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Electronic displays, including laptops, tablets, and smartphones, have dramatically altered the way information is accessed and become significant factors in human daily life. They interfere with the blink rate and increase dry eye symptoms, which lead to more discomfort compared to hard copy while reading. Digital eye strain occurs when an individual suffers from symptoms, or they are exacerbated, while performing a task requiring digital screen viewing. This study assessed the tear film status immediately following reading on a laptop computer screen versus an identical hard copy. Thirty young adults with normal ocular health and reporting no significant symptoms of dry eye (ocular surface disease index (OSDI) score < 13 and non-invasive tear break-up time (NITBUT) > 10 seconds) read a text as hard copy and on a laptop computer screen for 30 min on separate days in a random sequence in a controlled reading experimental condition. The texts were matched in size and contrast and presented at a viewing distance of 40 cm. The NITBUT and strip meniscometry tube tests were administered at baseline and after reading in both conditions. The median baseline NITBUT decreased from 13.0 s to 10.0 s (P < 0.001) after hardcopy reading and to 7.0 (P < 0.001) after reading from a laptop computer screen, with a significant difference between the task medium (P = 0.001). The baseline strip meniscometry tube results decreased from 6.7 mm to 5.0 mm (P < 0.001) after hardcopy reading and to 5.0 mm (P < 0.001) after reading from a laptop computer screen, but there was no significant difference with the task medium (P = 0.085). Reading in both conditions led to tear film instability in terms of the tear film quality and quantity. Additionally, the computer screen has a greater impact on the TBUT compared to hardcopy reading, while these two reading mediums had a similar effect on the tear volume. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: Occupational musculoskeletal disorders are prevalent in ophthalmic surgeons and can impact surgeons' well-being and productivity. Heads-up displays may reduce ergonomic stress compared to conventional microscopes. This cross-sectional, non-interventional study compared ergonomic experience between heads-up display and conventional ocular microscopes. Methods: The study protocol was approved by the independent ethics committee and nonprofit organization MINS Institutional Review Board. An online questionnaire was distributed to a sample of ophthalmic surgeons in Japan with experience operating with heads-up display. The questionnaire captured surgeon-specific variables, the standardized Nordic Musculoskeletal Questionnaire, and custom questions to compare heads-up display and conventional microscope and understand long-term impacts of musculoskeletal disorders. Results: Analysis was conducted on responses from 67 surgeons with a mean 25 years of practice and 2.7 years using heads-up display. Many surgeons agreed or strongly agreed that heads-up display reduced the severity (40%) and frequency (40%) of pain and discomfort, improved posture (61%), and improved overall comfort (61%). Of respondents who experienced asthenopia (n = 59) or pain/discomfort during operation (n = 61), 54% reported improvement in asthenopia and 72% reported feeling less pain/discomfort since using heads-up display. Overall, 69% reported preference for heads-up display. Conclusion: This study provides novel data on musculoskeletal disorders and the long-term impacts of ergonomic strain reported by ophthalmologists building on existing literature demonstrating ergonomic and other advantages of heads-up display. Future studies with objective ergonomic assessment are warranted to validate these findings. [ABSTRACT FROM AUTHOR]

Sjögren's disease (SjD) is a heterogeneous autoimmune disease characterized by severe dryness of mucosal surfaces, particularly the mouth and eyes; fatigue; and chronic pain. Chronic inflammation of the salivary and lacrimal glands, auto-antibody formation, and extra-glandular manifestations occur in subsets of patients with SjD. An aberrant expression of long, non-coding RNAs (lncRNAs) has been described in many autoimmune diseases, including SjD. Here, we review the current literature on lncRNAs in SjD and their role in regulating X chromosome inactivation, immune modulatory functions, and their potential as biomarkers. [ABSTRACT FROM AUTHOR]

Human gamma-D crystallin (HGD) is a major constituent of the eye lens. Aggregation of HGD contributes to cataract formation, the leading cause of blindness worldwide. It is unique in its longevity, maintaining its folded and soluble state for 50-60 years. One outstanding question is the structural basis of this longevity despite oxidative aging and environmental stressors including ultraviolet radiation (UV). Here we present crystallographic structures evidencing a UV-induced crystallin redox switch mechanism. The room-temperature serial synchrotron crystallographic (SSX) structure of freshly prepared crystallin mutant (R36S) shows no post-translational modifications. After aging for nine months in the absence of light, a thiol-adduct (dithiothreitol) modifying surface cysteines is observed by low-dose SSX. This is shown to be UV-labile in an acutely light-exposed structure. This suggests a mechanism by which a major source of crystallin damage, UV, may also act as a rescuing factor in a finely balanced redox system. Understanding the stability of the eye lens protein human gamma-D crystallin (HGD) is essential to developing tools to prevent the formation of cataracts, however, structural investigations of the response of HGD to ultraviolet radiation are lacking. Here, the authors use continuous illumination serial crystallography to directly probe the mechanism of R36S HGD in response to ultraviolet radiation damage. [ABSTRACT FROM AUTHOR]

Background: Internet Gaming Disorder (IGD) has been associated with symptoms of Digital Eye Strain (DES) and poor academic performance among adolescent students. The purpose of this study is to assess whether a student's achievement of a specific academic goal within a short period of time can be directly predicted by symptoms of IGD and DES. Methods: This is a cross-sectional survey of 140 high school graduates who received an examination of visual acuity as a pre-requisite for entering the written admission examinations of law enforcement and military academies. The students completed the Digital Eye Strain Questionnaire (DESQ) and the Ten-Item Internet Gaming Disorder Test (IGDT-10) and stated their own evaluation of their chances for success. They were contacted following their admission examinations, and their success or failure to be admitted was recorded. Results: The students with IGD symptomatology were more likely to present with symptoms of DES. They were also more pessimistic about their chances of success in the subsequent written admission examinations; none succeeded, while the rest of the students recorded an expected rate of success. A combination of IGD and complaints related to the prolonged fixation of the upper body in a specific viewing position was the best predictor variable set for future success in admission examinations. Conclusions: IGD is associated with a failure to achieve academic success. Combining a factor for physical discomfort during prolonged sessions of gaming with the typical criteria for IGD may expand the predictive validity of the construct of gaming disorder. [ABSTRACT FROM AUTHOR]

The diagnostic value of the computer accommodation method remains insufficiently studied. Accommodative and refractive error is a common problem, accounting for 23% of the world's population. The aim of the study was to investigate the objective parameters of accommodative insufficiency in young people with and without myopia. A cross-sectional study was carried out using a random sample of 116 of university students at the age of 21–23 years. Normal ranges for accommodation parameters in non-myopic participants were defined by 10th and 90th percentile values. The normal ranges were from −0.17 to −0.38 conventional units (c.u.) for accommodative response coefficient (ARC), from 0.08 to 0.41 c.u. for deviation of ARC (σARC), from 0.0 to 0.43 c.u. for accommodogram growth coefficient (AGC), from 54.26 to 58.55 microfluctuations per minute (mcf/min) for coefficient of microfluctuations (CMF), and from 2.58 to 5.26 c.u. for deviation of CMF (σCMF). Signs of computer visual syndrome were observed in 40.9% of non-myopic participants, eye strain in 11.9%, accommodation cramp in 4.5%, and absence or little accommodative response in 3.6%. Therefore, computer accommodation assessment allowed the detection of young people with an increased risk of myopia among those without this ophthalmic pathology. [ABSTRACT FROM AUTHOR]

Despite remarkable advances in virtual reality (VR) technologies, serious challenges remain in making extended VR sessions with head-mounted displays (HMDs) thoroughly comfortable. 3D stereo imagery can cause discomfort and eye fatigue due to poor stereo camera settings that result in extreme disparities and vergence-accommodation conflicts. The default stereoscopic parameters of consumer HMDs produce images with shallow depth to circumvent these issues. In this work, we propose a methodology to utilize the gaze-directed and visual saliency-guided paradigms for automatic stereo camera control in real-time interactive VR by employing the basics of stereo grading. We evaluate these two approaches at different levels of interaction, first through a user study and then through a performance benchmark. The results show that the gaze-directed approach outperforms the saliency-guided approach in the VEs tested and both methods are able to convey a better overall depth feeling than the default HMD setting without hindering visual comfort. It is also shown that both approaches lead to a significant overall enhancement of the VR experience in the more interactive VE. [Display omitted] • A methodology for gaze-directed and saliency-guided stereo camera control in VR. • Gaze-directed approach outperforms the saliency-guided approach. • Both approaches convey a better overall depth feeling than the default HMD setting. • Both lead to a significantly improved experience in the more interactive VE. • Both can surpass 80 FPS using a modest setup. [ABSTRACT FROM AUTHOR]

Purpose: To assess the therapeutic efficacy and safety of Mingmu nourishing cream in asthenopia. Methods: This study retrospectively analyzed data from 124 patients who were treated for asthenopia in the Affiliated Hospital of Shanxi University of Traditional Chinese Medicine, China from January 2015 to January 2018. Patients were divided into control group (n = 63; received conventional eye drops) and study group (n = 61; received Mingmu nourishing cream in addition to control group treatment). The ocular symptom scores and tear secretion test (Schirmer's I test (SIT)) were compared between the two groups before and after treatment. Furthermore, the clinical efficacy of Mingmu nourishing cream in the treatment of asthenopia was evaluated. Results: The differences in SIT, conjunctival congestion classification and ocular symptoms between the two groups after treatment were statistically significant (p < 0.05). Moreover, the rate of total therapeutic efficacy in the study group was 86.9 % (53/61), which was significantly higher than the control group (p < 0.05). Conclusion: Mingmu nourishing cream significantly improves symptoms and exhibits favourable tolerability profile. Multi-center large sample study is needed for further verifications of the findings of this study. [ABSTRACT FROM AUTHOR]

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]

Background: Data from WHO shows that asthenopia cases in the world range from 75-90%. Astenopia can result from excessive efforts of the vision system to obtain the quality of vision it should. Excessive online gaming habits have the potential to result in decreased vision quality. This problem needs to be considered because asthenopia is an early symptom sign of more serious visual impairment. This study aimed to discover an overview of the incidence of asthenopia among online game players in Kupang City based on the duration, distance of smartphones, body position, and eye rest while playing online games. Subjects and Method: It was a descriptive study conducted in Kupang City from March to April 2023. With a total of 378 online game players aged 15-24 years selected by purposive sampling. The dependent variable was the incidence of asthenopia. The independent variables were the duration of playing online games, the viewing distance of smartphone, body position, and eye rest. The data collection techniques used was questionnaires. The data were presented descriptively. Results: A total of 367 people (97.1%) complained about symptoms of eyestrain (asthenopia), 251 people (66.4%) played online games with a duration of >2 hours and other 127 people (33.6%) played online games <2 hours. 277 people (73.3%) used smartphones with a distance of <30 cm and other 101 people (26.7%) with a distance of >30 cm. 184 people (48.7%) played online games while lying down and 194 people (51.3%) sitting. 187 people (49.5%) did not do eye rest and as many as 191 people (50.5%) did eye rest consisting of 53 people (14.0%) doing micro break, 55 people (14.6%) doing mini break and 83 people (22.0%) doing maxi break. Conclusion: Different types of asthenopia have been discovered. The most common incidence of asthenopia is experienced by online game players with risky viewing distance of smartphone. [ABSTRACT FROM AUTHOR]

Background and Aims: Recent studies on endoscopic submucosal dissection have aimed to reduce the difficulty of the procedure by using multi‐degrees‐of‐freedom articulating devices. In this study, we evaluated the usefulness of adding three‐dimensional (3D) video imaging into simulated endoscopic submucosal dissection tasks using multi‐degrees‐of‐freedom devices. Methods: We designed an endoscopic platform with a 3D camera and two multi‐degrees‐of‐freedom devices. Four ex vivo bench tasks were created, and a crossover study comparing 2D and 3D conditions was conducted on 15 volunteers. In each task, performance such as procedure time and accuracy were objectively evaluated. Additionally, a comprehensive visual analogue scale questionnaire was conducted. Results: In the tasks simulating submucosal flap grasping, marking, and full‐area incision, the use of 3D imaging significantly improved the speed and accuracy of the multi‐degrees‐of‐freedom device manipulation (p <.01). No significant differences were observed in the task that simulated the dissection procedure. Furthermore, it appears that the accuracy of recognizing curved surfaces may be reduced in the 3D environment. Operators reported subjective increases in recognizability and operability with the 3D camera, along with an increase in asthenopia (p <.01). Conclusions: 3D vision improves the technical accuracy of certain simulated multi‐degrees‐of‐freedom endoscopic submucosal dissection tasks and subjectively improved operating conditions, at the cost of increased eye strain. [ABSTRACT FROM AUTHOR]

Besides haptics, the visual channel provides the most essential feedback to the operator in teleoperation setups. For optimal performance, the view on the remote scene must provide 3D information, be sharp, and of high resolution. Head‐mounted displays (HMD) are applied to improve the immersion of the operator into the remote environment. Still, so far, no near‐eye display technology was available that provides a natural view on objects within the typical manipulation distance (up to 1.2 m). The main limitation is a mismatch of the 3D distance and the focal distance of the visualized objects (vergence‐accommodation conflict) in displays with fixed focal distance. This conflict potentially leads to eye strain after extended use. Here, we apply a light‐field HMD providing close‐to‐continuous depth information to the user, thus avoiding the vergence‐accommodation conflict. Furthermore, we apply a time‐of‐flight sensor to generate a 2.5D environment model. The displayed content is processed with image‐based rendering allowing a 6 degree‐of‐freedom head motion in the visualized scene. The main objective of the presented study is evaluating the effects of view perspective and light‐field on performance and workload in a teleoperation setup. The reduction of visual effort for the user is confirmed in an abstract depth‐matching task. [ABSTRACT FROM AUTHOR]

The rapid growth and proliferation within healthcare of Virtual Reality (VR) technology's make it a promising platform for treating central nervous system (CNS)-related ailments. From neurorehabilitation to pain management and even cognitive enhancement, there are numerous benefits that VR offers this portion of medicine. Nevertheless, multiple risks among motion sickness and eye strain, exist with utilizing this new tech for CNS treatments. Beyond immediate physical harm concerns like these - researching the long-term impact on this area remains paramount regarding future implementation. The utilization of VR technology in the field of CNS presents considerable promise, the same its potential risks necessitate a meticulous analysis and resolution before its extensive acceptance across clinical settings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this cohort study was to investigate the association between the prevalence of abnormal ocular examination results and the common visual symptoms of eye strain, blurred vision and photophobia. Methods: Consecutive first-visit outpatients with best-corrected visual acuity better than 20/30 in both eyes were enrolled and those with a history of intra-ocular lens implantation and glaucoma were excluded. Dry eye-related examinations and retinal thickness measurement were conducted. The odds ratio (OR) was calculated with logistic regression analyses of ocular data in relation to the presence of visual symptoms. Results: A total of 6078 patients (3920 women, mean age 49.0 ± 20.4 years) were analyzed. The prevalence of each symptom was 31.8% for eye strain, 22.5% for blurred vision and 16.0% for photophobia. A significant risk factor for eye strain was short tear break-up time (TBUT) (OR 1.88), superficial punctate keratitis (SPK) (OR 1.44), and thickness of ganglion cell complex (GCC) (OR 1.30). Risk factors for blurred vision were short TBUT (OR 1.85), SPK (OR 1.24) and GCC (OR 0.59). Risk factors for photophobia were short TBUT (OR 1.77) and SPK (OR 1.32). Schirmer test value, peripapillary nerve fiber layer thickness and full macular thickness were not associated with the tested symptoms. Conclusion: The current study successfully identified female gender, short TBUT, and SPK as significant risk factors for eye strain, blurred vision, and photophobia with considerable ORs. [ABSTRACT FROM AUTHOR]

Aging is generally defined as a time-dependent functional decline that affects most living organisms. The positive increase in life expectancy has brought along aging-related diseases. Oxidative stress caused by the imbalance between pro-oxidants and antioxidants can be given as one of the causes of aging. At the same time, the increase in oxidative stress and reactive oxygen species (ROS) is main reason for the increase in aging-related diseases such as cardiovascular, neurodegenerative, liver, skin, and eye diseases and diabetes. Carotenoids, a natural compound, can be used to change the course of aging and aging-related diseases, thanks to their highly effective oxygen-quenching and ROS-scavenging properties. Therefore, in this narrative review, conducted using the PubMed, ScienceDirect, and Google Scholar databases and complying with the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines, the effects of carotenoids on aging and aging-related diseases were analyzed. Carotenoids are fat-soluble, highly unsaturated pigments that occur naturally in plants, fungi, algae, and photosynthetic bacteria. A large number of works have been conducted on carotenoids in relation to aging and aging-related diseases. Animal and human studies have found that carotenoids can significantly reduce obesity and fatty liver, lower blood sugar, and improve liver fibrosis in cirrhosis, as well as reduce the risk of cardiovascular disease and erythema formation, while also lowering glycated hemoglobin and fasting plasma glucose levels. Carotenoid supplementation may be effective in preventing and delaying aging and aging-related diseases, preventing and treating eye fatigue and dry eye disease, and improving macular function. These pigments can be used to stop, delay, or treat aging-related diseases due to their powerful antioxidant, restorative, anti-proliferative, anti-inflammatory, and anti-aging properties. As an increasingly aging population emerges globally, this review could provide an important prospective contribution to public health. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of our research is to assess the impact of monitor use and computer learning process on the visual comfort and ocular health of students from Medical Universities in Bulgaria. METHODS: 219 students participated in the study. They were interviewed anonymously in January 2023, through an online survey. Questions concern students' ocular and visual comfort during the process of self-preparation for exams during session. RESULTS: The survey results indicate that digital learning increases screen time at potentially dangerous for eye health levels. The most common complaints among students are eye fatigue (83.1%), tearing (58.9%), dry eyes (58.4%), blurred vision (40.2%), photophobia (37.4%), and itchiness (34.7%). Results show that 32% of respondents spent 1-2 hours working on a computer without a break; 57.1% reported that they work for more than 2 hours, and only 3.7% spent less than 20 min before taking a break. CONCLUSIONS: It was noted that eye fatigue and visual discomfort among medical students were negatively affected by the monitor learning during the session. Increased screen time causes digital eye strain, which impairs life quality and is a socially significant phenomenon. [ABSTRACT FROM AUTHOR]

The importance of digital disconnection in the workplace cannot be overstated, as it plays a crucial role in preserving the physical and mental well-being of employees. In today's hyper-connected world, the constant use of digital devices and online communication has blurred the boundaries between work and personal life. This continuous connectivity can lead to a range of health issues. Physically, excessive screen time and sedentary work can result in eye strain, headaches, and musculoskeletal problems. Additionally, a lack of time for relaxation and exercise can contribute to a host of chronic health conditions. Mentally, the relentless notifications and information overload can lead to burnout, stress, and anxiety. Continuous work-related communication, even after office hours, disrupts personal lives and makes it challenging for individuals to recharge and spend quality time with loved ones. Promoting digital disconnection by setting boundaries, encouraging regular breaks, and respecting off-hours can help employees maintain a healthier work-life balance. Ultimately, these practices enhance physical and mental health, leading to happier and more productive workers. Employers and employees must recognize the significance of this disconnect to create a sustainable and healthy work environment. [ABSTRACT FROM AUTHOR]

Bilberry (Vaccinium myrtillus L.) is a fruit with high polyphenolic content and rich in anthocyanins. Due to its strong antioxidant capacity, it has potential effects in improving human health and reducing the risk of diseases. In addition to its antioxidant effect, it also possesses potential anti-inflammatory, anti-carcinogenic, anti-angiogenic, anti-proliferative, anti-atherogenic, anti-microbial, anti-diabetic, anti-lipidemic, neuroprotective, anti-metastatic, anti-radical effects, as well as preventing lipid oxidation, reducing oxidative stress and improving eye health. Bilberry consumption can potentially protect against and reduce the risks of chronic inflammation, dyslipidemia, hyperglycemia, increased oxidative stress, cardiovascular diseases, diabetes, dementia, and other age-related diseases and cancer. This review focuses on the potential mechanisms of action of bilberry in cancer. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: A retained ferrous intraocular foreign body (IOFB), introduced via penetrating ocular trauma, may result in ocular siderosis and visual loss that may occur after days or years. If diagnosis is delayed, therapy may also be delayed, resulting in a poor outcome. The present report presents the case of a 58-year-old man with a retained iron IOFB and late-onset siderotic glaucoma 1 month after the initial trauma. Case Report: A 58-year-old man presented with redness and eye pain in the right eye for 1 month after ocular trauma. His visual acuity was very good, with no sign of eye strain. High intraocular pressure had been detected for several weeks, but the B-scan ultrasound and fundus examination were normal and the reason for the high intraocular pressure was unknown. He was later transferred to our senior hospital. The diagnosis of IOFB was confirmed by computed tomography (CT) scan and ultrasound biomicroscopy (UBM). The patient was successfully managed by vitrectomy. Conclusions: This report highlights that a retained IOFB can be challenging to diagnose and that cases associated with siderotic glaucoma require multiple investigations. Early detection of the IOFB using the right tools is vital to reduce the risk of siderotic glaucoma. Although the fundus examination was normal after ocular trauma, the use of CT scan and UBM assisted in finding the IFOB and the patient was successfully treated by vitrectomy. [ABSTRACT FROM AUTHOR]

Augmented reality (AR) has been shown to improve productivity in industry, but its adverse effects (e.g., headaches, eye strain, nausea, and mental workload) on users warrant further investigation. The objective of this study is to investigate the effects of different instruction methods (i.e., HoloLens AR-based and paper-based instructions) and task complexity (low and high-demanding tasks) on cognitive workloads and performance. Twenty-eight healthy males with a mean age of 32.12 (SD 2.45) years were recruited in this study and were randomly divided into two groups. The first group performed the experiment using AR-based instruction, and the second group used paper-based instruction. Performance was measured using total task time (TTT). The cognitive workload was measured using the power of electroencephalograph (EEG) features and the NASA task load index (NASA TLX). The results showed that using AR instructions resulted in a reduction in maintenance times and an increase in mental workload compared to paper instructions, particularly for the more demanding tasks. With AR instruction, 0.45% and 14.94% less time was spent on low- and high-demand tasks, respectively, as compared to paper instructions. According to the EEG features, employing AR to guide employees during highly demanding maintenance tasks increased information processing, which could be linked with an increased germane cognitive load. Increased germane cognitive load means participants can better facilitate long-term knowledge and skill acquisition. These results suggested that AR is superior and recommended for highly demanding maintenance tasks since it speeds up maintenance times and increases the possibility that information is stored in long-term memory and encrypted for recalls. [ABSTRACT FROM AUTHOR]

To determine the prevalence of ophthalmological findings suggesting an ocular cause for headache or occult neurological disease, among children with headache. Retrospective cross-sectional study on children with headache at a tertiary outpatient ophthalmology clinic. All children underwent sensorimotor, anterior segment, and dilated fundoscopic examinations, with or without cycloplegic refraction. Prevalence of one or more new findings of ocular or occult neurological cause of headache, including glaucoma, uveitis, optic nerve elevation, or possible asthenopia from strabismus or refractive issues. Headache characteristics and associated symptoms were evaluated as risk factors for ocular findings. Among 1,878 children with headache (mean age 10 yrs, range 2–18), 492 (26.1%, 95% CI 24.3–28.2%) children had one or more new ocular findings that could cause headache or indicate intracranial disease: refractive issues (342, 18.2%), strabismus (83, 4.4%), optic nerve elevation (51, 2.7%; 26 with papilledema, 25 with pseudopapilledema), uveitis (6, 0.3%), and glaucoma (2, 0.1%). Shorter headache duration was associated with ocular findings (p =.047), but headache frequency, photophobia, nausea/vomiting, and visual changes were not. In univariable analysis, visual changes (p ≤.001), nausea/vomiting (p ≤.002), and morning headache (p =.02) were associated with optic nerve elevation. An ophthalmologic examination including cycloplegic refraction is indicated in children with headache, as one-quarter have a treatable ocular condition, which may be related to the headache, or sign of intracranial pathology. While nausea, visual changes, or morning headache should raise concern, coincident visual, ocular, or systemic symptoms are not reliable predictors of discovering ocular pathology in a child with headache. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the knowledge, attitude, and practice towards digital eye strain (DES) among Northern Border University (NBU) students in Arar city. A total of 389 students from all nine NBU colleges willingly participated in this population-based cross-sectional study. The majority of the participants (65.6%) were in the age group 18-22 and females (76.3%), while 67.6% of the participants belonged to health-related colleges. Around 60% of students were familiar with the terms like DES and computer vision syndrome. More than fifty people (55.5%) had sufficient knowledge about DES. The most commonly used digital devices were IPads (56.6%). A significant difference in the knowledge in relation to the ages, faculty type, and academic year existed. A positive attitude regarding adjustment of brightness, appropriate seating position and viewing distance was demonstrated by 74%, 73.8%, and 81% of participants respectively. Regarding the duration, 61.2% of participants above six hours of total digital exposure per day. The symptoms associated with digital devices were fatigue of the eyes, foreign body sensation, and also non-ocular symptoms like shoulder or neck pain. The commonest source of participants’ information about digital eye strain was an awareness campaign. Sufficient knowledge about DES was demonstrated above half of the studied population. The current study highlights the need to reduce the digital exposure hours among university students and also to strengthen awareness about DES and its methods of prevention with a target to reach out to the community at large. [ABSTRACT FROM AUTHOR]

Dry eye disease (DED) is a worldwide, multifactorial disease mainly caused by a deficit in tear production or increased tear evaporation with an increase in tear osmolarity and inflammation. This causes discomfort and there is a therapeutic need to restore the homeostasis of the ocular surface. The aim of the present work was to develop a biodegradable and biocompatible liposomal formulation from the synthetic phospholipids 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) and 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) that is able to reduce the effects of hypertonic stress by helping to restore the lipid layer of the tear film. Liposomes were made using the lipid film hydration method with synthetic phospholipids (10 mg/mL) with and without 0.2% HPMC. They were characterised in terms of size, osmolarity, pH, surface tension, and viscosity. Additionally, the in vitro toxicity of the formulation at 1 and 4 h in human corneal epithelial cells (hTERT-HCECs) and human conjunctival cells (IM-HConEpiC) was determined. Furthermore, osmoprotective activity was tested in a corneal model of hyperosmolar stress. In vivo acute tolerance testing was also carried out in albino New Zealand rabbits by topical application of the ophthalmic formulations every 30 min for 6 h. All the assayed formulations showed suitable physicochemical characteristics for ocular surface administration. The liposomal formulations were well-tolerated in cell cultures and showed osmoprotective activity in a hyperosmolar model. No alterations or discomfort were reported when they were topically administered in rabbits. According to the results, the osmoprotective liposomal formulations developed in this work are promising candidates for the treatment of DED. [ABSTRACT FROM AUTHOR]

Purpose: Globally, the COVID-19 pandemic has influenced academic studies. Since 2019, most schools in Thailand have implemented online learning. Thus, several students are experiencing eye problems, including stinging, blurred vision, and epiphora. This study investigated the prevalence, eye symptoms, and characteristics associated with digital eye strain (DES) in children using digital devices. Patients and Methods: In this cross-sectional study, a self-administered electronic questionnaire via google forms was used to collect demographic data, digital device information, and DES characteristic information in children of age 8– 18 years using online digital devices. The data collection was conducted between December 2021 and January 2022. Moreover, multivariable logistic regression analysis was performed to evaluate the potential characteristics associated with DES in children. Results: From a total of 844 parents, 782 parents completed the questionnaire. The mean age of the children was 12.42 ± 2.82 years (8– 18 years). During the pandemic, the most common duration of using digital devices was > 8 hours (39.90%), compared to only 2– 4 hours (36.70%) before. The prevalence of DES was 42.2% (330/782), divided into mild (29.8%), moderate (8.1%), and severe (4.3%) symptoms. The most common symptoms of DES included: a burning sensation in the eyes (55.24%), fear of worsening eyesight (53.07%), and excessive blinking of eyes (48.33%). The associated characteristics with DES were advanced age (OR=1.21, P< 0.001), refractive error with (OR=2.04, P=0.004) and without (OR=6.11, P< 0.001) correction, and unknown refractive error (OR=2.85, P< 0.001). Conclusion: The use of digital devices are inevitable; therefore, regulating the duration of study and entertainment using digital devices, especially in older ages, and correcting refractive error in children, is necessary to ameliorate DES. [ABSTRACT FROM AUTHOR]

Introduction: The prolonged use of digital devices is a major risk factor for digital eye strain (DES) syndrome. Aim: To estimate the prevalence of DES symptoms among students at Imam Abdulrahman University who use digital devices for virtual learning and leisure activities. Methods: This was a retrospective cross-sectional study conducted by asking medical students of Imam Abdulrahman bin Faisal University to complete a self-administered online questionnaire. The questionnaire was used to determine the effect of the hours spent on digital devices and other factors, such as screen distance and not using artificial tears, on the development of DES. The severity (moderate or severe) and frequency (occasionally, always, or never) of 16 eye strain-related symptoms, including eye pain, headache, and itching, were evaluated by using the Computer Vision Syndrome Questionnaire. Results: The overall prevalence of DES in the sample was found to be 68.53%. The largest proportion of students were found to have mild DES (43.20%), and only 11% had severe DES. The most common symptoms reported in our sample were headache, dryness, and burning. Female gender, using smartphones for online classes, and not using eye lubricants were significantly associated with increased severity of DES. Conclusion: In the wake of the COVID-19 pandemic, virtual learning has become an integral part of education, leading to increased use of digital technology. The aim of this study was to investigate the impact of virtual learning on eye strain and to determine the prevalence and effects of DES. A questionnaire was administered to participants, and the findings revealed a DES prevalence of 68.53%. The use of eye drops for lubrication and smartphones for classes was significantly associated with DES. Furthermore, females were found to be more susceptible to severe DES symptoms than males. The development of a tool such as the Computer Vision Syndrome Questionnaire to predict DES prevalence could reduce clinic time and resources by minimizing unnecessary follow-up and ophthalmology referrals. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to develop an interpretable machine learning model to predict the onset of myopia based on individual daily information. Method: This study was a prospective cohort study. At baseline, non-myopia children aged 6–13 years old were recruited, and individual data were collected through interviewing students and parents. One year after baseline, the incidence of myopia was evaluated based on visual acuity test and cycloplegic refraction measurement. Five algorithms, Random Forest, Support Vector Machines, Gradient Boosting Decision Tree, CatBoost and Logistic Regression were utilized to develop different models and their performance was validated by area under curve (AUC). Shapley Additive exPlanations was applied to interpret the model output on the individual and global level. Result: Of 2221 children, 260 (11.7%) developed myopia in 1 year. In univariable analysis, 26 features were associated with the myopia incidence. Catboost algorithm had the highest AUC of 0.951 in the model validation. The top 3 features for predicting myopia were parental myopia, grade and frequency of eye fatigue. A compact model using only 10 features was validated with an AUC of 0.891. Conclusion: The daily information contributed reliable predictors for childhood's myopia onset. The interpretable Catboost model presented the best prediction performance. Oversampling technology greatly improved model performance. This model could be a tool in myopia preventing and intervention that can help identify children who are at risk of myopia, and provide personalized prevention strategies based on contributions of risk factors to the individual prediction result. [ABSTRACT FROM AUTHOR]

Fatigue is a significant cause of traffic accidents. Developing a method for determining driver fatigue level by the state of the driver's eye is a problem that requires a solution, especially when the driver is wearing a mask. Based on previous work, this paper proposes an improved DeepLabv3+ network architecture (IDLN) to detect eye segmentation. A Gaussian-weighted Eye State Fatigue Determination method (GESFD) was designed based on eye pixel distribution. An EFSD (Eye-based Fatigue State Dataset) was constructed to verify the effectiveness of this algorithm. The experimental results showed that the method can detect a fatigue state at 33.5 frames-per-second (FPS), with an accuracy of 94.4%. When this method is compared to other state-of-the-art methods using the YawDD dataset, the accuracy rate is improved from 93% to 97.5%. We also performed separate validations on natural light and infrared face image datasets; these validations revealed the superior performance of our method during both day and night conditions. [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]

Three-dimensional video services delivered through wireless communication channels have to deal with numerous challenges due to the limitations of both the transmission channel's bandwidth and receiving devices. Adverse channel conditions, delays, or jitters can result in bit errors and packet losses, which can alter the appearance of stereoscopic 3D (S3D) video. Due to the perception of dissimilar patterns by the two human eyes, they can not be fused into a stable composite pattern in the brain and hence try to dominate by suppressing each other. Thus, a psychovisual sensation that is called binocular rivalry occurs. As a result, undetectable changes causing irritating flickering effects are seen, leading to visual discomforts such as eye strain, headache, nausea, and weariness. This study addresses the observer's quality of experience (QoE) by analyzing the binocular rivalry impact on the macroblock (MB) losses in a frame and its error propagation due to predictive frame encoding in stereoscopic video transmission systems. To simulate the processing of experimental videos, the Joint Test Model (JM) reference software has been used as it is recommended by the International Telecommunication Union (ITU). Existing error concealing techniques were then applied to the contiguous lost MBs for a variety of transmission impairments. In order to validate the authenticity of the simulated packet loss environment, several objective evaluations were carried out. Standard numbers of subjects were then engaged in the subjective testing of common 3D video sequences. The results were then statistically examined using a standard Student's t-test, allowing the impact of binocular rivalry to be compared to that of a non-rivalry error condition. The major goal is to assure error-free video communication by minimizing the negative impacts of binocular rivalry and boosting the ability to efficiently integrate 3D video material to improve viewers' overall QoE. [ABSTRACT FROM AUTHOR]

Given the expanding elderly population in the United States and the world, it is important to understand the processes underlying both natural and pathological age-related changes in the eye. Both the anterior and posterior segment of the eye undergo changes in biological, chemical, and physical properties driven by oxidative stress. With advancing age, changes in the anterior segment include dermatochalasis, blepharoptosis, thickening of the sclera, loss of corneal endothelial cells, and stiffening of the lens. Changes in the posterior segment include lowered viscoelasticity of the vitreous body, photoreceptor cell loss, and drusen deposition at the macula and fovea. Age-related ocular pathologies including glaucoma, cataracts, and age-related macular degeneration are largely mediated by oxidative stress. The prevalence of these diseases is expected to increase in the coming years, highlighting the need to develop new therapies that address oxidative stress and slow the progression of age-related pathologies. [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]

Aim. Multisystemic physiological changes in pregnancy can result in tear film and refractive changes in the eye. We report dry eye prevalence in pregnant women using Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire. Methods. The SPEED questionnaire was self-administered cross-sectionally to 428 pregnant women (mean age: 26.8 ± 4.4 years) with clinically confirmed pregnancy from two obstetric clinics in Chennai, India. Subjects with predisposing risk factors for dry eye were excluded from the study. Subjects were categorized as normal, moderate, and severe dry eye based on the SPEED score. Results. Among the women, 48.5% of the subjects had symptoms like dryness, grittiness or scratchiness, soreness or irritation, burning or watering, or eye fatigue. About 2.3% had moderate dry eye according to SPEED questionnaire criteria. Eye fatigue was the most reported symptom and was present in 76.4% of women. The symptom frequency score and severity score had a strong and significant correlation (r = 0.95 , P <.001). No significant correlation was noted among SPEED score vs age (r = − 0.02 , P >.05). No significant correlation was found between symptoms of dry eye and gravidity (ρ = − 0.006 , P >.05) and trimester (ρ = 0.38 , P >.05). Binary logistic regression showed that only occupational status and systemic condition was significantly associated with dry eye symptoms. Conclusion. About half the pregnant women at the visit reported having one or more dry eye-related symptoms. As per the composite SPEED questionnaire score, dry eye was not prevalent among pregnant women irrespective of their age, gravidity, and the trimester, but we found a majority of pregnant women reported to have experienced dry eye-related symptoms, though tolerable. Awareness about dry eye during pregnancy will improve eye care seeking behaviour in pregnant women. [ABSTRACT FROM AUTHOR]

Purpose: A self‐controlled study to determine the influence of illuminance and correlated colour temperature (CCT) of light‐emitting diode (LED) lighting on asthenopia. Methods: Twenty‐two healthy postgraduates (nine women) were recruited to read under eight LED lighting conditions with four illuminances (300 lx, 500 lx, 750 lx and 1000 lx) and four CCTs (2700, 4000, 5000 and 6500 K) for 2 h. A subjective asthenopia questionnaire, the optical quality analysis system (OQAS) and an inflammatory cytokine assay were used to assess the levels of asthenopia. Results: Increased asthenopia was observed after reading, but the degree varied with lighting conditions. There were significant differences among the groups in terms of subjective symptoms (inattention, eye pain, dry eye and total score), optical performance parameters (modulation transfer function [MTF] cut‐off frequency, Strehl ratio [SR], objective scattering index [OSI], mean OSI and accommodative amplitude [AA]) as well as inflammatory cytokines in the tears (epidermal growth factor [EGF], transforming growth factor [TGF]‐α, interleukin [IL]‐6, IL‐8, macrophage inflammatory protein [MIP]‐1β, tumour necrosis factor [TNF]‐α, TNF‐β and vascular endothelial growth factor [VEGF]‐A). All of the subjective and objective measurements collectively suggested that asthenopia was lessened for the 500 lx–4000 K condition. However, asthenopia was significantly worse for 300 lx–2700 K and 1000 lx–6500 K in terms of subjective symptoms and objective optical performance, respectively. Conclusions: LED illuminance and CCT do have a significant effect on asthenopia during reading. 500 lx–4000 K lighting resulted in the lowest level of asthenopia. Conversely, low illuminance at low CCT (300 lx–2700 K) and high illuminance at high CCT (1000 lx–6500 K) promoted more severe asthenopia. [ABSTRACT FROM AUTHOR]

There is some controversy about the utility of prescribing blue-blocking filters to mitigate digital eye strain. We found that using commercially available blue-blocking filters was ineffective in reducing orbicularis oculi muscle activity and visual symptomatology during a 30-min reading task from a computer screen. There are some claims that blue-blocking (B-B) filters may be effective in reducing symptoms and signs of digital eye strain. However, recent studies have suggested that there is no sufficient evidence to support their use. This study assessed the short-term effects of a commercially available, B-B filter on orbicularis oculi (OO) muscle activity and symptoms of digital eye strain during the execution of a 30-min reading tas. Twenty-three healthy young adults (22.9 ± 3.2 years of age) performed two reading tasks from a computer screen with or without a B-B filter on two different days. OO muscle activity was recorded by surface electromyography 4–5, 9–10, 14–15, 19–20, 24–25 and 29–30 min into the trial. Participants reported their perceived levels of visual discomfort and activation before and after completing the reading task. A Bayesian analysis favoured the null hypothesis that there was no change in OO muscle activity with or without using the B-B filter (Bayes Factor01 [BF01] = 7.08). Regarding symptomatology, the analysis favoured the time model that reading increased visual fatigue and discomfort but reduced activation levels (BF01 < 0.33 in all cases). However, our data did not support the alternative model that using B-B filter affected these visual symptoms. The B-B filter did not alter OO muscle activity or visual symptomatology significantly during the execution of a 30-min reading task in asymptomatic subjects. These findings support the idea that B-B filters do not attenuate signs and symptoms of digital eye strain. [ABSTRACT FROM AUTHOR]

PURPOSE: The digital eye strain (DES) is of public health magnitude in students undertaking online studies during the COVID-19 pandemic. The DES prevention strategies will be effective if all stakeholders, including parents, work together. We present an awareness level of preventive measures among parents of students studying online for 1 year. METHODS: This web-based survey was held in December 2021. Parents of Saudi students in the Qassim region responded to 15 questions about the preventive measures for DES. The responses were summed up and graded into very poor, poor, good, and excellent. The level of awareness was associated with determinants. RESULTS: The awareness was excellent in 566 of 704 (80.4%) (95% confidence interval 77.5–83.3) participants. Parents had poor awareness about the importance of the 20-20-20 rule (43.8%), frequent blinking (56.7%), using digital devices beyond studies (57.4%), using eye lubricants while using a digital device (56%), and using devices at night in lying position (69.6%). Excellent awareness was significantly associated with primary-level students (P = 0.0004), those having ophthalmic consultation in the past (P = 0.02), and students with DES (P = 0.0006). Parents with excellent awareness were not satisfied with online studies of their wards (P = 0.001). CONCLUSION: Awareness of parents about preventive measures to address DES in students is relatively high. However, health promotion is recommended, especially focusing on the weak areas to improve DES and its impact on students. [ABSTRACT FROM AUTHOR]

Background: Digital eye strain (DES) affects an estimated 60 million people worldwide, with a higher prevalence among populations that are occupationally reliant on digital display devices. Aim: This study investigated risk factors of DES and ergonomic practices among computer users at Al-Baha University. Setting: The study was conducted among computer users at Al-Baha University. Methods: This study used a descriptive cross-sectional design and data were gathered using self-administered questionnaires. Results: A total of 360 computer users participated (mean age: 36.33 years, standard deviation [s.d.]: 7.08). The lifetime and daily computer usage were 8.38 (s.d.: = 1.04) years and 4.37 (s.d.: = 2.07) hours, respectively, with 30% of respondents having used computers for more than 10 years. The baseline total eye complaints score was either mild or moderate for 64.7% and severe for 35% of the sample. The total workstation design score was poor for 47.1% and fair for 35.5% of the sample. The regression analysis of potential DES risk factors found statistically significant coefficients for the duration of daily computer use, use of contact lenses, poor ergonomic practices, poor workstation design and use of non-prescription spectacles. Conclusion: This study emphasises the need for learning institutions and public health policy makers to not only raise awareness about digital eye strain but also impose time restrictions and breaks on digital-based activities and generally improve workstation design and ergonomic conditions. Contribution: This study offers a basis for targeted interventions to prevent and manage DES, particularly within learning settings. [ABSTRACT FROM AUTHOR]

As a clinical empirical prescription for ophthalmology, compound chrysanthemum has been used gradually and has a good effect on eye fatigue. However, the detailed mechanisms of antiasthenopia have not been studied. In order to clarify the mechanisms of the compound chrysanthemum in the treatment of asthenopia, network pharmacology was combined with experimental study in this paper. A total of 593 genes and 39 active chemicals were identified, and both were considered to be essential to the advancement of asthenopia research. The results of the molecular docking analysis demonstrated a certain affinity between PRKACA, PRKCA, PRKCB, and their related compounds; molecular dynamic simulations assessed the stability of these receptors and ligands. The effects of compound chrysanthemum extract on ciliary muscle were studied in vitro and in vivo. By using the MTT assay, compound chrysanthemum extracts (50, 100, 200, 400, and 800 g·mL-1) showed no effect on the proliferation of rCSMCs for 24 and 48 hours. It raised nitric oxide and decreased Ca2+ in ciliary muscle cells isolated from the eyeballs of rats. Besides, compound chrysanthemum extract had a direct relaxing effect on the isolated gastric smooth muscle of rats by reducing the contractile tension. Furthermore, in vivo experiment results showed that, compared to the incandescent lamp-irradiated rats (model group), SD rats treated with compound chrysanthemum extracts (660 mg·kg-1 and 1320 mg·kg-1, orally) displayed considerably retracted pupils and increased NO content. It is also found that compound chrysanthemum extract can downregulate the mRNA expression of PKA and PKC in the calcium signaling pathway. Overall, our results suggested that compound chrysanthemum extract may lessen visual fatigue through multiple components, multiple targets, and multiple pathways. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the correlation between eye movements and asthenopia so as to explore the possibility of using eye-tracking techniques for objective assessment of asthenopia. Methods: This prospective observational study used the computer visual syndrome questionnaire to assess the severity of asthenopia in 93 enrolled college students (age 20–30) who complained about asthenopia. Binocular accommodation and eye movements during the reading task were also examined. The correlations between questionnaire score and accommodation examination results and eye movement parameters were analyzed. Differences in eye movement parameters between the first and last reading paragraphs were compared. The trends in eye movement changes over time were observed. Results: About 81.7% of the subjects suffered from computer visual syndrome. Computer visual syndrome questionnaire total score was positively correlated with positive relative accommodation (p < 0.05). In the first reading paragraph, double vision was positively correlated with unknown saccades (all p < 0.05). Difficulty focusing at close range was positively correlated with total fixation duration, total visit duration, and reading speed (all p < 0.05). Feeling that sight was worsening was positively correlated with regressive saccades (p < 0.05). However, visual impairment symptoms were not significantly correlated with any accommodative function. In a total 20 min reading, significantly reduced eye movement parameters were: total fixation duration, fixation count, total visit duration, visit count, fixation duration mean, and reading speed (all p < 0.01). The eye movement parameters that were significantly increased were: visit duration mean and unknown saccades (all p < 0.001). Conclusion: Eye tracking could be used as an effective assessment for asthenopia. Among the various eye movement parameters, a decrease in fixation duration and counts may be one of the potential indicators related to asthenopia. [ABSTRACT FROM AUTHOR]

Background: Activity on digital screen has increased so much during the COVID era that there is surge in persons complaining of symptoms of computer vision syndrome (CVS). Aims and Objectives: The aim of the study was to determine the prevalence of CVS among the medical students and its associated factors during COVID period and to compare it with pre-COVID period. Materials and Methods: A cross-sectional study was conducted among 337 undergraduate medical students at Government Medical College, Haldwani, Uttarakhand using pretested structured questionnaire which was filled through Google form for which link was circulated in class WhatsApp group. Data were analyzed using SPSS version 16. Frequency, percentage, binary logistic regression, and McNemar test was applied. P<0.05 was considered significant. Results: The prevalence of CVS was significantly higher during COVID period, 54.9% (95% CI=49.7–60.1) that was significantly higher than non-COVID period. Eye strain (16.6%) was the most common CVS symptom during both pre-COVID and COVID period. The prevalence of CVS was significantly associated with use of preventive measures. During COVID period, average hours spent in digital screen was significantly higher as compared to non-COVID period. Conclusion: This study showed that there was increase in CVS among the study participants during COVID era as there was increase in spending hours on digital screen and not or reduction in adopting preventive measures. It is important to increase awareness regarding the symptoms and precautions related to CVS. [ABSTRACT FROM AUTHOR]

Introduction - Postural deficiency syndrome is a multifactorial proprioceptive dysfunction with varied signs and symptoms, including convergence insufficiency and asthenopia which impact visual performance. The near point of convergence measurement is used to diagnose and clinically explore convergence insufficiency, test speed, and stimulus size influencing values obtained. The definition of the most effective method to measure the near point of convergence and the point of asthenopia will allow early detection of alterations. This study aims to investigate the accuracy of measurements and variations in values obtained using different methods for the near convergence point and the point of asthenopia measurements in cases of postural deficiency syndrome. Methods - The sample contained 39 patients, 27 with and 12 without postural deficiency syndrome, measuring the near point of convergence and point of asthenopia with two stimuli (standard RAF near point rule and modified RAF near point rule) at two speeds (1cm and 3cm/s). Results - Neither method of measuring the near point of convergence had statistically significant values. The RAF near point rule at a slow speed is more sensitive for alterations in the point of asthenopia (AUC 0.761±0.084 standard error, p=0.010). The slow speed generated higher values for near point of convergence and point of asthenopia point measurements, especially in the postural deficiency syndrome group. Conclusion - The methods used to measure the parameters studied influenced the final values. No statistically significant values were obtained in the measurement of the near convergence point. To measure the point of asthenopia, the method using visual cues at a slow speed has the highest accuracy. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this cohort study was to describe the change in ocular surface signs and symptoms before and during the COVID-19 pandemic, and to associate changes with potential pandemic-related events. Methods: First-visit patients from 2019 to 2021 were examined for corneal staining, lacrimal function and refraction. We assessed the presence of seven common ocular symptoms. Patients with glaucoma and macular disease were excluded. Dry eye (DE) was diagnosed according to the criteria of the Asia Dry Eye Society. Results: The mean age of 3,907 participants was 59.6±18.6y and 63.8% were female. Mean age and the prevalence of diagnosed DE and shortened tear break-up time decreased from 2019 to 2021. The prevalence of eye fatigue, blurring and photophobia decreased in 2020. Conclusions: The prevalence of diagnosed DE did not increase among first-visit patients during the pandemic compared with 2019, despite many survey results suggesting that DE may have worsened due to frequent masking, increased screen time, mental stress, and depression under quarantine and social infection control. It might be considered however, that many elderly DE patients might have refrained from consulting an ophthalmologist and possibly delayed treatment of DE during the pandemic. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this research is evaluating the effects of wearing face masks on ocular health among medical students in the current COVID-19 pandemic. METHODS: The study includes 147 students in total, all are from Medical University in Pleven. They were interviewed anonymously about their eye health and comfort during periods of wearing face masks. RESULTS: Findings of the study highlighted that wearing face masks for prolonged periods decreases eye comfort levels. Most common presenting complaints were dryness, grittiness, scratchiness, soreness, burning and watering. Almost one quarter of interviewed students sometimes experienced eye fatigue or ocular discomfort. Severity of symptoms was described as "tolerable" in 30.8%, "uncomfortable" in 13%. Of the asked students 25.4% answered that their symptoms were getting worse while being with a protective face mask. In terms of longest uninterrupted time wearing face masks, results show: almost 20% reported more than 5 hours without break. CONCLUSIONS: As a conclusion of this study, it was observed that eye health and dry eye symptoms among medical students was adversely affected by wearing full face covering protective masks during the pandemic situation, which interferes with the quality of life and is an emerging public health issue. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy and safety of interventions for treating eye strain related to computer use relative to placebo or no treatment. Computer use is pervasive and often associated with eye strain, referred to as computer vision syndrome (CVS). Currently, no clinical guidelines exist to help practitioners provide evidence-based advice about CVS treatments, many of which are marketed directly to patients. This systematic review and meta-analysis was designed to help inform best practice for eye care providers. Eligible randomized controlled trials (RCTs) were identified in Ovid MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and trial registries, searched from inception through November 23, 2021. Eligible studies were appraised for risk of bias and were synthesized. The certainty of the body of evidence was judged using the Grading of Recommendations, Assessment, Development, and Evaluation system. Standardized mean differences (SMDs) were used when differently scaled measures were combined. Forty-five RCTs, involving 4497 participants, were included. Multifocal lenses did not improve visual fatigue scores compared with single-vision lenses (3 RCTs; SMD, 0.11; 95% confidence interval [CI], –0.14 to 0.37; P = 0.38). Visual fatigue symptoms were not reduced by blue-blocking spectacles (3 RCTs), with evidence judged of low certainty. Relative to placebo, oral berry extract supplementation did not improve visual fatigue (7 RCTs; SMD, –0.27; 95% CI, –0.70 to 0.16; P = 0.22) or dry eye symptoms (4 RCTs; SMD, –0.10; 95% CI, –0.54 to 0.33; P = 0.65). Likewise, berry extract supplementation had no significant effects on critical flicker-fusion frequency (CFF) or accommodative amplitude. Oral omega-3 supplementation for 45 days to 3 months improved dry eye symptoms (2 RCTs; mean difference [MD], –3.36; 95% CI, –3.63 to –3.10 on an 18 unit scale; P < 0.00001) relative to placebo. Oral carotenoid supplementation improved CFF (2 RCTs; MD, 1.55 Hz; 95% CI, 0.42 to 2.67 Hz; P = 0.007) relative to placebo, although the clinical significance of this finding is unclear. We did not identify high-certainty evidence supporting the use of any of the therapies analyzed. Low-certainty evidence suggested that oral omega-3 supplementation reduces dry eye symptoms in symptomatic computer users. [ABSTRACT FROM AUTHOR]

Digital eye strain (DES) is an entity encompassing visual and ocular symptoms arising due to the prolonged use of digital electronic devices. It is characterized by dry eyes, itching, foreign body sensation, watering, blurring of vision, and headache. Non-ocular symptoms associated with eye strain include stiff neck, general fatigue, headache, and backache. A variable prevalence ranging from 5 to 65% has been reported in the pre-COVID-19 era. With lockdown restrictions during the pandemic, outdoor activities were restricted for all age groups, and digital learning became the norm for almost 2 years. While the DES prevalence amongst children alone rose to 50–60%, the symptoms expanded to include recent onset esotropia and vergence abnormalities as part of the DES spectrum. New-onset myopia and increased progression of existing myopia became one of the most significant ocular health complications. Management options for DES include following correct ergonomics like reducing average daily screen time, frequent blinking, improving lighting, minimizing glare, taking regular breaks from the screen, changing focus to distance object intermittently, and following the 20-20-20 rule to reduce eye strain. Innovations in this field include high-resolution screens, inbuilt antireflective coating, matte-finished glass, edge-to-edge displays, and image smoothening graphic effects. Further explorations should focus on recommendations for digital screen optimization, novel spectacle lens technologies, and inbuilt filters to optimize visual comfort. A paradigm shift is required in our understanding of looking at DES from an etiological perspective, so that customized solutions can be explored accordingly. The aim of this review article is to understand the pathophysiology of varied manifestations, predisposing risk factors, varied management options, along with changing patterns of DES prevalence post COVID-19. [ABSTRACT FROM AUTHOR]