Orbicularis oculi muscle activity during computer reading under different degrees of artificially-induced aniseikonia.

Background: Aniseikonia is a binocular vision disorder that has been associated with asthenopic symptoms. However, asthenopia has been evaluated with subjective tests that make difficult to determine the level of aniseikonia. This study aims to objectively evaluate the impact of induced aniseikonia at different levels on visual fatigue by measuring the orbicularis oculi muscle activity in the dominant and non-dominant eyes while performing a reading task. Methods: Twenty-four collegiate students (24.00 ± 3.86 years) participated in this study. Participants read a passage for 7 minutes under four degrees of aniseikonia (0%, 3%, 5% and 10%) at 50 cm. Orbicularis oculi muscle activity of the dominant and non-dominant eye was recorded by surface electromyography. In addition, visual discomfort was assessed after each task by completing a questionnaire. Results: Orbicularis oculi muscle activity increased under induced aniseikonia (i.e., greater values for the 10% condition in comparison to 0%, and 3% conditions (p = 0.034 and p = 0.023, respectively)). No statistically significant differences were observed in orbicularis oculi muscle activity for the time on task and between the dominant and non-dominant eyes. Additionally, higher levels of subjective visual discomfort were observed for lower degrees of induced aniseikonia. Conclusion: Induced aniseikonia increases visual fatigue at high aniseikonia degrees as measured by the orbicularis oculi muscle activity, and at low degrees as measured with subjective questionnaires. These findings may be of relevance to better understand the visual symptomatology of aniseikonia.

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.

High-Frequency Discrete-Interval Binary Sequence in Asynchronous C-VEP-Based BCI for Visual Fatigue Reduction.

In code-modulated visual evoked potential (c-VEP) based BCI systems, flickering visual stimuli may result in visual fatigue. Thus, we introduced a discrete-interval binary sequence (DIBS) as visual stimulus modulation, with its power spectrum optimized to emphasize high-frequency components (40 Hz-60 Hz). 8 and 17 subjects participated, respectively, in offline and online experiments on a 4-target asynchronous c-VEP-based BCI system designed to realize a high positive predictive value (PPV), a low false positive rate (FPR) during idle states, and a high true positive rate (TPR) in control states, while minimizing visual fatigue level. Two visual stimuli modulations were introduced and compared: a maximum length sequence (m-sequence) and the high-frequency discrete-interval binary sequence (DIBS). The decoding algorithm was compared among the canonical correlation analysis (CCA), the task-related component analysis (TRCA), and two approaches of sub-band component weight calculation (the traditional method and the proportional method) for FBCCA and FBTRCA. In the online experiments, the average PPV, FPR and TPR achieved, respectively [Formula: see text], [Formula: see text], [Formula: see text] with m-sequence, while [Formula: see text], [Formula: see text] and [Formula: see text] with DIBS. Estimated by objective eye-related metrics and a subjective questionnaire, the visual fatigue in DIBS cases is significantly smaller than that in m-sequence cases. In this study, the feasibility of a novel modulation approach for visual fatigue reduction was proved in an asynchronous c-VEP system, while maintaining comparable performance to existing methods, which provides further insights towards enhancing this field's long-term viability and user-friendliness.

Investigate the Neuro Mechanisms of Stereoscopic Visual Fatigue.

Stereoscopic visual fatigue (SVF) due to prolonged immersion in the virtual environment can lead to negative user experience, thus hindering the development of virtual reality (VR) industry. Previous studies have focused on investigating the evaluation indicators associated with SVF, while few studies have been conducted to reveal the underlying neural mechanism, especially in VR applications. In this paper, a modified Go/NoGo paradigm was adopted to induce SVF in VR environment with Go trials for maintaining participants' attention and NoGo trials for investigating the neural effects under SVF. Random dot stereograms (RDSs) with 11 disparities were presented to evoke the depth-related visual evoked potentials (DVEPs) during 64-channel EEG recordings. EEG datasets collected from 15 participants in NoGo trials were selected to conduct individual processing and group analysis, in which the characteristics of the DVEPs components for various fatigue degrees were compared and independent components were clustered to explore the original cortex areas related to SVF. Point-by-point permutation statistics revealed that DVEPs sample points from 230 ms to 280 ms (component P2) in most brain areas changed significantly when SVF increased. Additionally, independent component analysis (ICA) identified that component P2 which originated from posterior cingulate cortex and precuneus, was associated statistically with SVF. We believe that SVF is rather a conscious status concerning the changes of self-awareness or self-location awareness than the performance reduction of retinal image processing. Moreover, we suggest that indicators representing higher conscious state may be a better indicator for SVF evaluation in VR environments.

Study of the Immediate Effects of Autostereoscopic 3D Visual Training on the Accommodative Functions of Myopes.

Purpose: Stereoscopic viewing has an impact on ocular dynamics, but its effects on accommodative functions are not fully understood, especially for autostereoscopic viewing. This study aimed to investigate the changes in dynamic accommodative response, accommodative amplitude, and accommodative facility of myopes after autostereoscopic visual training. Methods: We enrolled 46 adults (men = 22 and women = 24; age = 21.5 ± 2.5 [range = 18-25] years, spherical equivalent: -4.52 ± 1.89 [-8.88 to -1.75] diopters [D]) who visited the Eye & ENT Hospital of Fudan University. The study population was randomly divided into three-dimensional (3D) and two-dimensional (2D) viewing groups to watch an 11-minute training video displayed in 3D or 2D mode. Dynamic accommodative response, accommodative facility, and accommodative amplitude were measured before, during, and immediately after the training. Accommodative lag and the variability of accommodation were also analyzed. Visual fatigue was evaluated subjectively using a questionnaire. Results: Accommodative lag decreased from 0.54 ± 0.29 D to 0.42 ± 0.32 D (P = 0.004), whereas accommodative facility increased from 10.83 ± 4.55 cycles per minute (cpm) to 13.15 ± 5.25 cpm (P < 0.001) in the 3D group. In the 2D group, there was no significant change in the accommodative lag (P = 0.163) or facility (P = 0.975), but a decrease in accommodative amplitude was observed (from 13.88 ± 3.17 D to 12.71 ± 2.23 D, P = 0.013). In the 3D group, the accommodative response changed with the simulated target distance. Visual fatigue was relatively mild in both groups. Conclusions: The immediate impact of autostereoscopic training included a decrease in the accommodative lag and an increase in the accommodative facility. However, the long-term effects of autostereoscopic training require further exploration.

How Do Different Digital Displays Affect the Ocular Surface?

SIGNIFICANCE: Digital display use has been accepted as a contributing factor to dry eye disease. Nowadays, plenty of new models of digital displays have been developed, and the differences in their nature and the ways in which they are set and used may contribute to differences in the eye-related problems they cause. PURPOSE: This study aimed to analyze the differences in ocular surface, tear film, and visual fatigue parameters after reading on different digital displays, with and without initial instillation of artificial tears. METHODS: Thirty-one healthy individuals ranging in age from 20 to 26 years (mean ± standard deviation, 21.26 ± 1.73 years) were included in this prospective clinical study. Subjects' ocular surface, tear film, and visual fatigue parameters were assessed after reading for 15 minutes on a laptop computer, tablet, e-reader, and smartphone with matching characteristics and a baseline measurement. Measurements were taken with and without the instillation of artificial tears before the reading tasks and included the Ocular Surface Disease Index questionnaire, the Computer Vision Syndrome Questionnaire, tear meniscus height, the Schirmer I test, noninvasive keratograph break-up time, osmolarity, bulbar redness, and pupil size. RESULTS: Statistically significant differences in the Ocular Surface Disease Index, Computer Vision the Syndrome Questionnaire, tear meniscus height, the Schirmer I test, noninvasive keratograph break-up time, osmolarity, and bulbar redness were obtained when comparing the displays (P < .05). Best results were obtained with the smartphone and the e-reader. Conversely, the computer produced the highest disturbance on the ocular surface and tear film. Finally, the instillation of artificial tears revealed no statistical improvement of ocular surface or tear film parameters for the same device (P > .05). CONCLUSIONS: Taking into account the clinical tests for dry eye diagnosis, the smartphone may be considered as the least disturbing display, producing lower dry eye signs and symptoms in comparison with other devices.

Effects of a blue-blocking screen filter on accommodative accuracy and visual discomfort.

INTRODUCTION: The prescription of blue-blocking (B-B) filters for the management of visual symptoms and signs associated with the use of electronic devices is routinely performed by eye care specialists. However, the utility of B-B filters is a matter of debate and discussion by the scientific community due to the lack of evidence supporting their use. Here, we aimed to determine the effects of using B-B filters on the dynamics of the accommodative response and pupil size and perceived levels of visual discomfort, while performing a 30-min reading task at a close distance in subjects who routinely use electronic devices. METHODS: Nineteen healthy young adults (22.0 ± 2.7 years) read two 30-min passages on a computer screen placed at 50 cm, either while using a commercially available B-B filter or without any filter on two different days. The magnitude and variability of both the accommodative response and pupil size were dynamically measured for 60 s using the WAM-5500 open field autorefractometer at 4-5, 9-10, 14-15, 19-20, 24-25, and 29-30 min into the trial. The perceived levels of visual discomfort were also obtained. RESULTS: The lag and variability of accommodation were insensitive to the blue light level (p = 0.34 and 0.62, respectively). There was a time-on-task effect for the variability of accommodation, showing greater instability over time regardless of the blue light level. The use of the B-B filter was associated with improved reading speed (p = 0.02), with an increase of 16.5 words per minute. However, it was not associated with any significant change in pupil dynamics or the perceived levels of visual discomfort (p> 0.05 in both cases). CONCLUSIONS: Our data showed that the use of a B-B filter had no effect on accommodative dynamics or visual symptomatology. Based on these findings, there is no support for the prescription of B-B filters to attenuate the visual symptoms and signs associated with the use of electronic devices in healthy young adults.

An investigation of low power convex lenses (adds) for eyestrain in the digital age (CLEDA).

INTRODUCTION: Digital eye strain (DES; computer vision syndrome) is a common cause of symptoms when viewing digital devices. Low-powered convex lenses (adds) have been recommended for the condition and "accommodative support" designs developed on this premise. The present research reports the extent to which dry eye is present in this population and the effect of convex lenses on symptoms and visual performance. METHODS: The CVS-Q instrument was used to select pre-presbyopic adults with the symptoms of DES. Participants received a full eye examination including an assessment of dry eye with a modified SANDE questionnaire and using DEWS I criteria. The immediate effect of low-powered convex lenses (low adds: +0.50D, +0.75D, +1.25D) was investigated using subjective preference and a double-masked comparison with plano lenses with the Wilkins Rate of Reading Test (WRRT). Throughout this testing, participants wore their full distance refractive correction, based on non-cycloplegic retinoscopy and subjective refraction. RESULTS: The signs and symptoms of dry eye were frequently present. Most participants reported a subjective preference for low adds, with +0.75D the most commonly preferred lens. Low adds (+0.50D and +0.75D; but not +1.25D) were associated with significantly improved performance at the WRRT. One quarter of participants read more than 10% faster with these additional convex lenses. CONCLUSIONS: The study population was aged 20-40y and mostly worked on desktop computers. It is possible that +1.25D add may be more advantageous for people who are older or work more at closer viewing distances. Many symptomatic users of digital devices report a preference for low adds and use of these lenses is often associated with an improvement in reading performance.

Accommodative asthenopia among Romanian computer-using medical students-A neglected occupational disease.

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

Assessment of eye fatigue caused by head-mounted displays using eye-tracking.

BACKGROUND: Head-mounted displays (HMDs) and virtual reality (VR) have been frequently used in recent years, and a user's experience and computation efficiency could be assessed by mounting eye-trackers. However, in addition to visually induced motion sickness (VIMS), eye fatigue has increasingly emerged during and after the viewing experience, highlighting the necessity of quantitatively assessment of the detrimental effects. As no measurement method for the eye fatigue caused by HMDs has been widely accepted, we detected parameters related to optometry test. We proposed a novel computational approach for estimation of eye fatigue by providing various verifiable models. RESULTS: We implemented three classifications and two regressions to investigate different feature sets, which led to present two valid assessment models for eye fatigue by employing blinking features and eye movement features with the ground truth of indicators for optometry test. Three graded results and one continuous result were provided by each model, respectively, which caused the whole result to be repeatable and comparable. CONCLUSION: We showed differences between VIMS and eye fatigue, and we also presented a new scheme to assess eye fatigue of HMDs users by analysis of parameters of the eye tracker.

Digitalization versus immersion: performance and subjective evaluation of 3D perception with emulated accommodation and parallax in digital microsurgery.

In the visually challenging situation of microsurgery with many altered depth cues, digitalization of surgical systems disrupts two further depth cues, namely focus and parallax. Although in purely optical surgical systems accommodation and eye movements induce expected focus and parallax changes, they become statically fixed through digitalization. Our study evaluates the impact of static focus and parallax onto performance and subjective 3D perception. Subjects reported decreased depth realism under static parallax and focus. Thus surgeons' depth perception is impacted further through digitalization of microsurgery, increasing the potential of artificial stereo-induced fatigue.

Effects of Optical Correction Method on the Magnitude and Variability of Accommodative Response: A Test-retest Study.

SIGNIFICANCE: The present study addresses the accommodative response and its dependence on the type of optical correction used. The results are discussed relative to their possible implications for myopia progression and visual fatigue. PURPOSE: The accommodative response has been investigated owing to its possible relationship with the onset and progression of myopia and visual fatigue. This study explored the influence of wearing soft contact lenses in comparison with spectacles in terms of magnitude and variability of accommodation. In addition, we analyzed the intersession and intermethod repeatability. METHODS: Dynamic accommodative response was recorded during 30-second epochs, at five different distances (50, 40, 33, 25, and 20 cm), in 21 individuals (mean refractive error ± SD, -0.79 ± 1.39 D) while wearing either soft contact lenses or spectacles on two different days. To assess repeatability, a second identical intervention was conducted. RESULTS: Higher lags of accommodation were obtained with the use of soft contact lenses in comparison with the spectacle condition (P = .04, partial η [ηp] = 0.204), and similarly, a higher variability of accommodation at near distances was found during the soft contact lens measurement (P < .001, ηp = 0.647). There was a strong intersession repeatability at all the distances tested for both optical correction methods. CONCLUSIONS: The higher accommodative lag and fluctuations found while wearing soft contact lenses in comparison with spectacles may help to understand the mechanisms underlying myopia progression and asthenopia. These findings may be also considered when testing the accommodative response in research settings. Our test-retest design confirmed that there is a very good intersession repeatability for all the distances in both optical correction methods.

IR-camera-based measurements of 2D/3D cognitive fatigue in 2D/3D display system using task-evoked pupillary response.

This study was carried out to evaluate a method used to measure three-dimensional (3D) cognitive fatigue based on the pupillary response. This technique was designed to overcome measurement burdens by using non-contact methods. The pupillary response is related to cognitive function by a neural pathway and may be an indicator of 3D cognitive fatigue. Twenty-six undergraduate students (including 14 women) watched both 2D and 3D versions of a video for 70 min. The participants experienced visual fatigue after viewing the 3D content. Measures such as subjective rating, response time, event-related potential latency, heartbeat-evoked potential (HEP) alpha power, and task-evoked pupillary response (TEPR) latency were significantly different. Multitrait-multimethod matrix analysis indicated that HEP and TEPR latency measures had stronger reliability and higher correlations with 3D cognitive fatigue than other measures. TEPR latency may be useful for quantitatively determining 3D visual fatigue, as it can be easily used to evaluate 3D visual fatigue using a non-contact method without measuring burden.

Association between Retinal Nerve Fiber Layer Thickness and Eye Fatigue.

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

The effects of reflected glare and visual field lighting on computer vision syndrome.

BACKGROUND: Computer vision syndrome is common and affects performance of visual tasks. Background illumination, light source, light compensation, position of the display, contrast and glare are environmental factors associated with computer vision syndrome. The aim of this study is to investigate the effects of reflected glare and visual field lighting on computer vision syndrome. METHODS: In a reflected glare experiment, participants performed a two-hour visual task using a glossy, matte, or glare-free surface display in two visual environments (normal, glare). In a visual field lighting experiment, participants performed the visual task in dim lighting, uneven supplementary lighting, or uniform supplementary lighting. Visual function parameters, including critical fusion frequency, heterophoria, amplitude of accommodation and accommodative facility were evaluated by the investigators and a visual fatigue questionnaire was completed before and after the visual task. Visual performance was also recorded. In addition, the variation of pupil size under different lighting conditions was analysed. RESULTS: Critical fusion frequency was the only visual function parameter which decreased significantly after the visual task. The questionnaire score was significantly higher in a glare environment and was lower when the task was performed using a glare-free display. Visual performance was significantly worse in the glossy display group. The increment in the questionnaire score was smaller in the uniform supplementary lighting group. Visual performance was significantly worse in the dim lighting or uneven supplementary lighting group, but not in the uniform supplementary lighting group. Variation in pupil size was significantly greater in the dim lighting condition than in the supplementary lighting condition. CONCLUSION: Critical fusion frequency is an effective indicator of computer vision syndrome. Glare-free displays could alleviate visual fatigue and preserve visual performance. Uniform supplementary lighting could decrease variation in pupil size and prevent eye strain.

Deficient vergence prism adaptation in subjects with decompensated heterophoria.

Vergence prism adaptability was evaluated in subjects with high symptomatic and asymptomatic heterophoria and compared to individuals with a heterophoria within normal range (the control group). A computer haploscope was used to measure phoria values and changes in the eye position after introducing 6 prism diopters base out in front of the right eye. Phoria values were measured with a nonius paradigm every minute for a period of 10 minutes during adaptation. The results showed that subjects with symptomatic heterophoria are characterized by a lower rate of prism adaptation and adapted to a smaller extent with respect to the control group. The group with high but asymptomatic heterophoria showed prolonged adaptation time but after several minutes of binocular viewing the subjects were able to adapt to the prism to a level similar to the control group. These findings suggest that an impairment in the slow vergence control system may be responsible for the inability to fully reduce vergence effort, which results in poor vergence ranges and asthenopic symptoms during prolonged viewing.

Ocular and visual discomfort associated with smartphones, tablets and computers: what we do and do not know.

Smartphone and tablet use in Australia and worldwide is reaching saturation levels and associated visual and ocular discomfort such as headaches, eyestrain, dry eyes and sore eyes are widespread. This review synthesises the available literature and considers these symptoms in the context of a binocular vision and/or ocular surface aetiology. Eye discomfort with smartphones and tablets is discussed alongside similar symptoms reported with desktop computer use. Handheld devices differ from computers in viewing position and distance, screen size and luminance, and patterns of use. Accommodation is altered with handheld device use, with increased lag and decreased amplitude. Smartphone and tablet use results in reduced fusional convergence and possibly a receded near point of convergence. This is similar to what happens with computer use. Findings related to blink rate with smartphone and tablet use are contradictory, perhaps due to the influence of task difficulty, and there is limited evidence related to blink amplitude. Reduced blink rate and amplitude are consistently reported with computer use. Use of handheld digital devices, like computers, may adversely impact tear stability. There is insufficient evidence to support the impact of handheld devices on tear volume, although this is reduced with computer use. The available literature does not conclusively link eye and visual discomfort symptoms reported with handheld digital devices, with changes in binocular vision, blinking or ocular surface. However, there is a gap in our understanding of symptoms which occur with smartphone and tablet use in the context of how these devices are used. In addition, studies are required in high users such as teenagers, and in patients with dry eye or accommodative/binocular vision anomalies, all of whom may have a higher risk of symptoms. A better understanding of symptom aetiology can guide clinical advice to minimise adverse impacts on visual and ocular surface health and discomfort.

Probabilistic assessment of visual fatigue caused by stereoscopy using dynamic Bayesian networks.

PURPOSE: In this article, we develop a dynamic Bayesian network (DBN) model to measure 3D visual fatigue. As far as our information goes, this is the first adaptation of a DBN structure-based probabilistic framework for inferring the 3D viewer's state of visual fatigue. METHODS: Our measurement focuses on the interdependencies between each factor and the phenomena of visual fatigue in stereoscopy. Specifically, the implementation of DBN with using multiple features (e.g. contextual, contactless and contact physiological features) and dynamic factor provides a systematic scheme to evaluate 3D visual fatigue. RESULTS: In contrast to measurement results between the mean opinion score (MOS) and Bayesian network model (with static Bayesian network and DBN), the visual fatigue in stereoscopy at time slice t is influenced by a dynamic factor (time slice t-1). In the presence of dynamic factors (time slice t-1), our proposed measuring scheme based on DBN is more comprehensive. CONCLUSION: (i) We cover more features for inferring the visual fatigue, more reliably and accurately; (ii) at different time slices, the dynamic factor features are significant for inferring the visual fatigue state of stereoscopy.

Correlation between handheld digital device use and asthenopia in Chinese college students: a Shanghai study.

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

Effects of AR Display Context Switching and Focal Distance Switching on Human Performance.

In augmented reality (AR) environments, information is often distributed between real world and virtual contexts, and often appears at different distances from the user. Therefore, to integrate the information, users must repeatedly switch context and refocus the eyes. To focus at different distances, the user's eyes must accommodate, which when done repeatedly can cause eyestrain and degrade task performance. An experiment was conducted that examined switching context and focal distance between a real and an AR environment, using a text-based visual search task and a monocular optical see-through AR display. Both context switching and focal distance switching resulted in significantly reduced performance. In addition, repeatedly performing the task caused visual fatigue to steadily increase. Performance was particularly poor for virtual text presented at optical infinity, and for target letters that participants tried to read before their eyes had completely accommodated to a new focal distance. The results show that context switching and focal distance switching are important AR user interface design issues.