of time that both adults and children spend on screens, driven by the recent COVID-19 health pandemic. A key adverse effect is digital eye strain (DES). Recent trends in human-computer interaction and user experience have proposed voice or gesture-guided designs that present more effective and less intrusive automated solutions. These approaches inspired the design of a solution that uses facial expression recognition (FER) techniques to detect DES and autonomously adapt the application to enhance the user's experience. This study sourced and adapted popular open FER datasets for DES studies, trained convolutional neural network models for DES expression recognition, and designed a self-adaptive solution as a proof of concept. Initial experimental results yielded a model with an accuracy of 77% and resulted in the adaptation of the user application based on the FER classification results. We also provide the developed application, model source code, and adapted dataset used for further improvements in the area. Future work should focus on detecting posture, ergonomics, or distance from the screen. [ABSTRACT FROM AUTHOR]

Prolonged electronic screen use can cause digital eye strain. It can be difficult to rectify due to increasing smartphone reliance, potentially leading to serious public health problems. To investigate the association between time spent on smartphones and digital eye strain (DES) among Hong Kong Chinese school-aged children. Of a total of 1,508 students (748 males, 49.6%) from 8 to 14 years old (mean age = 10.91 years, SD = 2.01) who provided valid data on DES, the 1,298 (86%) who completed the DES questionnaire at 1-year follow-up were included in the analysis. DES was measured using a 10-item scale, and the sum of the 10 dichotomised scores was used as the DES total score. The most commonly reported symptoms were eye fatigue (n = 804, 53.3%), blurred vision (changing from reading to distance viewing) (n = 586, 38.9%), and irritated or burning eyes (n = 516, 34.2%). The DES total scores at baseline and 1-year follow-up were 2.91 (SD = 2.90) and 3.20 (SD = 3.19), respectively. Linear regression controlling for demographic and socio-economic confounders showed that participants with baseline smartphone usage of 241 + min/d had a significantly higher baseline total DES score than those with baseline smartphone usage of 0–60 min/d (2.44 vs 3.21, P < 0.001), and participants with baseline smartphone usage of 181–240 min/d had a significantly higher 1-year follow-up total DES score than those with baseline smartphone usage of 0–60 min/d (2.80 vs 3.50, P = 0.003). [ABSTRACT FROM AUTHOR]

Greater usage of digital devices and change of work pattern as working from home have created an impact on both visual and musculoskeletal systems. Developing an understanding of these changes could assist in providing appropriate care. The current study aims to elicit the changes in work patterns due to COVID-19 lockdown and understand the impact of the usage of digital devices on the visual system and musculoskeletal system. A survey was designed using Delphi technique and circulated through electronic communication sources using Google form to the working population and students across India, who consented to participate. The survey had components designed to develop an understanding of work patterns, digital device usage, associated visual/ocular symptoms, work-related musculoskeletal disorder (WRMSD) symptoms, and relevant information on psychological factors, and practice of yoga/exercises. There were 1302 valid responses. Mean age of respondents was 24 (IQR 11) years and 548 (42.1%) were male. A total of 1231 (94.5%) reported having one or many visual and ocular symptoms associated with the use of digital devices and 1140 (87.6%) responses indicated WRMSD symptoms. Of the symptomatic respondents, 561 (43.1%) had reported visual/ocular symptoms and 586 (45%) WRMSD symptoms during lockdown, which they did not experience during regular work. Risk factors for visual/ocular symptoms and WRMSD were females, spending more than 6 h on digital devices, taking breaks from digital devices after 2 h, inability to maintain a fair sleep schedule, and inability to make ergonomic modifications at home. A high prevalence of both visual/ocular symptoms (43.1%) and WRMSD symptoms (45%) was encountered during COVID-19 lockdown. [ABSTRACT FROM AUTHOR]

Purpose: To know the magnitude and determinants of dry eye syndrome among health professionals and to study the correlation of computer vision syndrome with dry eye disease. Methods: In total, 501 participants took part in the study, which included history followed by baseline ocular examination, which included visual acuity using Snellen’s chart and anterior segment examination using a slit lamp. Later, a questionnaire was administered to health professionals to be filled out for analysis in the present study. Results: The symptoms reported occasionally were burning (35.5%), itching (34.5%), foreign body sensation 22.6%, and tearing (35.3%). The majority of participants used mobiles and laptops (56.1%) as a display. Also, 53.3% of participants have heard about dry eye syndrome, and the source of information was from friends and doctors in 17% of participants. One hundred twenty‑one participants (24.2%) had taken the consultation for ocular symptoms. Eighty‑six participants had mild, 29 participants had moderate, and 6 participants had severe dry eye disease, respectively. Conclusion: The pandemic effect, and the drastic shift of educational media from the classroom to the digital platform have increased the use of mobiles, laptops, or other digital pads for learning. This has increased the risk for health professionals. [ABSTRACT FROM AUTHOR]

Background: The outbreak of COVID-19 has significantly affected people’s lives worldwide. Governments have used various measures to contain the spread of the pandemic, including confinement policies that have changed children’s lifestyles. Children had to limit their outdoor activities and daily routine to indoor activities. Alternative learning systems, such as online and offline teaching via digital devices have replaced traditional teaching methods. Therefore, children have to spend many hours in front of digital devices. As a natural side effect of the pandemic, these changes may influence children’s ocular health who may not be able to complain about these problems as early as adults. Objectives: This study reviews the literature regarding the effects of the COVID-19 pandemic on children’s eye health, including myopia and digital eye strain. Methods: For this narrative review, a comprehensive literature search was performed on December 30, 2021, in Google Scholar, PubMed, and Scopus using the following keywords: “COVID-19,” “lockdowns,” “children,” “ocular health,” “eye health,” “visual health,” “ocular complications,” “myopia,” “ myopia progression,” “digital eye strain,” “computer vision syndrome,” “quarantine,” and “prevention.” A total of 22 eligible studies were identified for review. Results: Studies performed during the COVID-19 pandemic have shown an increase in myopia prevalence, incidence, and progression in children, especially among young children. Strategies imposed by governments to control the spread of COVID-19 during confinement have led to dramatic changes in children’s lifestyles. These measures have compelled children to restrict outdoor activities and increase their near-work time (e.g., online e-learning), which contributes to the increase in digital eye strain and myopia progression. Conclusions: Children’s eye health can be influenced by the COVID-19 outbreak. These can serve as a warning to policymakers, health professionals, teachers, parents, and children about the effects of pandemics, such as COVID-19, on children’s visual health and the need to implement preventive and therapeutic measures.

Purpose: Critical flicker‐fusion frequency (CFF) has been used in clinical studies as a measure of visual fatigue. We examine the correlation between CFF and subjective reports of visual fatigue in a group of symptomatic computer users, to consider whether CFF may be used as a surrogate measure of visual fatigue symptoms. Methods: We analysed data from a previous randomised controlled trial. One hundred and twenty adults, diagnosed with computer vision syndrome, had CFF and visual fatigue symptoms quantified before and after a visually demanding 2‐h computer task. Symptoms were assessed using a questionnaire with nine subcomponents that summed to a total score of 900. CFF was measured using a two‐interval forced‐choice method, with the flicker rate altered by a computer‐controlled staircase procedure. For our primary analysis, we determined Spearman correlation coefficients between post‐task symptom scores and CFF, and between change from baseline symptom scores and CFF. We also used a bootstrap procedure to consider whether symptom score subcomponents were significantly (Bonferroni‐corrected) different from overall scores with regard to their correlations with CFF. Results: Although visual fatigue symptom scores altered significantly post‐task (mean change: 92 units; 95% confidence interval [CI]: 11 to 122), CFF did not (mean change −0.7 Hz; 95% CI: −1.7 to 0.3). There was no significant correlation between overall symptom scores and CFF, either for the post‐task (r = −0.13; 95% CI: −0.31 to 0.05) or the change from baseline (r = −0.18; 95% CI: −0.35 to 0.01) analysis. Subcomponents of the symptom questionnaire did not show a significant correlation with CFF, either for the post‐task or the change from baseline analysis. Conclusions: We find that CFF is not a useful surrogate for symptoms of visual fatigue, given its low correlation with scores on a visual fatigue symptom questionnaire. [ABSTRACT FROM AUTHOR]

The recent outbreak of the coronavirus disease of 2019 (Covid-19) has been causing many disruptions among the education systems worldwide, most of them due to the abrupt transition to online learning. The sudden upsurge in digital electronic devices usage, namely personal computers, laptops, tablets and smartphones is unprecedented, which leads to a new wave of both mental and physical health problems among students, for example eye-related illnesses. The overexposure to electronic devices, extended screen time usage and lack of outdoor sunlight have put a consequential strain on the student's ophthalmic health because of their young age and a relative lack of responsibility on their own health. Failure to take appropriate external measures to mitigate the negative effects of this process could lead to common ophthalmic illnesses such as myopia or more serious conditions. To remedy this situation, we propose a software solution that is able to track and capture images of its users' eyes to detect symptoms of eye illnesses while simultaneously giving them warnings and even offering treatments. To meet the requirements of a small and light model that is operable on low-end devices without information loss, we optimized the original MobileNetV2 model with depth-wise separable convolutions by altering the parameters in the last layers with an aim to minimize the resizing of the input image and obtained a new model which we call EyeNet. Combined with applying the knowledge distillation technique and ResNet-18 as a teacher model to train the student model, we have successfully increased the accuracy of the EyeNet model up to 87.16% and support the development of a model compatible with embedded systems with limited computing power, accessible to all students. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

BACKGROUND: To analyze the impact of online classes on eye health of children and young adults during the COVID-19 pandemic. MATERIALS AND METHODS: An observational study with a written questionnaire and comprehensive ophthalmic evaluation at a tertiary eye care center in South India, during the COVID-19 pandemic. RESULTS: Of the 496 patients, most were 5-10 years old, attending online classes 1-2 h/day with majority (84.7%) having <4 h of classes. Electronic gadget use after classes was seen in 95.6% participants and 28.6% admitted to using it for more than 2 h/day. Digital eye strain (DES) was seen in 50.8% of patients of which headache or eye ache were the most common symptom (30.8%). Duration of online class was found to be the single most independent factor associated with the development of eye complaints (P= 0.001). Duration of class hours (P = 0.007) and light setting (P= 0.008) was found to be independent determinants of developing DES. CONCLUSIONS: Increased screen time, inadequate light setting, and excessive application of near vision can produce undesirable effects including the development of DES, worsening or development of new refractive errors and squint. [ABSTRACT FROM AUTHOR]

PURPOSE: The digital eye strain (DES) is of public health magnitude in students undertaking online studies during the COVID-19 pandemic. The DES prevention strategies will be effective if all stakeholders, including parents, work together. We present an awareness level of preventive measures among parents of students studying online for 1 year. METHODS: This web-based survey was held in December 2021. Parents of Saudi students in the Qassim region responded to 15 questions about the preventive measures for DES. The responses were summed up and graded into very poor, poor, good, and excellent. The level of awareness was associated with determinants. RESULTS: The awareness was excellent in 566 of 704 (80.4%) (95% confidence interval 77.5–83.3) participants. Parents had poor awareness about the importance of the 20-20-20 rule (43.8%), frequent blinking (56.7%), using digital devices beyond studies (57.4%), using eye lubricants while using a digital device (56%), and using devices at night in lying position (69.6%). Excellent awareness was significantly associated with primary-level students (P = 0.0004), those having ophthalmic consultation in the past (P = 0.02), and students with DES (P = 0.0006). Parents with excellent awareness were not satisfied with online studies of their wards (P = 0.001). CONCLUSION: Awareness of parents about preventive measures to address DES in students is relatively high. However, health promotion is recommended, especially focusing on the weak areas to improve DES and its impact on students. [ABSTRACT FROM AUTHOR]

Excessive exposure to digital technology has been linked to adverse physical, social, and mental health. Questions have been raised about the impact of electronic devices with a drastic shift to online learning in education. This article aimed to investigate the impact of digital technology in the education setting using a mixed-method approach: laboratory-based exploration and an online survey. First, we compared the illumination profile of the screen display in comparison to traditional hardcopy materials. The luminance and spectrum profiles of smartphones and laptops were studied using the 2D Color Analyzer CA-2500 and illuminance spectrophotometer CL-500A. Second, we surveyed the digital usage profile of university students from six different universities to gather information on the total hour of daily digital engagement and the incidence of digital eye strain. The surface luminance for smartphone is 94.76 ± 11.46 cd/m2) and laptop (250.28 ± 22.88 cd/m2). The surface luminance of smartphones rises by 7% in comparison to hardcopy surfaces. The surface luminance of laptops upsurges by 203% in comparison to hardcopy surfaces. The digital engagement time of university students is about 12.80 ± 3.47 hours per day. Digital eye strain is approximately 22.15%. Self-luminosity screen displays from electronic devices emitted more luminance compared to the hardcopy materials. The electronic surface has low luminance uniformity compared to the hardcopy surface. University students exhibit high digital usage patterns and are susceptible to digital eye strain. The long-term accumulative effects of the high illuminance profile, digital engagement inclination and uprising digital eye strain from our cross-section study require further investigation.