Since computer use is such a visually demanding task, vision problems and symptoms have become very common in today’s work place . Most studies indicate that computer operators who view their video display terminals (VDT) report more eye related problems than non VDT office workers. NIOSH Survey (National Institute of Occupational Safety and Health) has reported that visual symptoms occur in 75-90 % of VDT workers as opposed to 22 % musculoskeletal disorders (carpel tunnel syndrome) in computer users .

Computer vision syndrome.

With an advancement of digital technology, excessive screen time has become a grave concern. This has pushed researchers and practitioners to focus on digital well-being. Screen time during COVID-19 has further increased as a result of public health measures enforced by governments to curb the pandemic. With the global societies under lockdown, the only medium to stay socio- emotionally connected was the digital one. A lack of comprehensive empirical overviews on screen time in COVID-19 era in the present literature prompted us to conduct this review. The present review attempts to understand the virtual social connectedness, excessive use of digital technology, its consequences and suggest strategies to maintain healthy use of digital technology. Results reveal that screen time has increased drastically during COVID-19. Though there are mixed consequences of prolonged screen time use and blurred understanding between healthy and unhealthy social connectedness over digital media, the suggestions for negative implications on (physical and) mental health warrant a strict need for inculcating healthy digital habits, especially knowing that digital technology is here to stay and grow with time.

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Social Connectedness, Excessive Screen Time During COVID-19 and Mental Health: A Review of Current Evidence

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. 

https://link.springer.com/content/pdf/10.1007/s40123-022-00540-9.pdf

Digital Eye Strain- A Comprehensive Review

This study aimed to evaluate the sleep-related problems and predictors of probable clinical insomnia among college students during the COVID-19 remission period in China. 146,102 college students from 22 colleges/universities in Guangdong province participated in this study from 1th to 15th June, 2020. Self-administered questionnaires were used to assess demographic characteristics. Sleep-related problems, depression and anxiety symptoms were measured by Youth Self-Rating Insomnia Scale, Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7, respectively. The prevalence of difficulty in initiating sleep, difficulty in maintaining sleep, early morning awakening, sleep insufficiency, unrefreshing sleep and daytime functioning impairment were 7.2%, 3.4%, 3.5%, 9.6%, 14.6%, and 7.6%, respectively. 16.9% students had varying degrees of insomnia and 6.3% were considered as displaying probable clinical insomnia. Moreover, being urban residents, having a history of physical or mental illness, and probable clinical depression or anxiety were significant risk factors of probable clinical insomnia, while college senior degree and 7-8 hours' sleep duration per day was the protective factor for probable clinical insomnia. Unrefreshing sleep was the most prominent sleep problem among college students during COVID-19 remission in China. Good sleep hygiene practices are strongly suggested to develop in the time of prolonged home isolation.

Insomnia and other sleep-related problems during the remission period of the COVID-19 pandemic: A large-scale survey among college students in China.

Purpose: To compare the prevalence of computer vision syndrome in university students of different teaching modes during the SARS-CoV-2 outbreak period. Methods: A cross-sectional survey study using the validated Computer Vision Syndrome Questionnaire in Chinese medical students of Sichuan University who took classroom lectures and the same-grade foreign students from a Bachelor of Medicine and Bachelor of Surgery (MBBS) program who took online lectures with similar schedules. Results: A total of 137 responses from 63 Chinese students and 74 MBBS students were obtained. The highest frequency of digital screen time was 7-9 h (43.24%, 32/74) for MBBS students and 2-4 h (46.03%, 29/63) for Chinese students. The prevalence of computer vision syndrome among Chinese students and MBBS students were 50.79% and 74.32%, respectively (P = 0.004). The average numbers of reported symptoms were 5.00 ± 2.17 in Chinese students and 5.91 ± 1.90 in MBBS students (P = 0.01). The three most highly reported symptoms were "heavy eyelids" (53.97%), "dryness" (50.79%), and "feeling of a foreign body" (46.03%) in Chinese students and "dryness" (72.97%), "feeling of a foreign body" (62.16%), and "heavy eyelids" (58.11%) in MBBS students. The sum grades of computer vision syndrome had a moderate positive correlation with screen time (Spearman's correlation coefficient = 0.386, P < 0.001). The grades of symptoms of "feeling of a foreign body," "heavy eyelids," and "dryness" showed a weak positive correlation with screen time (Spearman's correlation coefficients were 0.220, 0.205, and 0.230, respectively). Conclusion: Online study may contribute to the prevalence of computer vision syndrome among university students.

/pdf/computer-vision-syndrome-during-sars-cov-2-outbreak-in-qz7tep11ce.pdf

Computer Vision Syndrome During SARS-CoV-2 Outbreak in University Students: A Comparison Between Online Courses and Classroom Lectures.

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.

Srinivasan Subramanian Grandee

Papers

Impact of the COVID-19 lockdown on digital device-related ocular health.