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To analyse the prevalence and progression of computer vision syndrome in secondary and high school students with the CVS-Q© adapted and validated for adolescents, depending on whether they use textbooks or digital books.The CVS-Q© will be adapted by a pilot study in adolescents and a nominal group of visual health specialists, teachers and parents. The resulting version (CVS-Q teen©) will be tested to confirm its quality and applicability and a validation study will be done with visual tests, retest and psychometric analysis. Subsequently, a prospective longitudinal study with four repeated measures will be carried out in adolescents from two secondary schools of San Juan de Alicante (one has replaced textbooks by tablets). Computer vision syndrome will be measured by the CVS-Q teen© with three follow-ups. The prevalence of computer vision syndrome will be analysed according to sociodemographic, visual and digital device use variables. Logistic regression models will be performed, with random effect by student and time of use.

Purpose To translate, cross-culturally adapt and validate the Computer Vision Syndrome Questionnaire (CVS-Q©) into Persian. Methods This study was carried out in 2 phases: (1) the CVS-Q© was translated and cross-culturally adapted into Persian and (2) the validity and reliability of CVS-Q FA© were assessed in a cross-sectional validation study. An expert committee composed of 15 optometrists evaluated content validity (item-level (I-CVI) and scale-level (S-CVI) content validity index were calculated). A pretest was performed (n = 20 participants) to verify the comprehensibility of the questionnaire. A total of 102 computer users completed the final questionnaire. Criterion validity and diagnostic performance of the CVS-Q FA© were assessed by calculating sensitivity, specificity and receiver characteristic operator curve. Cronbach's alpha was calculated for the assessment of internal consistency and 46 participants refilled the questionnaire for the second time and the interclass correlation coefficient (ICC) and Cohen's kappa (κ) were evaluated for test–retest reliability. Results The translation and cross-cultural adaptation process was performed successfully according to accepted scientific recommendations without any major difficulties. The I-CVI was above 0.80 for all items (symptoms) except item 15 (feeling that sight is worsening) and the S-CVI was 0.92. The CVS-Q FA© showed good sensitivity (81.1%) and acceptable specificity (69.2%). Also, it achieved good internal consistency (Cronbach's alpha = 0.80) and test–retest reliability (ICC = 0.81 and κ = 0.65). Conclusion The CVS-Q FA© was successfully translated, cross-culturally adapted, and validated into Persian. This study provides a valid and reliable tool for the assessment of computer vision syndrome among the Iranian working population.

The use of digital devices affects eye health; this can influence the performance of workers. To assess this impact, validated patient-reported outcome questionnaires are needed. The purpose of this study was to validate the psychometric properties of the Italian version of the Computer Vision Syndrome Questionnaire (CVS-Q©) using Rasch analysis. Two hundred and forty-one Italian workers completed an ad hoc questionnaire on anamnesis and exposure to digital devices, and the Italian version of the CVS-Q©. Subsequently, a battery involving three clinical ocular surface and tear tests was performed. The reliability and validity of the scale was assessed using the Andrich Rating Scale Model, and the prevalence of computer vision syndrome (CVS) was calculated. A good fit of both items and persons to the predictions of the Rasch model was observed, with acceptable reliability, unidimensionality, and no or minimal severe differences as a function of gender or age; moreover, good test–retest repeatability, adequate values of sensitivity, reliability, and area under the curve, and adequate construct validity based on clinical tests were obtained. Workers with a questionnaire score ≥ 7 were found to present with CVS. The prevalence of CVS was 76.6%. The CVS-Q IT© is a valid and reliable scale to assess CVS in Italian workers who use digital devices.

Purpose: Dry eye disease (DED) is a frequent chronic ophthalmic condition. Its diagnosis includes tests and Patient Reported Outcomes (PRO) questionnaires. Although many PRO dry eye questionnaires (PRO-DEQ) are available, they differ greatly from each other and not all have been validated. The purpose of this study was to retrieve the PRO-DEQ present in the scientific literature by performing a descriptive analysis of them and identifying those with known validity and reliability characteristics and to perform a descriptive analysis of the geographical area, year of publication and characteristics of the target population of the clinical studies that have used validated PRO dry eye questionnaires. Design: Scoping review of the literature. Methods: Search was conducted in PubMed to retrieve PRO-DEQ published up to July 2018 and written in English, French, Italian or Spanish. Results: 1602 records were identified, 973 were finally included. Of these, 56 provided information on the design and validation of PRO-DEQ and 49 PRO-DEQ were identified. 22 PRO-DEQ were validated (17 original and 5 modified) and 27 had no associated design, validity, and reliability studies. Most of the validated PRO-DEQ have been designed in English, the number of items varies between 1-57, the dimensions are generally not specified, and they are self-administered. The greatest use of validated PRO-DEQ in clinical studies has been in Asia since 2010, with the Ocular Surface Disease Index (OSDI) being the most used. These questionnaires have been used mostly in adults, retired professionals and people with visual diseases to diagnose DED. Conclusions: This study aims to encourage the use of validated PRO-DEQ to guarantee the quality of the results obtained, as well as the comparability and replicability among studies. The authors thank the Vice-Rectorate of Research of the University of Alicante for the pre-doctoral training contract for the third author (UAFPU2019-08). Jose María Ramada receives a salary as head of the occupational health service at Hospital del Mar (Barcelona) and as associate professor at the University Pompeu Fabra in Barcelona (Spain). Likewise, he has received competitive funding from the European Regional Development Fund (ERDF), through the Instituto de Salud Carlos III for the INTEVAL_Plus project (PI17/00779), of which he is the principal investigator.

Objetivo: Analizar la prevalencia y la evolución del síndrome visual informático en estudiantes de secundaria y bachillerato mediante el CVS-Q© adaptado y validado para adolescentes, según empleen libros en papel o en soporte digital. Método: Se adaptará el CVS-Q© mediante un pilotaje en adolescentes y un grupo nominal compuesto por especialistas en salud visual, profesorado y padres/madres. Se evaluarán la calidad y la aplicabilidad de la versión resultante (CVS-Q teen©) y se realizará un estudio de validación con pruebas visuales, retest y análisis psicométrico. Posteriormente, se realizará un estudio prospectivo longitudinal con cuatro medidas repetidas en adolescentes de dos institutos de San Juan de Alicante (uno ha sustituido libros por tabletas). Se medirá el síndrome visual informático mediante el CVS-Q teen© con tres seguimientos. Se analizará la prevalencia de síndrome visual informático según factores sociodemográficos, visuales y de uso de dispositivos digitales. Se realizarán modelos de regresión logística con efecto aleatorio por estudiante y tiempo de uso. Objective: To analyse the prevalence and progression of computer vision syndrome in secondary and high school students with the CVS-Q© adapted and validated for adolescents, depending on whether they use textbooks or digital books. Method: The CVS-Q© will be adapted by a pilot study in adolescents and a nominal group of visual health specialists, teachers and parents. The resulting version (CVS-Q teen©) will be tested to confirm its quality and applicability and a validation study will be done with visual tests, retest and psychometric analysis. Subsequently, a prospective longitudinal study with four repeated measures will be carried out in adolescents from two secondary schools of San Juan de Alicante (one has replaced textbooks by tablets). Computer vision syndrome will be measured by the CVS-Q teen© with three follow-ups. The prevalence of computer vision syndrome will be analysed according to sociodemographic, visual and digital device use variables. Logistic regression models will be performed, with random effect by student and time of use. Los autores agradecen al Vicerrectorado de Investigación de la Universidad de Alicante por el contrato de formación predoctoral de la segunda autora (UAFPU2019-08). El presente proyecto ha sido financiado por la convocatoria «Proyectos de Investigación en Salud», Fondo de Investigación en Salud del Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación y Unión Europea, a través de los Fondos Europeos de Desarrollo Regional (FEDER) «Una manera de hacer Europa», con la referencia PI20/01629.

Aim To estimate the prevalence of computer vision syndrome (CVS) in university students and its relationship with sociodemographic and optical correction factors and exposure to video display terminal (VDT). Methods This cross-sectional study included 244 Spanish university students who responded to an anamnesis, a VDT exposure questionnaire and the Computer Vision Syndrome Questionnaire (CVS-Q© ). A descriptive analysis was performed and the prevalence of CVS was calculated. Logistic regression models were used to measure the association between CVS and the variables studied. Results The mean age was 20.7 years (SD = 2.1), 57% were women, 78.3% used VDTs ≥ 2 hours/day to study. The prevalence of CVS was 76.6%, and the most frequent symptoms were headache and itching. In the crude analysis, being a woman, using glasses daily and to study, and a longer VDT use to study and in total were associated with a higher prevalence of CVS; while in the older group, the prevalence was lower. In the multivariate model, VDT use to study was associated with a greater probability of CVS (aOR: 3.43; 95%CI: 1.03-11.42), and being between 22 and 29 years was associated with a lower probability of it (aOR: 0.36; 95%CI: 0.15-0.89). Conclusion CVS has a high prevalence amongst Spanish university students. The most affected are the younger ones and those who use VDTs for longer hours to study. It is essential to continue investigating the influence of the type of tasks conducted with VDTs on CVS and thus to establish the preventive measures to reduce this syndrome.

Background and Objectives: The prolonged use of digital screens can cause a set of visual and ocular symptoms known as Computer Vision Syndrome (CVS), which is a common health issue among computer users. This study aimed to estimate the prevalence of CVS among university employees and graduate students in their occupational environment in Iran. Methods: A cross-sectional study was carried out in the Rehabilitation School of Iran University of Medical Science, Tehran, Iran. The study population (n=154) included all university employees and graduate students who spend at least one hour of computer work per day in their workplace. The participants completed a validated self-administered questionnaire. A descriptive analysis was performed and the prevalence of CVS was calculated. The correlations between variables were assessed using the Pearson and Spearman correlation coefficients and non-parametrical tests were used to evaluate the association between CVS and predictor variables, as well as differences between subgroups. Results: The Mean±SD age of the sample was 37.7±11.0 years, 64.3% were women, 57.8% were employee, 56.5% have higher education and the Mean±SD of computer usage time was 5.08±2.2. The total prevalence of CVS was 48.7% and the most frequent symptoms were eye redness (62.3%) and burning (56.5%). A significant positive correlation was found between the number of hours working with a computer and the total score of CVS (Pearson correlation coefficient = 0.248, P=0.02). Moreover, the total score of CVS significantly differed between participants who use six or more hours the computer and those who spend less than six hours (Mann-Whitney U test: P=0.007). Conclusion: This is the first investigation using a validated questionnaire to estimate the prevalence of CVS among computer users in the occupational environment, in Iran. The results show a relatively high prevalence of CVS these populations. The most affected are those who use the computer for a longer duration. This study was supported by Iran University of Medical Sciences.

Latin American immigrants make up 49% of the total immigrant population in Spain, yet little is known about their eye health. The aim of this study is to determine if there are differences in self-perceived eye health, access to eye care specialists, and use of lenses between a sample of Latin American immigrant workers from Colombia and Ecuador, and native-born workers in Spain. We used data from the PELFI cohort (Project for Longitudinal Studies of Immigrant Families). The sample consisted of 179 immigrant workers born in Colombia or Ecuador, and 83 Spanish-born workers. The outcome variables were self-perceived eye health, access to eye specialists, and use of lenses. A descriptive analysis of the sample was carried out, and the prevalence of the three outcome variables in immigrants and natives was calculated and adjusted for explanatory variables. Random effects logistic regression models examined eye health outcomes by workers&rsquo, country of birth. Immigrants are less likely to report poor self-perceived eye health than native-born (ORc 0.46, CI 95%, 0.22&ndash, 0.96). Furthermore, they have less access to specialists (ORc 2.61, CI 95%, 1.32&ndash, 5.15) and a higher probability of needing lenses but not having them (ORc 14.14, CI 95%, 1.77&ndash, 112.69). This latter variable remained statistically significant after adjusting for covariates (ORa 34.05, CI 95%, 1.59&ndash, 729.04). Latin American immigrants may not value the use of lenses, despite eye care specialists indicating that they need them. Eye health education is required to recognize the importance of using lenses according to their visual needs.