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Purpose: This study aimed to determine the prevalence, risk factors, symptoms, and awareness of computer vision syndrome (CVS) among medical students during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A cross-sectional observational study was conducted among 283 undergraduate medical students at a tertiary healthcare center. An electronic survey was conducted to collect the data. Data were analyzed using Statistical Package for Social Sciences (SPSS version 23). The Chi-square test (Fisher's exact test when required) was used to study the significance of associations. A P value <0.05 was considered statistically significant. Results: A high prevalence of CVS was observed in which 92% reported at least one symptom while using a digital device, the most frequent being eye strain (49%). Among extraocular complaints, joint pain in the wrist and fingers was most frequent. Significant association (P < 0.05) of CVS was found with increased duration of digital device usage, refractive error, use of glasses or contact lens, preexisting dry eye disease, and use of topical eye drops. 37% of the participants were aware of the 20-20-20 rule, while only 11% followed it. Conclusion: CVS is a common health concern among medical students. Hence, to increase the productivity of work, significant risk factors need to be addressed and awareness must be raised. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study was to compare the difference in binocular visual function for high and low-moderate myopes before and after femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Methods: Thirty-three subjects (17 males and 16 females) were divided into two groups according to their preoperative refractive errors in spherical equivalent (SE): low-moderate myopia group (SE ≥−6.00 D) and high myopia group (SE <−6.00 D). The binocular visual function including accommodative amplitude (AA), accommodative facility (AF), positive and negative relative accommodation (PRA and NRA, respectively), horizontal phoria measurement, positive and negative fusion vergence, accommodative–convergence over accommodation (AC/A) ratio, and stereopsis were assessed with the best-corrected vision before patients received FS-LASIK and 7 and 30 days after the surgery. Repeated measures analysis of variance (ANOVA) was applied to study the change in binocular visual function. Results: The AF values in both groups were significantly reduced after 7 days of FS-LASIK (baseline vs. day 7 (mean): high myopia group: 7.85 vs. 5.62 cpm, repeated ANOVA, P = 0.01; low-moderate myopia group: 5.95 vs. 4.40 cpm, repeated ANOVA, P = 0.04). This change returned to the baseline level 30 days after the operation. In addition, the horizontal phoria values in both groups were significantly reduced for both distant (P = 0.019 and P = 0.001, respectively) and near (P = 0.003 and P = 0.049, respectively) 7 days after the operation, but they rebound to preoperative state after 30 days. Conclusion: A transient change in binocular visual function was noticed after 7 days of FS-LASIK operation, which could cause symptoms of asthenopia. Our data showed all the binocular visual functions returned to baseline level after 30 days of operation. [ABSTRACT FROM AUTHOR]

Purpose: This study was undertaken to identify the prevalence of symptoms related to the use of display devices and contributing factors in children engaged in distance learning during the COVID-19 pandemic.Methods: An online electronic survey form was prepared using Google Forms (Alphabet Co., Mountain View, CA) and sent to parents of children under the age of 18 years engaged in distance learning during the COVID-19 pandemic. The types of display devices children use, how often such devices are used, the symptoms of digital eye strain, and the severity and frequency of the symptoms were recorded, and the associations between the factors were analyzed.Results: A total of 692 participants were included. The mean age of the children was 9.72±3.02 years. The most common display devices used were personal computers (n=435, 61.7%) for online classes and smartphones (n=400, 57.8%) for nonacademic purposes. The mean duration of display device use was 71.1±36.02 min without a break and 7.02±4.55 h per day. The most common reported symptom was headache (n=361, 52.2%). Of the participants, 48.2% (n=332) reported experiencing 3 or more symptoms. The multivariate analysis detected that being male (P=0.005) and older age (P=0.001) were independent risk factors for experiencing 3 or more symptoms.Conclusion: The increasing use of digital devices by children is exacerbating the problem of digital eye strain in children as a side effect of online learning. Public awareness should be improved. [ABSTRACT FROM AUTHOR]

Purpose: To describe the variables that may be utilized in the optimization of three-dimensional heads-up surgeries (3D-HUS) for achieving better ergonomics among ophthalmic surgeons.Methods: A.cross-sectional study was conducted at the operating room of a tertiary eye care center, equipped with an ARTEVO 800 3D surgical microscope and display monitor. The parameters noted were monitor height (MH), surgeon eye-to-floor distance (ETFD), surgeon eye-to-monitor distance (ETMD) and viewing tilt (VT) angle. The neck and eye strain of the surgeon and assistant were scored as per Borg's CR-10 scale, before and after surgeries.Results: Thirty (13 right, 17 left) eye surgeries were analyzed. The minimum ETMD was 51 inches (in) and the eye strain reduced with shorter ETMD (within the range 51 inches to 83 inches).The VT and ETFD were higher for right eye surgeries. The optimum MH was between 50 and 55 in. Overall, the neck strain and eye strain were in the range of 0-3 and 0-1, respectively.Conclusion: The various parameters affecting the 3D image quality, neck and eye strain are chair height, VT angle, eye centration, monitor distance, laterality of the eye, and room illumination. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe the clinical characteristics and risk factors of short tear film break-up time (TBUT) type of dry eye disease and compare it with other types of dry eye diseases.Methods: This cross-sectional study included 570 patients (≥ 20 years) from the outpatient department using systematic random sampling.Results: The age-adjusted prevalence of short TBUT type of dry eye disease was 5.4% (95% confidence interval: 3.2-6.8%). There was no difference (P > 0.05) between the total and subscale scores of the Ocular Surface Disease Index® questionnaire between patients with short TBUT and those with aqueous tear deficiency. Both these groups differed significantly (P < 0.05) in the findings of TBUT, Schirmer I test, and Lissamine green staining score. The common symptoms in patients with short TBUT type of dry eye disease were eye fatigue (25.4%), heaviness in the eye (19.7%), and an uncomfortable sensation (14.1%). The symptoms in the aqueous tear deficiency group were light sensitivity (28.2%), dryness (19.2%), burning (13.0%), foreign body sensation (12.8%), and blurring of vision (14.1%). The risk factors associated with short TBUT type of dry eye disease were the presence of meibomian gland dysfunction (odds ratio: 3.759 [95% confidence interval: 2.135-6.618], P < 0.0001) and female sex [odds ratio: 1.954 (95% confidence interval: 1.042-3.667), P = 0.037].Conclusion: Patients with short TBUT type of dry eye disease have symptom severity similar to aqueous tear-deficient dry eyes, but the pattern is different. The finding of this type of dry eye disease in India indicates its global presence, and ophthalmologists should consider it in their differential diagnoses. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine prevalence, symptoms frequency and associated risk factors of digital eye strain (DES) among children attending online classes during COVID-19 pandemic.Methods: The online electronic survey form was prepared on the Google app. Children/parents were asked to indicate the total duration of digital device use before and during COVID era. The symptoms of DES, its severity and frequency were recorded & measured with the Computer Vision Syndrome Questionnaire.Results: Two hundred and sixty one parents responded to the questionnaire, of these 217 were complete. Mean age of children was 13 ± 2.45 years. Mean duration of digital device used during COVID era was 3.9 ± 1.9 h which is more than pre COVID era (1.9 ± 1.1 h, P = <0.0001). 36.9% (n = 80) were using digital devices >5 h in COVID era as compared to 1.8% (n = 4) before COVID era. The most common digital device used were smartphones (n = 134, 61.7%). One hundred and eight children (49.8%) were attending online classes for >2 h per day. Prevalence of DES in our cohort is 50.23% (109/217). Of these 26.3% were mild, 12.9% moderate and 11.1% of severe grade. Most common symptoms were itching and headache (n = 117, 53.9%). Multivariate analysis revealed age >14 years (P = 0.04), male gender (P = 0.0004), smartphone use (P = 0.003), use of device >5 h (P = 0.0007) and mobile games >1 h/day (P = 0.0001) as independent risk factors for DES in children.Conclusion: There is an increased prevalence of DES among children in COVID era. Parents should be considerate about duration, type and distance of digital device use to avoid DES symptoms in children. [ABSTRACT FROM AUTHOR]

Purpose: Since the declaration of the lockdown due to COVID-19, the usage of digital devices has gone up across the globe, resulting in a challenge for the visual systems of all ages. The purpose of this study is to assess the impact of the lockdown on digital device usage, and consequently, the ocular surface health implications and circadian rhythm abnormalities related to digital eye strain.Methods: An open online survey was sent through various social media platforms and was open for a period of 2 weeks.Results: A total of 407 usable responses were obtained; the average age of respondents was 27.4 years. Typically, 93.6% of respondents reported an increase in their screen time since the lockdown was declared. The average increase in digital device usage was calculated at about 4.8 ± 2.8 h per day. The total usage per day was found to be 8.65 ± 3.74 hours. Sleep disturbances have been reported by 62.4% of people. Typically, 95.8% of respondents had experienced at least one symptom related to digital device usage, and 56.5% said that the frequency and intensity of these symptoms increased since the lockdown was declared.Conclusion: The study highlighted the drastic increase in use of digital devices after the initiation of the COVID-19 lockdown, and along with it, the slow deterioration of ocular health across all age groups. Awareness about prevention of digital eye strain should be stressed, and going forward, measures to bring these adverse effects to a minimum should be explored. [ABSTRACT FROM AUTHOR]

Asthenopic and related symptoms are a major problem in school-going children. With the inception of computers and other gadgets for near work, the unseen problems arising out of constant and continuous near work, are on the rise. Parents wander from pillar to post, seeking respite from their child's constant complaints from near work; but despite best spectacle correction and avoidance of excessive near work, the complaints continue. Studies have shown that the majority of these problems arise from defects in accommodation, even in a young child. Therefore, various aspects of accommodation deficiencies have to be studied clinically, detected, and treated to ameliorate the symptoms. [ABSTRACT FROM AUTHOR]

Did the authors perform autorefraction before cycloplegic refraction as well? Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Dear Editor, The global coronavirus pandemic contributed to a silent myopic pandemic and digital eye strain among children.[[1]] Myopia is the most common refractive error worldwide, and the rise in its number of cases during the lockdown has also added to the global prevalence of myopia.[[2]] Aside from conventional methods, the use of low-dose atropine in controlling myopia progression has been well documented. [Extracted from the article]

Since the commencement of the coronavirus disease 2019 (COVID-19) pandemic, governments have imposed unmatched public health measures such as travel bans, workplace distancing, and closure of schools to reduce the size of the outbreak as well as its peak.[[1]] School closure definitely protects children from COVID-19. Eye pain, foreign body sensation, and watering were significantly associated with over 4 h screen time, while spending over 5 h a day using a display device was found to be a significant risk factor for eye fatigue and eye redness. [Extracted from the article]

It is important to consider some evidence-based approaches to prevent and decrease DES symptoms, like blinking often, taking breaks from screen time, set devices to night mode, and enlarging screen type sizes for easier reading.[[2]] Also, more people should be made aware of the preventive measures that can be taken to prevent DES. CVS, also known as Digital Eye Strain (DES), describes a group of eye- and vision-related problems that result from prolonged use of electronic gadgets. [Extracted from the article]