Refractive error changes and associated asthenopia observed after COVID-19 infection: Case reports from two continents

COVID-19 infection has been linked to various ocular complications and complaints, but not to refractive errors. In this case report, we present ethnically diverse patients who reported asthenopic symptoms shortly after recovering from COVID-19 infection. The hyperopic shift in the refractive error, post-COVID could indicate the ciliary body muscle’s inability to sustain accommodation, resulting in asthenopia. Hence, refractive errors should also be considered as a post-COVID complication, even if the magnitude is small, especially when patients have a headache and other asthenopic symptoms. Performing dynamic retinoscopy and cycloplegic refraction will also aid in the better management of these patients

Dry eye symptoms and digital eyestrain - Emerging epidemics among university students due to online curriculum amid the COVID-19 pandemic. A cross-sectional study

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

Research progress on the correlation between adolescent digital lifestyles and digital eye strain / 中国学校卫生

Abstract@#To explore the association between a digital lifestyle and digital eye strain among adolescents, the present study analyses that a digital lifestyle has direct, mediating and moderating effects on digital eye strain of adolescents, and explores that visual load, attention and cognitive load are identified as the associated mechanisms of digital eye strain. In terms of management, the article highlights the need to raise awareness and promote healthy behavior in respect to the use of digital devices, as well as the importance of diversifying lifestyles, ensuring family and school support, and engaging in multidisciplinary cooperation to promote visual health and digital literacy among adolescents.

Validación del instrumento "Computer Vision Syndrome Questionnaire (CVS-Q)" para la evaluación del síndrome visual informático en personal de salud de Lima

Objetivos: Determinar la validez y confiabilidad del instrumento "Computer Vision Syndrome Questionnaire (CVS-Q)" en la medición del Síndrome Visual Informático en personal de salud de Lima. Material y métodos: Estudio observacional, descriptivo y de corte transversal, de tipo evaluación de cuestionario, realizado en 82 trabajadores de salud. La validez de contenido se evaluó mediante juicio de expertos con método estadístico de V de Aiken; Validez de constructo, mediante análisis factorial; validez discriminante, a través de la curva operador-receptor (ROC) contrastada con el cuestionario CSSV17; confiabilidad de consistencia interna, con alfa de Cronbach; confiabilidad test - re-test (con 7 días de diferencia); con Rho de Spearman y Coeficiente de Correlación Intraclase (CCI), con intervalos de confianza (IC) del 95%. Se empleó para el procesamiento el software SPSS versión 20.0 para Windows con licencia de prueba. Resultados: El V de Aiken obtuvo un valor de 100%. El análisis factorial extrajo 3 componentes principales que explicaron el 69,455% de la varianza total. El área bajo la curva ROC fue 0,889 [(0,845-0,934); IC=0,95] (p=0,000), sensibilidad 72,22% y especificidad 100%. El alfa de Cronbach fue 0,939, Rho de Spearman 0,884 (p=0,000) y CCI 0,856 [(0,777 - 0,907); IC=0,95] (p=0,000). Conclusiones: El Cuestionario CVS-Q es válido y confiable para ser aplicado sobre el grupo ocupacional de profesionales de la salud con buenas propiedades psicométricas.

SUMMARY Objectives: To determine the validity and reliability of the instrument "Computer Vision Syndrome Questionnaire (CVS-Q)" in the measurement of the Computer Visual Syndrome in health personnel in Lima. Methods: A quantitative, observational, descriptive, cross-sectional and questionnaire study was carried out in 82 health workers. Content validity was evaluated by expert judgment with the Aiken V statistical method; construct validity, through factor analysis; discriminant validity, through the receiver operating characteristic curve (ROC) curve contrasted with the CSSV17 questionnaire; internal consistency reliability, with Cronbach's alpha; reliability test - re-test (7 days apart); with Spearman's Rho and Interclass Correlation Coefficient (ICC) with 95% CI. The SPSS software version 20.0 for Windows with a trial license was used for its processing. Results: The V of Aiken obtained a value of 100%. The factor analysis extracted 3 main components that explain 69.455% of the total variance. The area under the ROC curve was 0.889 [(0.845-0,934); CI=0.95] (p=0.000), sensitivity 72.2% and specificity 100%. Cronbach's alpha was 0.939, Spearman's Rho 0.884 (p=0.000) and ICC 0.856 [(0.777 - 0.907); CI=0.95] (p=0.000). Conclusions: The CVS-Q questionnaire is valid and reliable to be applied in the health professionals' occupational group with good psychometric properties.

Application of asthenopia survey scale in patients with accommodative asthenopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the visual fatigue of patients with accommodative asthenopia and the difference in scores before and after treatment by using the asthenopia survey scale(ASS), and to evaluate its reliability, validity and responsiveness in this population.METHODS: A total of 112 patients with accommodative asthenopia were admitted to the department of ophthalmology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine and recruited online were investigated using the ASS questionnaire, and 48 subjects were randomly selected and retested 1wk later. A variety of reliability, validity and responsiveness indicators were used to evaluate the scale.RESULTS: The overall Cronbach's α coefficients of the scale entries was 0.91; The split-half reliability coefficients was 0.86; Repeated measurement correlation coefficient of the scale total score was 0.74, there was no significant difference before and after(P>0.05); The results of confirmatory factor analysis showed that the absolute fit index of the three-factor structural model was χ2/df<2.0, RMSEA=0.08; The correlation coefficients of each dimension's total score and the scale's total score were 0.92, 0.90 and 0.83 respectively; The standard association validity analysis showed statistically significant differences between groups(P<0.01). Response analysis was statistically significant before and after treatment(P<0.01).CONCLUSION: The ASS has high reliability, validity and responsiveness in the clinical evaluation of accommodative asthenopia, and it's an effective tool for clinical research and screening of asthenopia in this population.

Digital asthenopia: blue-blocking lenses and + 0,40D additional power in the near zone, for eye strain, accommodation and convergence functions / Astenopia digital: avaliação de lentes com filtro de luz azul e poder adicional de +0,40D na zona de perto, para fadiga visual e nas funções de convergência e acomodação

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

RESUMO Objetivo Avaliar os efeitos do uso de lentes oftálmicas com filtro seletivo de luz azul-violeta, sem e com poder adicional de + 0,4D na zona de perto nas funções de acomodação e convergência e para sintomas de astenopia digital (AD). Métodos Ensaio clínico controlado, randomizado e mascarado, com 49 voluntários (idade, 29 ± 5,5 anos; masculino: feminino, 18: 31). Cada participante usou lentes de teste (+0,40 D na zona de perto) e controle (visão simples), por 4 semanas de forma randomizada. Ambas as lentes tinham filtro seletivo de luz azul-violeta. A medição inicial (baseline) foi feita com os óculos atualizados de cada participante. A amplitude de acomodação (AA) e o ponto de convergência próximo (PPC) foram medidos binocularmente com a régua RAF. A AD foi avaliada por um questionário. Resultados Não houve diferença estatisticamente significante (p=0,52) para as medidas de AA comparando as lentes baseline (11,50±1,88 D), teste (11,61±1,62 D) e controle VS (11,88±1,50 D). Nenhuma diferença significativa foi encontrada para a medida do PPC (p=0,94), entre as lentes baseline (6,50 ± 2,89cm), teste (6,71±3,49) e controle VS (6,82±3,50 cm). Nenhuma diferença significativa foi encontrada comparando lentes teste de VS e controle nos sintomas de AD (p=0,20). Conclusões As lentes com +0,40 D não têm impacto negativo na convergência ou na perda de acomodação. As lentes +0,40 D e controle VS, tiveram impacto semelhante na redução dos sintomas de AD.

Improvement of asthenopia caused by abnormal visual functions via visual training in adult patients / 中华实验眼科杂志

Objective:To analyze the improving effect of visual therapy on the symptoms of asthenopia caused by abnormal visual function in adults.Methods:A serial case study was conducted.Ninety-three adult patients (186 eyes) with visual dysfunction caused by abnormal visual function who underwent training in the visual training room of the Optometry Center of Tianjin Eye Hospital from October 2018 to October 2019 were enrolled, among which there were 48 males and 45 females.The average age of patients was (30.43±6.39) years old.Binocular visual function examination included vision examination by phoropter, simultaneous vision and stereopsis by Worth 4 Dots test, distance and near heterophoria by Von-Graefe method test, fusion range by rotating prism method, the accommodation reaction by fusion cross cylindrical lens (FCC), the accommodation amplitude by minus technique, the accommodation flexibility and the vergence flexibility by flipper, and a personalized training program was formed on the basis of the above examination results.The training process was divided into initial examination, first review and second review, and each stage containing 5 times of training was followed by a review.The results of the initial examination, first review and second review were compared.The study protocol was approved by an Ethics Committee of Tianjin Eye Hospital (No.KY201906). Written informed consent was obtained from each patient prior to any examination.Results:The average near heterophoria was -8.0 (-15.3, -3.0) △ at the initial examination, and it was reduced to -5.0 (-9.0, 0.0) △ at the first review, showing significant difference (Z=-3.586, P<0.01). The mean accommodation amplitude of left and right eyes were 4.00 (3.25, 5.25)D and 4.00 (3.00, 5.00)D respectively before visual training, which were increased to 5.50 (4.25, 7.00)D and 5.00 (3.75, 7.00)D at the first review, showing significant differences (Z=-4.284, -3.995; both at P<0.01). The broken point and the recovery point of the long-distance positive fusion at the initial inspection were 7.5 (5.0, 15.8) △ and 0.0 (0.0, 4.0) △ respectively, which were increased to 11.0 (6.0, 22.0) △ and 4.0 (0.0, 7.0) △ respectively at the first review, showing significant differences (Z=-3.192, -3.748; both at P<0.01). The broken point and the recovery point of the near positive fusion at the initial inspection were 18.0 (8.0, 28.0) △ and 6.0 (0.0, 12.0) △, respectively, which were increased to 26.0 (21.5, 35.0) △ and 11.5 (6.0, 16.0) △ respectively at the first review, showing significant differences (Z=-4.695, -3.377; both at P<0.01). The monocular and binocular accommodation flexibility were increased from 2-3 cycles/minute at the initial examination to 10-12 cycles/minute at the first review, showing significant differences (all at P<0.01). Logistic regression analysis showed that age, distance heterophoria and near heterophoria were not related to the difference in accommodation improvement of the right and left eyes.At the initial examination, the average CISS score of 22 patients was (25.13±9.64) points, which was dropped to (19.18±7.22) points at the first review, showing significant difference ( t=6.79, P<0.01). The 67.60% (48/71) of the patients who did not answer the questionnaire had obvious improvement in their main complaints and physical signs, and 29.58% (21/71) of them had improvement but still needed more training, and 2.82% (2/71) had no improvement in visual fatigue symptoms. Conclusions:Systemic visual therapy can improve the visual function and alleviate symptoms majority of the adult patients with abnormal visual function, suggesting that adult visual function is still of strong plasticity.

The relationship between online learning and eye strain in college students during the COVID-19 outbreak / 中国学校卫生

Objective@#To describe online learning and eye strain situation of college students during the COVID-19 outbreak, to provide a scientific basis for guiding students eye health.@*Methods@#A self-filled electronic questionnaire survey through questionnaire star was administered to college students across China. Information about online learning and eye strain of 1 046 college students during the epidemic was collected in Hefei, Anhui Province from March 16 to 20, 2020. The univariate and multivariate Logistic regression analysis were performed to analyze the association between online learning and eye strain of college students.@*Results@#The rate of eye strain during online learning was 72.1%, totally of 68.4% in 421 male students and 74.6% in 625 female students. Boys with online learning time <6 h/d, slow internet access，difficulty in understanding online class reported higher rate of eye strain than girls( χ 2=17.36,8.72,7.02, P ＜0.05). Freshmen reported the highest rate of slow internet access occasionally and active online class( χ 2=15.26,16.11, P ＜0.05), junior students reported highest rate of online learning time <6 h/d, and easy understandable online class( χ 2=15.33,32.59, P ＜0.05), medical college students reported higher rate of slow internet access, inactive online class than non-medical college students( χ 2=11.79,11.03, P ＜0.05). Multivariate Logistic regression analysis showed that odds ratio( OR ) of eye strain in females was 1.40 (1.06-1.87), compared with males; the OR of eye strain were 1.43 (1.01-2.03) and 1.54 (1.10-2.15) in the groups with online learning time 6-<8 h/d and ≥8 h/d, respectively, compared with the group with online learning time <6 h/d, the OR of eye strain in the groups with slow internet access was 2.28 (1.25-4.14), compared with students without slow internet access, the OR of eye strain in the capable to understand and difficult to understand group were 2.54 (1.73-3.74) and 5.40 (2.70-10.80) respectively, compared with the easy to understand group.@*Conclusion@#Female students, online learing time ≥ 8 h/d, slow internet access, difficult to understand class content were positively related with college students eye strain. Attention should be paid to the eye health of college students to reduce the adverse effects of online learning on vision.during the COVID-19 epidemic.

Application of fresnel prism in patients with different types of binocular diplopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To discuss the efficacy of fresnel prism in different types of binocular diplopia patients.<p>METHODS: This retrospective study reviewed 20 patients who received fresnel prism treatment between June 2018 and November 2020 in Jiangmen Central Hospital. Eight of them were diagnosed as acute acquired comitant esotropia, five patients were thyroid-associated ophthalmopathy, and seven patients were eye misalignment caused by cranial nerve palsies. The outcome measures were deviation, near stereoacuity, asthenopia and driving ability at pre-treatment and post-treatment.<p>RESULTS: The deviations were decreased after treatment. There were significant differences between pre-treatment and post-treatment(<i>P</i><0.05). The patients with acute acquired comitant esotropia or eye misalignment caused by cranial nerve palsies recovered near stereoacuity meanwhile significant difference between before and after treatment(<i>P</i><0.05). There were no significant differences between before and after treatment in patients with thyroid-associated ophthalmopathy(<i>P</i>>0.05). Thirteen patients recovered in the driving ability while fifteen patients were cured of asthenopia. There were significant differences between before and after treatment(all <i>P</i><0.05).<p>CONCLUSION: Fresnel prism treatment could decrease deviations in binocular diplopia patients, improved near stereoacuity and quality of life.

Analysis of visual fatigue of naval crew in continuous voyage / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate and analyze the status of visual fatigue of naval crew on continuous voyage, explore the risk factors related to visual fatigue, and build a decision tree model for visual fatigue prediction.<p>METHODS:A total of 373 naval fleet members were selected by stratified random sampling method from July to October 2016. By asking the medical history and basic personal information of the subjects, the naked eye visual acuity, the best corrected visual acuity, slit lamp examination including: eyelid, eyelid margin, meibomian gland changes, cornea and conjunctiva signs of ocular surface damage, and corneal fluorescein staining to determine the tear breakup time(BUT). The Ocular Surface Disease Analysis Scale(OSDI)and ocular fatigue questionnaire were filled in, the incidence and severity of ocular fatigue were counted, and the risk factors of ocular fatigue were analyzed.<p>RESULTS: Totally 63.0%(235)of the crew members had different degrees of visual fatigue. There was no correlation between asthenopia and gender, age and previous corneal refractive surgery(<i>P</i>>0.05); Dry eyes and exposure time of electronic screen were the risk factors(<i>P</i><0.01). The overall prediction accuracy was 76.9%.<p>CONCLUSION: The exposure time of dry eye and electronic screen is the risk factor of visual fatigue in continuous navigation crew.

Analysis of correlation between eye strain and eye health behavior in college students during the period of COVID-19 epidemic / 中国学校卫生

Objective@#To understand the relationship between eye strain and eye health behavior in college students learning at home during the period of COVID-19 epidemic, and to provide a scientific reference for improving the hygiene of using eyes among the college students.@*Methods@#A cross sectional study and stratified cluster sampling was used to select 2 671 college students from 8 colleges in Anhui Province during the March 1st to July 1st in 2020, and an online questionnaire was survey included general information,eye strain,and daily eye health behavior.@*Results@#The prevalence of eye strain in college students was 69.64%. Multivariable Logistic regression analysis showed that eye strain was correlated with gender, myopia, siesta habit, staying up until 2:00 am, and the use of eye liquid, with OR values(95% CI ) were 0.64(0.53-0.76), 1.77(1.42- 2.20 ),0.71(0.59-0.86), 1.39(1.17-1.65), and 2.18(1.71-2.79), respectively. There was no correlation among daily outdoor activity time, daytime reading time and the occurrence of eye strain( P >0.05).@*Conclusion@#During the period of COVID-19 epidemic, eye strain among college students is common. The daily eye health behavior is related to the occurrence of eye strain. Under the special learning context, eye care measures should be encouraged specifically.

Astenopia digital em controladores de tráfego aéreo: diagnóstico e avaliação na Força Aérea Portuguesa / Digital-related eye strain in air traffic control specialists: diagnosis and evaluation in the Portuguese Air Force staff

RESUMO A função de controlador aéreo exige várias horas de visualização de ecrãs, o que torna esses profissionais um grupo particularmente exposto à astenopia digital. Procuramos, com este artigo de revisão, compreender quais os métodos quantitativos e qualitativos usados atualmente para diagnosticar e avaliar a fadiga ocular em controladores de tráfego aéreo. Trata-se de pesquisa bibliográfica utilizando as bases de dados PubMed® e ClinicalKey®, usando palavras-chave, tendo sido selecionados artigos de revisão e estudos observacionais com publicação posterior ao ano 2000, de modo que os termos buscados estivessem no título e/ou resumo do trabalho. Excluímos artigos em línguas que não inglesa. Existem vários métodos para melhor caracterizar a astenopia digital, destacando-se os subjetivos, como questionários, e os objetivos, que procuram, por um lado, diagnosticar o olho seco, bem como alterações da acomodação e da convergência. Da análise efetuada, ressaltou-se uma escassez de estudos prospectivos com Níveis de Evidência moderados e altos relacionados com a aplicação dos vários métodos de diagnóstico. A Computer-Vision Symptom Scale parece ser um questionário confiável e que pode ser aplicado aos controladores de tráfego aéreo, para diagnóstico de astenopia digital. Vários métodos objetivos podem também ser utilizados para essa avaliação, sendo importante, numa fase posterior, aplicar esses dois tipos de métodos de diagnóstico para avaliar a prevalência dessa patologia em controladores de tráfego aéreo.

ABSTRACT The work of air traffic control specialists require several hours looking at screens, and they comprise a group particularly exposed to digital-related eye strain. In this review we aim to understand the quantitative and qualitative methods currently used to diagnose and evaluate asthenopia in air traffic control specialists. A bibliographic search was carried out at the databases PubMed® and ClinicalKey®, using keywords, and selecting review articles and observational studies, dated after 2000, containing the keywords in the title and/o abstract. Articles not published in English were excluded. There are several subjective and objective methods to better describe digital-related eye strain, including questionnaires, aiming to make diagnosis of dry eye disease or changes in accommodation and convergence. From our analysis, there are few prospective studies with moderate and high levels of evidence regarding these diagnostic methods. The Computer-Vision Symptom Scale seems to be a reliable questionnaire to be applied to air traffic control specialists, for diagnosis of digital-related eye strain. Several objective methods can also be employed in this evaluation, and, in a later stage, it will be important to apply both diagnostic methods to evaluate the prevalence of this condition in air traffic control specialists.

Evaluation of the effects of single vision lenses with additional near-power on computer-induced asthenopia / Avaliação dos efeitos de lentes de visão simples com poder adicional de perto na astenopia induzida por computador

Abstract Objective: Compared to standard spectacle lenses, do +0.40 EyeZenTM lenses reduce symptoms of asthenopia induced by computer? Methods: A prospective clinical study was carried out with 39 volunteers who spent more than 4 hours a day using a computer (age, 27.31±4.24; male: female =13:26). Asthenopia and visual comfort were assessed using a questionnaires. All participants completed the asthenopia questionnaire with updated regular lenses (baseline). After 4 weeks of +0.40 Eyezen™ lenses wearing all subjects answered the asthenopia questionnaire and a second questionnaire to establish their level of satisfaction with these lenses. Statistical analysis was performed usind the Shapiro-Wilk test and Wilcoxon test, and p-values less than 0.05 were considered statistically significant. Results: Compared to standard spectacle lenses (baseline), +0.40 EyeZenTM lenses wearing reduced the total asthenopia score from17.44 ± 5.51 to 13.18 ± 10.22 (p < 0.001). Regarding the perception of the visual comfort levels with these lenses in the management of digital devices, more than 90% of subjects said they were entirely or delighted with their visual comfort.. Conclusions: Digital asthenopia induced by computer was significantly reduced by +0.40 EyeZen lenses wearing.

Resumo Objetivo: Comparadas com lentes oftálmicas regulares, as lentes de visão simples com +0,40D de poder adicicional de perto reduzem os sintomas de astenopia induzida por computador? Métodos: Foi realizado um estudo clínico prospectivo com 39 voluntários que passavam mais de 4h diárias utilizando computador (idade: 27,31±4,24 anos; masculino:feminino = 26:13). A astenopia e a percepção do conforto visual foram avaliadas com questionários. Todos os participantes respoderam ao questionário de astenopia com lentes regulares atualizadas (baseline). Após 4 semanas de uso das lentes +0.40 Eyezen™ os participantes responderam aos questionários de astenopia e de conforto visual. A análise estatística foi feita com os testes de Shapiro-Wilk e Wilcoxon. Valores de p<0,05 foram considerados estatísticamente significantes. Resultados: Comparadas com lentes oftálmicas regulares (baseline), o uso das lentes de visão simples com +0,40D de poder adicional de perto reduziu o escore total de astenopia de 17,44 ± 5,51 para 13,18± 10,22 (p< 0,001). Mais de 90% dos participantes se declaram completamente ou muito satisfeitos com o conforto visual percebido no uso de dispositivos digitais. Conclusão: A astenopia induzida por computadores foi significativamente reduzida pelo uso das lentes +0,40 Eyezen™ combinadas Crizal® Sapphire™.

Relationship between Ocular Fatigue and Use of a Virtual Reality Device

PURPOSE: To investigate ocular fatigue after the use of a head-mounted display (HMD)-type virtual reality device.METHODS: Healthy adult volunteers were examined for ocular fatigue before and after watching videos for 10 min with an HMD-type virtual reality device. Subjective ocular fatigue was measured using a questionnaire. Objective fatigue was measured using the critical flicker fusion frequency (CFF), high frequency component of accommodative microfluctuation, and accommodation amplitude. The accommodation amplitude was measured using the push-up method and the dynamic measurement mode of the autorefractometer. Changes in the spherical equivalent were also measured.RESULTS: The questionnaire-based subjective ocular fatigue increased (p = 0.020) after use of the HMD device. In the dominant eye, the high frequency component of accommodative microfluctuation increased (p < 0.05). The accommodation amplitude using the push-up method was decreased in the nondominant eye (p = 0.007), and temporary myopia was observed (p < 0.05). However, there was no increase in ocular fatigue in the CFF or the accommodation amplitude using the dynamic measurement mode, which showed no significant difference before and after using the HMD device (p > 0.05).CONCLUSIONS: A subjective test and some objective tests suggested that use of the HMD-type virtual reality display increased ocular fatigue. However, no increase in ocular fatigue was measured using CFF nor in the accommodation amplitude using the dynamic measurement mode which was a limitation of the study. More studies with the aim to alleviate ocular fatigue after using HMD-type virtual reality devices are therefore needed.

Prevalence of asthenopia among computer operators in Central India and effectiveness of educational intervention

Background: Objective was to study the prevalence of asthenopic symptoms among computer operators in central India and assess the change in their practices related to factors affecting asthenopia symptoms and relief measures.. Methods: Longitudinal Educational Interventional Study, done on 150 employees of computer based company offices of Bhopal city in duration of 3 months from August 2018 to October 2018 after obtaining Ethical clearance from the institutional ethics committee and they were asked to fill a pre-tested questionnaire, after obtaining their verbal consent. Other relevant information was obtained by personal interview and inspection of their working area. The data was entered in MS excel and analysis was done using Epi-info 7 software. Results: Among the 150 participants studied, the overall prevalence of asthenopia (at least 1 symptom present) is 87.3%. The prevalence of various asthenopic symptoms varied from 85.3% (eye fatigue) to 18.7% (blurring of vision). With educational intervention, significant change was observed in symptoms and relief measures. Conclusions: Prevalence of asthenopia was found to be quite high in computer operators, especially in those who started its use at an early age. Individual as well as work-related factors were found to be associated with asthenopia.

Overview of Research on Chinese Medicine Patents for Prevention and Treatment of Asthenopia and Analysis Their Medication Rule / 中国实验方剂学杂志

Objective: To explore drug utilizing regularity of traditional Chinese medicine(TCM) in treating and preventing asthenopia by analyzing the patent status of TCM in the field of asthenopia control for nearly 20 years. Method: Global patents about TCM in treating and preventing asthenopia were systematic searched in IncoPat platform.The application trend,legal status and categories of patents were analyzed.Meanwhile,the oral prescriptions and external prescriptions were performed correlation index analysis by IBM SPSS Modeler 18.0,respectively;the difference of compatibility rules between them was compared. Result: The number of global patents in treating and preventing asthenopia gradually increased,and the proportion of patents from China was more than 99%.The main patent applications were pharmaceutical composition,oral preparation,external eye patch and so on,but the ratio of licensed patents in total patents was low.In term of drug utilizing regularity,the oral prescriptions paid much attention to using TCM for nourishing the liver and kidney,while external prescriptions highlighted relieving sickness heat and detoxification. Conclusion: Patents of TCM in treating and preventing asthenopia has been kept increasing in recent years,but the authorization rate is low.Formulation based on TCM theory can be statistically summarized,which can be helpful for the development of anti-asthenopia products.

Clinical study on visual display terminal syndrome with local treatment near the eyes in combination with systemic comprehensive treatment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To research the clinical effects of visual display terminal(VDT)syndrome after local treatment near the eyes in combination with systemic comprehensive treatment.<p>METHODS: Totally 62 patients(124 eyes)with VDT syndrome were randomly divided into a trial group and a control group, 31 cases(62 eyes)in each group. In the control group, artificial tears as eye drops were given. In addition to the above local treatment with artificial tears, the trial group was also treated with the auricular acupressure and tuina at the acupoints near orbits and the whole body. A health education was carried out in both of the two groups. The course of the treatment of the two groups was 2wk. The symptomatic scores, and the amplitude of accommodation, facility of accommodation, accommodative response, near point of convergence and the ratio of accommodative convergence to accommodation(AC/A)based on refractive error correction of all the patients were detected before and after the treatment. The parameters gained before and after the treatment were compared for evaluating efficacy. <p>RESULTS: After treatment, the symptomatic scores and facility of accommodation of the two groups were significantly improved compared with those before treatment(<i>P</i><0.05). Amplitude of accommodation and near point of convergence in the trial group were significantly improved after treatment(<i>P</i><0.05). <p>CONCLUSION: Local treatment near the eyes in combination with systemic comprehensive treatment can effectively improve the accommodative and convergent functions of patients with VDT syndrome, and relieve their symptoms of asthenopia and fatigue.

Incidence and risk factors of near vision impairment in patients with asthenopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the incidence and risk factors of near vision impairment(NVI)in patients with asthenopia.<p>METHODS: Totally 51 patients(102 eyes)with visual fatigue in our hospital from May 2017 to May 2018 were enrolled. According to whether the near vision of daily life is damaged, it is divided into daily near vision impairment group(24 cases)and no near vision impairment group(27 cases). General information of all patients were collected, and routine eye examination, subjective optometry and binocular eye movement parameter detection were detected.<p>RESULTS: In the survey, 27 patients(53%)with near vision impairment in naked eye and 24 patients(47%)with impaired near vision in daily life, and all patients had a significant improvement in visual acuity after correct optometry, and there was no one who has best corrected near visual acuity impairment. The age of patients with daily near vision impairment was significantly higher than that of patients without near vision impairment. The proportion of patients aged ≥45 years was significantly higher than that without near vision impairment(<i>P</i><0.01). NRA/PRA, vergence \〖BO(40cm)\〗, and amplitude of vergence(40cm)were significantly different between the two groups(<i>P</i><0.05).<p>CONCLUSION: Nearly half of patients with asthenopia would suffer NVI. The increase of age and imbalance between NRA and PRA as the predominant risk factors for its development.

Asthenopic symptoms prevalence in undergraduate students / Prevalência de sintomas astenópicos em estudantes do ensino superior

Abstract Objective: To analyze the prevalence of asthenic symptoms in students of higher education and to assess their influence on academic performance and learning. Methods: Descriptive research with cross-sectional design through the application of the College of Optometrists Questionnaire in Vision Development Quality of Life (COVDL-QoL), in its cross-cultural and linguistic adaptation to the Portuguese language, to the students of a private college in the city of Montes Claros. Results: The questionnaire was answered by 132 university students. There was no significant discrepancy in the prevalence of asthenopia between genders and age. Symptoms of headache, poor memory and loss of objects predominated in women, while sleepiness during reading and poor management of time were predominant in males. Conclusion: A high prevalence rate of asthenic symptoms among university students and positive associations with sex and time of use of electronic equipment was identified.

Resumo Objetivo: Analisar a prevalência de sintomas astenópicos em estudantes do ensino superior e avaliar a sua influência no desempenho acadêmico e no aprendizado. Métodos: Pesquisa descritiva com delineamento transversal por meio da aplicação do Questionário College of Optometrists in Vision Development Quality of Life (COVDL-QoL), em sua adaptação transcultural e linguística para a língua portuguesa, aos alunos de uma faculdade particular da cidade de Montes Claros. Resultados: O questionário foi respondido por 132 universitários. Não houve discrepância significativa na prevalência de astenopia entre os sexos e a idade. Os sintomas de dor de cabeça, memória fraca e perda de objetos predominaram nas mulheres, enquanto a sonolência durante a leitura e o mau gerenciamento do tempo foram predominantes no sexo masculino. Conclusão: Foi identificada alta taxa de prevalência de sintomas astenópicos entre os universitários e associações positivas com sexo e tempo de utilização de equipamentos eletrônicos.

Orthoptic parameters and asthenopic symptoms analysis after 3D viewing at varying distances / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyse visual modifications such as amplitude of accommodation, near point of convergence (NPC) reopsis and near phoria associated with asthenopic symptoms after 3D viewing at varying distances. METHODS: A prospective study. Thirty young adults were randomly selected. Each individual was exposed to 3D viewing thrice in a day for a fixed distance and the distance was varied on three consecutive days. Same video of equal duration and different screen sizes were used for every distance. Cyclic 3D mode of K-multimedia (KM) player was used for projecting the 3D video. Different variables like stereopsis, amplitude of accommodation, near point of accommodation, near phoria and asthenopic symptoms were recorded immediately after 3D video viewing. Stereopsis was measured with "Toegepast Natuurwetenschappelijk Onderzoek冶 or"Netherlands Organisation for Applied Scientific Research 冶 ( TNO test ), amplitude of accommodation and NPC were measured using RAF ruler, near phoria was measured using prism bar and a closed ended sample questionnaire was used to know the occurrence of asthenopic symptoms. Statistical analyses were performed using descriptive statistics, paired t-test etc. Qualitative data was analyzed using Chi-square test. RESULTS: For every distance of 40 cm, 3 m and 6 m, amplitude of accommodation was significantly reduced by 0.66 D,1.12 D and 1.44 D. NPC got significantly receded by 0.63 cm, 0.93 cm and 1.23 cm, and the near phoria was significantly increased by 0. 87, and 2. 2 prism dioptres (PD) base-in respectively. It was found that most of the subjects got pain around the eyes, headache and irritation for each viewing distance. This study also revealed that 3D video viewing in theaters may increase the symptoms of headache, watering and irritation. Symptoms like headache,watering,fatigue,irritation and nausea may increase considerably at home environment and symptoms such as headache and watering may cause significant discomfort by 3D viewing using a laptop. CONCLUSION: There was a significant difference in amplitude of accommodation, NPC, near phoria and asthenopic symptoms before and after viewing a 3D video and also at three viewing distances. There was a predominant occurrence of asthenopic symptoms after 3D video viewing at different distances.