Digital eye strain and its impact on working adults in the UK and Ireland.

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

Attitudes of optometrists in the UK and Ireland to Digital Eye Strain and approaches to assessment and management.

PURPOSE: To investigate the attitudes and understanding of optometrists in the UK and Ireland towards Digital Eye Strain (DES), and to examine related practice patterns. METHODS: An anonymous online questionnaire was developed, covering attitude and understanding of DES, examination of patients who may be experiencing DES and approaches to management options. The questionnaire was promoted to UK and Ireland optometrists via professional bodies and local and area optometric committees. RESULTS: 406 responses were included in the analysis. Most respondents agreed that DES was an important concern for optometrists (88.9%). 91.4% reported they felt confident in discussing possible symptoms of DES and management options; this was weakly and negatively associated with number of years qualified (rs  = -0.198, p ≤ 0.001). Estimations of the proportion of patients affected by DES were lower than reports in the literature (median 25%, IQR 10%-50%). Most respondents always (60.6%) or frequently (21.9%) inquired about device usage in routine case history taking, and also asked follow-up questions, although 29.3% only asked about the presence of symptoms half the time or less. Advising on regular breaks (84.0%), lubricants (55.7%) and environment/set up (69.2%) were felt to be extremely or very important by most respondents. Advising on specialist spectacle lenses, specifically blue filtering designs, was considered extremely or very important by 34.2% and 15.2%, respectively. CONCLUSION: Given the agreement that DES is a significant issue causing frequent and persistent symptoms, and practitioners reported high levels of confidence in discussing DES, patients can expect to receive advice on symptoms and management from their optometrist. Simple management strategies were felt to be most important to advise on, with more uncertainty linked to specialist spectacle lenses.

Amination of Bis(trimethylsilyl)-1,2-bisketene to Ketenyl Amides, Succinamides, and Polyamides: Preparative and Kinetic Studies.

The reaction of the bisketene (Me(3)SiC=C=O)(2) (1) with amines is facile and proceeds by two distinct steps forming first ketenylcarboxamides 3 and then succinamides 5. Successive reaction of 1 with two different amines gives mixed succinamides, while phenylhydrazine gives succinimide 7. The reactions of 1.8 equiv of 1 with 1,4-(H(2)NCH(2))(2)C(6)H(4) gives alpha,omega-bisketenyldiamide 13, while equivalent amounts of 1 and diamines gave polymeric amides. Mixed ester amides 8 are formed by sequential reaction of 1 with an alcohol, followed by an amine, or vice versa. Kinetic studies of the amination reaction of 1 with excess amines in CH(3)CN gave rate constants k(obs) for the formation of ketenylcarboxamides that were fit by the relationship k(obs) = k(a)[amine](2) + k(b)[amine](3). Further reaction of the n-butyl ketenylcarboxamide 3b with n-BuNH(2) to give the succinamide 5b was first order in [n-BuNH(2)], while the further reaction of the CF(3)CH(2) ketenylcarboxyamide 3c with CF(3)CH(2)NH(2) to form 5c was fit by the equation k(obs) = k(c)[amine](2)/(k(d)[amine] + 1). The reaction of 3b with CH(3)OH to form the ester amide 8a is strongly accelerated compared to CH(3)OH addition to the corresponding ketenyl ester and gives significant stereoselectivity for formation of erythro product, and both these effects, as well as the absence of higher order kinetic terms in the reaction of 3b with n-BuNH(2), may arise from coordination by the carboxamido group to the nucleophile.

Alkoxide-Induced Succinate Ester Formation from Alcohols and Bis(trimethylsilyl) 1,2-Bisketene.

Reaction of the 1,2-bisketene (Me(3)SiC=C=O)(2) (1) with alcohols (ROH) catalyzed by LiOR gives rapid and efficient conversion to mixtures of the meso and dl succinates (Me(3)SiCHCO(2)R)(2) (4). There is a change in selectivity with the dl/meso ratio varying from 18/82 with MeOH to 92/8 for t-BuOH. This procedure occurs with minimal desilylation, which is the predominant path in the uncatalyzed reaction. Preferential attack of lithium alkoxides on the carbonyl carbon of ketenes induced by lithium coordination to the ketenyl oxygen is proposed to account for the low extent of desilylation. The stereochemical assignments of the meso and dl configurations are based upon vicinal H,H coupling constants both from a mixed succinate ester and also from (13)C,(1)H satellite spectra and are confirmed by X-ray structure determinations. Reaction of 1 with catechols 10-12 catalyzed by n-BuLi leads to ortho esters 15-18, while reaction with the perhalo catechols 13 and 14 gives isolable hydroxaryl ketenyl esters 19 and 20.