Visual, ocular surface, and extraocular diagnostic criteria for determining the prevalence of computer vision syndrome: a cross-sectional smart-survey-based study.

Background: The American Optometric Association defines computer vision syndrome (CVS), also known as digital eye strain, as "a group of eye- and vision-related problems that result from prolonged computer, tablet, e-reader and cell phone use". We aimed to create a well-structured, valid, and reliable questionnaire to determine the prevalence of CVS, and to analyze the visual, ocular surface, and extraocular sequelae of CVS using a novel and smart self-assessment questionnaire. Methods: This multicenter, observational, cross-sectional, descriptive, survey-based, online study included 6853 complete online responses of medical students from 15 universities. All participants responded to the updated, online, fourth version of the CVS questionnaire (CVS-F4), which has high validity and reliability. CVS was diagnosed according to five basic diagnostic criteria (5DC) derived from the CVS-F4. Respondents who fulfilled the 5DC were considered CVS cases. The 5DC were then converted into a novel five-question self-assessment questionnaire designated as the CVS-Smart. Results: Of 10 000 invited medical students, 8006 responded to the CVS-F4 survey (80% response rate), while 6853 of the 8006 respondents provided complete online responses (85.6% completion rate). The overall CVS prevalence was 58.78% (n = 4028) among the study respondents; CVS prevalence was higher among women (65.87%) than among men (48.06%). Within the CVS group, the most common visual, ocular surface, and extraocular complaints were eye strain, dry eye, and neck/shoulder/back pain in 74.50% (n = 3001), 58.27% (n = 2347), and 80.52% (n = 3244) of CVS cases, respectively. Notably, 75.92% (3058/4028) of CVS cases were involved in the Mandated Computer System Use Program. Multivariate logistic regression analysis revealed that the two most statistically significant diagnostic criteria of the 5DC were ≥2 symptoms/attacks per month over the last 12 months (odds ratio [OR] = 204177.2; P <0.0001) and symptoms/attacks associated with screen use (OR = 16047.34; P <0.0001). The CVS-Smart demonstrated a Cronbach's alpha reliability coefficient of 0.860, Guttman split-half coefficient of 0.805, with perfect content and construct validity. A CVS-Smart score of 7-10 points indicated the presence of CVS. Conclusions: The visual, ocular surface, and extraocular diagnostic criteria for CVS constituted the basic components of CVS-Smart. CVS-Smart is a novel, valid, reliable, subjective instrument for determining CVS diagnosis and prevalence and may provide a tool for rapid periodic assessment and prognostication. Individuals with positive CVS-Smart results should consider modifying their lifestyles and screen styles and seeking the help of ophthalmologists and/or optometrists. Higher institutional authorities should consider revising the Mandated Computer System Use Program to avoid the long-term consequences of CVS among university students. Further research must compare CVS-Smart with other available metrics for CVS, such as the CVS questionnaire, to determine its test-retest reliability and to justify its widespread use.

Correlation between mental status and prevalence of asthenopia in Chinese college students.

BACKGROUND: The purpose of this study was to identify the possible association between mental status and the risk of self-reported asthenopia among college students in China. METHODS: Ten thousand students were randomly assessed in the study using a self-reported asthenopia questionnaire. Their demographic characteristics and mental status were recorded. Univariate analysis was performed to preliminarily select potential risk and protective factors. Then, multivariate logistic regression was used to estimate odds ratios for the selected risk factors of interest. RESULTS: Among the 8370 students who completed the survey, the prevalence of asthenopia was 61.0%. Multivariate analysis revealed a significant relationship between asthenopia and depressive symptoms (OR 1.511 95% CI: 1.350-1.691), obsessive-compulsive symptoms (OR 1.477, 95% CI: 1.338-1.632), gender and study load. The place college students spent their off-hours (OR 0.841, 95% CI: 0.784-0.902) was found to be the strongest factor for decreasing the occurrence of asthenopia complaints. CONCLUSION: Asthenopia appears common in Chinese college students. In addition to depressive symptoms, we should pay attention to obsessive-compulsive symptoms when considering means of preventing asthenopia. Harmonious social relationships, outdoor off-hour activities and exercising more than three times per week are crucial to relieving visual fatigue. Further study is still needed in this area.

Diagnostic values of questionnaires of Convergence Insufficiency Symptom Survey and College of Optometrists Vision Development Quality of Life in the screening of convergence insufficiency.

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

Síndrome visual informático en pacientes menores de 35 años

Introducción: El síndrome visual informático o fatiga visual digital es una enfermedad causada por el cansancio ocular que provoca el pasar mucho tiempo frente a una pantalla. Objetivo: Diagnosticar el síndrome visual informático en pacientes menores de 35 años atendidos en la consulta de refracción. Métodos: Se realizó un estudio descriptivo prospectivo y transversal de pacientes atendidos en la consulta de refracción del Policlínico Especialidades del Hospital Provincial Docente Clínicoquirúrgico Saturnino Lora, durante el periodo de abril a junio de 2022. Resultados: Predominaron los pacientes en las edades comprendidas entre 26 y 35 años y del sexo femenino; los síntomas más frecuentes fueron el cansancio visual, ardor ocular, sensación de ojo seco, visión borrosa de cerca, ojo rojo y el dolor de cabeza después del esfuerzo visual. Los dispositivos digitales más usados fueron el celular y la computadora con un tiempo de uso de una a tres horas, destacándose este último con un tiempo superior a 4 horas. Los defectos refractivos constituyeron la principal causa de limitaciones visuales. Los pacientes con síndrome visual informático y alguna ametropía sin corrección fueron los que mayor cantidad de síntomas tuvieron, seguidos de los pacientes corregidos inadecuadamente. Conclusiones: Este síndrome afecta en gran medida a la población más joven. El adecuado interrogatorio y la incorporación de los procedimientos correctos en el estudio optométrico diario permitió el diagnóstico de tal síndrome en los pacientes atendidos y la corrección óptica pertinente.

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

Accommodative response and visual fatigue following a non-congruent visual task in non-asthenopic and asthenopic individuals.

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

Is there a relationship between somatic sensations, impaired vision, and cognitive performance using the factor structure of the convergence insufficiency symptoms survey questionnaire?

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

Contributions of educational interventions in the management of Computer Vision Syndrome: a review of the literature / Aportes de las intervenciones educativas en el manejo del Síndrome Visual Informático: una revisión de literatura / Contribuições das intervenções educacionais no Manejo da Síndrome da Visão Computacional: uma revisão de literatura

Objective: To identify health education interventions that have demonstrated improvements in the visual and ocular health of computer-using workers with Computer Vision Syndrome. Method: Bibliographic review of original articles in Spanish and English, published between 2017 and June 2022 in PubMed, Scopus, MEDLINE (EBSCO), Redalyc, and Ovid databases. Results: Out of 1,695 articles, 11 complied with the protocol. Of these, 90.90% were published from 2020 to June 2022 and India had the highest number of publications (27.27%). Most of the studies were experimental or quasi-experimental (36.36%), and for the qualitative synthesis they were classified in educational interventions with technology 54.54% (n=6) and those that handled traditional education 45.45% (n=5). Conclusion: Health education interventions were shown to contribute to the improvement of visual and ocular health of computer users with Computer Vision Syndrome. It is necessary to investigate and divulge results about the topic, which contribute to the processes of promotion of visual and ocular health, as well as in the prevention of Computer Vision Syndrome in the workplace

Objetivo: Identificar intervenciones de educación para la salud que hayan demostrado me-joras en la salud visual y ocular de trabajadores usuarios de computadoras con Síndrome de Visión por Computador. Método: Revisión bibliográfica de artículos originales en español e inglés, publicados entre 2017 y junio de 2022 en las bases de datos PubMed, Scopus, MEDLINE (EBSCO), Redalyc y Ovid. Resultados: De 1.695 artículos, 11 cumplieron con el protocolo. De estos, el 90,90% se publicaron desde 2020 hasta junio de 2022 y la India tuvo el mayor número de publicaciones (27,27%). La mayoría de los estudios fueron experimentales o cuasi-experimentales (36,36%), y para la síntesis cualitativa se clasificaron en intervenciones educativas con tecnología 54,54% (n=6) y las que manejaban educación tradicional 45,45% (n=5). Conclusión: Se demostró que las intervenciones de educación en salud contribuyen a la mejora de la salud visual y ocular de los usuarios de computadora con Síndrome de Visión por Computador. Es necesario investigar y divulgar resultados sobre el tema, que contribuyan a los procesos de promoción de la salud visual y ocular, así como en la prevención del Síndrome de Visión por Computador en el ámbito laboral

Objetivo: Identificar intervenções de educação em saúde que demonstraram melhorias na saúde visual e ocular de trabalhadores usuários de computador com Síndrome de Visão de Computa-dor. Método: Revisão bibliográfica de artigos originais em espanhol e inglês, publicados entre 2017 e junho de 2022 nas bases de dados PubMed, Scopus, MEDLINE (EBSCO), Redalyc e Ovid. Resultados: Dos 1.695 artigos, 11 estavam de acordo com o protocolo. Destes, 90,90% foram publicados de 2020 a junho de 2022 e a Índia apresentou o maior número de publicações (27,27%). A maioria dos estudos foi experimental ou quase-experimental (36,36%), e para a síntese qualitativa foram classificados em intervenções educativas com tecnologia 54,54% (n=6) e aquelas que tratavam da educação tradicional 45,45% (n=5). Conclusão: As intervenções de educação em saúde demonstraram contribuir para a melhoria da saúde visual e ocular de usuários de computador com Síndrome de Visão de Computador. É preciso investigar e divulgar resulta-dos sobre o tema, que contribuam nos processos de promoção da saúde visual e ocular, bem como na prevenção da Síndrome da Visão do Computador no ambiente de trabalho

Advances in the correlation between digital eye strain and sleep quality in adolescents / 中国学校卫生

Abstract@#Digital eye strain can affect not only adolescents visual health, but also sleep quality. In order to provide a reference for safeguarding adolescents visual health and physical health, the paper reviews the direct correlation, feedback correlation, mediating role and the mechanisms between their digital eye strain and sleep quality, as well as proposes some strategies to reduce digital eye strain and improve sleep quality, such as screen time limits, adjusting the brightness and contrast of electronic screen devices, maintaining correct posture and viewing distance, increasing eye nutrition and protection, establishing a regular sleep routine, avoiding the use of electronic screen devices before bedtime, creating a comfortable and quiet sleep environment, and paying attention to the effects of diet and exercise.

Computer vision syndrome and associated factors in university students and teachers in Nampula, Mozambique.

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

Development of a new 17-item Asthenopia Survey Questionnaire using Rasch analysis.

AIM: To develop the 17-item Asthenopia Survey Questionnaire (ASQ)-17 by Rasch analysis, and to generate a predictiveness score. METHODS: Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective, cross-sectional study. Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options. RESULTS: Phase 1 assessed the original ASQ-19, adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item. Phase 2 deleted the 11th item. Phases 3 and 4 assessed the new ASQ-17. All the evaluation indexes of ASQ-17 were acceptable. The Infit and Outfit MnSq values of items were 0.67-1.48, the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40% and 1.50-1.80 in three dimensions. The curve peaks of scores in each dimension were separated and in the same order. The PSR and PSI values were 2.80 and 0.89, respectively. The mean scores of dimensions A (9.5±4.1 vs 3.5±3.2), B (7.3±3.3 vs 2.5±2.7), C (4.3±2.2 vs 1.4±2.0) and total (21.1±8.1 vs 7.4±7.0) in asthenopia participants were significantly higher than those without asthenopia (all P<0.001). The area under the curve in two groups was 0.899 (P<0.001). Youden's index was up to the maximum value of 0.784 when the cut-off value was 12.5. CONCLUSION: ASQ-17 has stronger option sorting and suitability than ASQ-19. It is an effective assessment tool for asthenopia with an optimal cut-off threshold value of 12.5, which is suitable for diagnosis and curative effect evaluation.

The changes and causes of asthenopia after ICL implantation.

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

Plant bioactive compounds alleviate photoinduced retinal damage and asthenopia: Mechanisms, synergies, and bioavailability.

The retina, an important tissue of the eye, is essential in visual transmission and sustaining adequate eyesight. However, oxidative stress and inflammatory reactions can harm retinal structure and function. Recent studies have demonstrated that exposure to light can induce oxidative stress and inflammatory reactions in retinal cells, thereby facilitating the progression of retinal damage-related diseases and asthenopia. Plant bioactive compounds such as anthocyanin, curcumin, resveratrol, lutein, zeaxanthin, epigallocatechin gallate, and quercetin are effective in alleviating retinal damage and asthenopia. Their strong oxidation resistance and unique chemical structure can prevent the retina from producing reactive oxygen species and regulating eye muscle relaxation, thus alleviating retinal damage and asthenopia. Additionally, the combination of these active ingredients produces a stronger antioxidant effect. Consequently, understanding the mechanism of retinal damage caused by light and the regulation mechanism of bioactive compounds can better protect the retina and reduce asthenopia.

Association Between Digital Device Utilization and Asthenopia Among Medical Students at King Khalid University.

Background Digital eye strain has become a serious concern due to the exponential increase in the usage of digital devices in recent years. This study aimed to assess the prevalence of digital eye strain among medical students. Methods A cross-sectional study was conducted over a period of one month, from 15th June to 15th July 2023, among undergraduate medical students at King Khalid University, Aseer Region, Saudi Arabia. An online survey was carried out using a structured questionnaire that was circulated through social media platforms (Facebook, Messenger, Instagram, Telegram, and WhatsApp). Results A total of 300 students were enrolled in this study. The prevalence of ocular problems, in descending order, was as follows: asthenopia had the highest prevalence at 30.5% (94), followed by conjunctivitis at 9.4% (29); squint, glaucoma, and cataract had lower prevalence rates of 3.9% (12), 1.6% (5), and 1.6% (5), respectively. The majority of participants used digital devices for fun (92.9% (286)) and study (95.5% (294)). Significant positive correlations were found between asthenopia and the hours spent on digital devices for studying (r = 0.161, p = 0.005), communication (r = 0.146, p = 0.011), and entertainment (r = 0.206, p < 0.001). Conclusions A substantial number of medical students are experiencing asthenopia. Prolonged usage of these devices is linked to a higher prevalence of asthenopia.

The Effect of Illumination on Positive Fusional Vergence.

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

Concordancia entre dos encuestas para el diagnóstico de fatiga visual digital en estudiantes de una universidad en Perú / Concordance between tow questionaries for the diagnosis of digital eye strain in students of a university in Peru

RESUMEN Objetivo: Obtener la frecuencia de fatiga visual digital (FVD) mediante dos cuestionarios entre los estudiantes de una universidad privada en Lima, Perú; para estimar el grado de concordancia entre ambos métodos. Métodos: Se realizó un estudio transversal en una muestra de 345 participantes mayores de 18 años, estudiantes de una universidad en Lima, Perú y que completaron el instrumento de recogida de datos. Los dos métodos usados para la medición de FVD fueron el cuestionario de Hayes que define un caso positivo para FVD con un puntaje igual o mayor a 20; y el cuestionario CVS-Q de Seguí, que define como positivo para FVD con un puntaje mayor a 6. Se estimó el coeficiente kappa de Cohen con su intervalo de confianza al 95% para medir la concordancia global y por estratos. Resultados: El cuestionario de Hayes identificó a 167 (48,4%) participantes con un diagnostico presuntivo de FVD, el cuestionario de Seguí identificó a 247 (71,6%) estudiantes. En el análisis de concordancia, el coeficiente Kappa de Cohen fue 0,45 (IC95%; 0,37 - 0,53) (p < 0,01) en el análisis global, considerado como moderado. Conclusiones: El grado de concordancia entre ambos métodos fue moderado, el instrumento de Seguí identificó una mayor proporción de estudiantes universitarios con FVD.

ABSTRACT Objective: To obtain the frequency of digital visual fatigue (DVF) using two questionnaires among students of a private university in Lima, Peru; to estimate the degree of agreement between both methods. Methods: A cross-sectional study was conducted in a sample of 345 participants over 18 years old, students of a university in Lima, Peru and who completed the data collection instrument. The two methods used for the measurement of DVF were the Hayes questionnaire, which defines a positive case for DVF with a score equal to or greater than 20; and the Seguí CVS-Q questionnaire, which defines a positive case for DVF with a score greater than 6. The Cohen's kappa coefficient with its 95% confidence interval was estimated to measure the overall agreement and by strata. Results: The Hayes questionnaire identified 167 (48.4%) participants with a presumptive diagnosis of DVF, the Seguí questionnaire identified 247 (71.6%) students. In the concordance analysis, Cohen's Kappa coefficient was 0.45 (95%CI; 0.37 - 0.53) (p < 0.01) in the overall analysis, considered moderate. Conclusion: The degree of concordance between both methods was moderate, the Seguí instrument identified a higher proportion of university students with DVF.

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.

Asthenopia prevalence and vision impairment severity among students attending online classes in low-income areas of western China during the COVID-19 pandemic.

INTRODUCTION: This study explored the impact of online learning during the coronavirus disease 2019 (COVID-19) pandemic on asthenopia and vision impairment in students, with the aim of establishing a theoretical basis for preventive approaches to vision health. METHODS: This balanced panel study enrolled students from western rural China. Participant information was collected before and during the COVID-19 pandemic via questionnaires administered at local vision care centres, along with clinical assessments of visual acuity. Paired t tests and fixed-effects models were used to analyse pandemic-related differences in visual status. RESULTS: In total, 128 students were included (mean age before pandemic, 11.82 ± 1.46 years). The mean total screen time was 3.22 ± 2.90 hours per day during the pandemic, whereas it was 1.97 ± 1.90 hours per day in the pre-pandemic period (P<0.001). Asthenopia prevalence was 55% (71/128) during the pandemic, and the mean visual acuity was 0.81 ± 0.30 logarithm of the minimum angle of resolution; these findings indicated increasing vision impairment, compared with the pre-pandemic period (both P<0.001). Notably, asthenopia prevalence increased by two- to three-fold, compared with the pre-pandemic period. An increase in screen time while learning was associated with an increase in asthenopia prevalence (P=0.034). CONCLUSION: During the COVID-19 pandemic, students spent more time on online classes, leading to worse visual acuity and vision health. Students in this study reported a significant increase in screen time, which was associated with increasing asthenopia prevalence and worse vision impairment. Further research is needed regarding the link between online classes and vision problems.

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.

The relationship between visual display terminal usage at work and symptoms related to computer vision syndrome.

Background: Although it is well known that the usage of visual display terminal (VDT) at the workplace causes computer vision syndrome (CVS), previous studies mainly focused on computer use and the health of white-collar workers. In this study, we explored the relationship between the usage of VDT including various devices, and symptoms related to CVS in a large population including pink-collar workers and blue-collar workers. Methods: 21,304 wage workers over the age of 20 years were analyzed from the 6th Korean Working Conditions Survey. To investigate the association between VDT use at work and symptoms related to CVS among wage workers, odds ratios (ORs) and 95% confidence interval (CI) were calculated by multivariate logistic regression models. Results: In the group with the highest VDT usage at work, the OR of headache/eyestrain was 2.16 (95% CI: 1.86-2.52). The OR of suspected CVS patients was significantly increased in the highest group of usage of VDT at work (OR: 1.69; 95% CI, 1.39-2.06). Compare with the reference group, the OR for headache/eyestrain in the highest group of VDT usage was 2.81 (95% CI: 2.13-3.70) in white-collar workers, 1.78 (95% CI: 1.32-2.40) in pink-collar workers, and 1.59 (95% CI: 1.18-2.15) in blue-collar workers. Conclusions: We observed a relationship in which the use of VDT in the workplace increases the risk of headache/eyestrain regardless of occupational classification. Our findings emphasize the importance of paying attention to the health of VDT workers and making plans to improve their working conditions.

Eye discomfort at close work in Portuguese university students: A comparative analysis between the pre-COVID and confinement period.

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.