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The Cochrane Database of Systematic... Apr 2018Computer users frequently complain about problems with seeing and functioning of the eyes. Asthenopia is a term generally used to describe symptoms related to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Computer users frequently complain about problems with seeing and functioning of the eyes. Asthenopia is a term generally used to describe symptoms related to (prolonged) use of the eyes like ocular fatigue, headache, pain or aching around the eyes, and burning and itchiness of the eyelids. The prevalence of asthenopia during or after work on a computer ranges from 46.3% to 68.5%. Uncorrected or under-corrected refractive error can contribute to the development of asthenopia. A refractive error is an error in the focusing of light by the eye and can lead to reduced visual acuity. There are various possibilities for optical correction of refractive errors including eyeglasses, contact lenses and refractive surgery.
OBJECTIVES
To examine the evidence on the effectiveness, safety and applicability of optical correction of refractive error for reducing and preventing eye symptoms in computer users.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; Embase; Web of Science; and OSH update, all to 20 December 2017. Additionally, we searched trial registries and checked references of included studies.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) and quasi-randomised trials of interventions evaluating optical correction for computer workers with refractive error for preventing or treating asthenopia and their effect on health related quality of life.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed study eligibility and risk of bias, and extracted data. Where appropriate, we combined studies in a meta-analysis.
MAIN RESULTS
We included eight studies with 381 participants. Three were parallel group RCTs, three were cross-over RCTs and two were quasi-randomised cross-over trials. All studies evaluated eyeglasses, there were no studies that evaluated contact lenses or surgery. Seven studies evaluated computer glasses with at least one focal area for the distance of the computer screen with or without additional focal areas in presbyopic persons. Six studies compared computer glasses to other types of glasses; and one study compared them to an ergonomic workplace assessment. The eighth study compared optimal correction of refractive error with the actual spectacle correction in use. Two studies evaluated computer glasses in persons with asthenopia but for the others the glasses were offered to all workers regardless of symptoms. The risk of bias was unclear in five, high in two and low in one study. Asthenopia was measured as eyestrain or a summary score of symptoms but there were no studies on health-related quality of life. Adverse events were measured as headache, nausea or dizziness. Median asthenopia scores at baseline were about 30% of the maximum possible score.Progressive computer glasses versus monofocal glassesOne study found no considerable difference in asthenopia between various progressive computer glasses and monofocal computer glasses after one-year follow-up (mean difference (MD) change scores 0.23, 95% confidence interval (CI) -5.0 to 5.4 on a 100 mm VAS scale, low quality evidence). For headache the results were in favour of progressive glasses.Progressive computer glasses with an intermediate focus in the upper part of the glasses versus other glassesIn two studies progressive computer glasses with intermediate focus led to a small decrease in asthenopia symptoms (SMD -0.49, 95% CI -0.75 to -0.23, low-quality evidence) but not in headache score in the short-term compared to general purpose progressive glasses. There were similar small decreases in dizziness. At medium term follow-up, in one study the effect size was not statistically significant (SMD -0.64, 95% CI -1.40 to 0.12). The study did not assess adverse events.Another study found no considerable difference in asthenopia between progressive computer glasses and monofocal computer glasses after one-year follow-up (MD change scores 1.44, 95% CI -6.95 to 9.83 on a 100 mm VAS scale, very low quality evidence). For headache the results were inconsistent.Progressive computer glasses with far-distance focus in the upper part of the glasses versus other glassesOne study found no considerable difference in number of persons with asthenopia between progressive computer glasses with far-distance focus and bifocal computer glasses after four weeks' follow-up (OR 1.00, 95% CI 0.40 to 2.50, very low quality evidence). The number of persons with headache, nausea and dizziness was also not different between groups.Another study found no considerable difference in asthenopia between progressive computer glasses with far-distance focus and monofocal computer glasses after one-year follow-up (MD change scores -1.79, 95% CI -11.60 to 8.02 on a 100 mm VAS scale, very low quality evidence). The effects on headaches were inconsistent.One study found no difference between progressive far-distance focus computer glasses and trifocal glasses in effect on eyestrain severity (MD -0.50, 95% CI -1.07 to 0.07, very low quality evidence) or on eyestrain frequency (MD -0.75, 95% CI -1.61 to 0.11, very low quality evidence).Progressive computer glasses versus ergonomic assessment with habitual (computer) glassesOne study found that computer glasses optimised for individual needs reduced asthenopia sum score more than an ergonomic assessment and habitual (computer) glasses (MD -8.9, 95% CI -16.47 to -1.33, scale 0 to 140, very low quality evidence) but there was no effect on the frequency of eyestrain (OR 1.08, 95% CI 0.38 to 3.11, very low quality evidence).We rated the quality of the evidence as low or very low due to risk of bias in the included studies, inconsistency in the results and imprecision.
AUTHORS' CONCLUSIONS
There is low to very low quality evidence that providing computer users with progressive computer glasses does not lead to a considerable decrease in problems with the eyes or headaches compared to other computer glasses. Progressive computer glasses might be slightly better than progressive glasses for daily use in the short term but not in the intermediate term and there is no data on long-term follow-up. The quality of the evidence is low or very low and therefore we are uncertain about this conclusion. Larger studies with several hundreds of participants are needed with proper randomisation, validated outcome measurement methods, and longer follow-up of at least one year to improve the quality of the evidence.
Topics: Asthenopia; Computer Terminals; Ergonomics; Eyeglasses; Headache; Humans; Randomized Controlled Trials as Topic; Refractive Errors
PubMed: 29633784
DOI: 10.1002/14651858.CD009877.pub2 -
International Ophthalmology Sep 2023To evaluate the prevalence of computer vision syndrome (CVS)-related symptoms in a presbyopic population using the computer as the main work tool, as well as the...
PURPOSE
To evaluate the prevalence of computer vision syndrome (CVS)-related symptoms in a presbyopic population using the computer as the main work tool, as well as the relationship of CVS with the electronic device use habits and the ergonomic factors.
METHODS
A sample of 198 presbyopic participants (aged 45-65 years) who regularly work with a computer completed a customised questionnaire divided into: general demographics, optical correction commonly used and for work, habits of electronic devices use, ergonomic conditions during the working hours and CVS-related symptoms during work performance. A total of 10 CVS-related symptoms were questioned indicating the severity with which they occurred (0-4) and the median total symptom score (MTSS) was calculated as the sum of the symptoms.
RESULTS
The MTSS in this presbyopic population is 7 ± 5 symptoms. The most common symptoms reported by participants are dry eyes, tired eyes and difficulties in refocusing. MTSS is higher in women (p < 0.05), in laptop computer users (p < 0.05) and in teleworkers compared to office workers (p < 0.05). Regarding ergonomic conditions, MTSS is higher in participants who do not take breaks while working (p < 0.05), who have an inadequately lighting in the workspace (p < 0.05) and in the participants reporting neck (p < 0.01) or back pain (p < 0.001).
CONCLUSION
There is a relationship between CVS-related symptoms, the use of electronic devices and the ergonomic factors, which indicates the importance of adapting workplaces, especially for home-based teleworkers, and following basic visual ergonomics rules.
Topics: Humans; Female; Computer Terminals; Occupational Diseases; Asthenopia; Ergonomics; Computers; Surveys and Questionnaires
PubMed: 37103757
DOI: 10.1007/s10792-023-02724-z -
Neuro-ophthalmology (Aeolus Press) 2022Photophobia is considered the second most common symptom of both concussion and post-concussion syndrome. Soldiers on duty experience photophobia after blast-related... (Review)
Review
Photophobia is considered the second most common symptom of both concussion and post-concussion syndrome. Soldiers on duty experience photophobia after blast-related concussions or mild traumatic brain injury in 60-75% of instances. In addition, soldiers report other symptoms, such as asthenopia, squinting, dry eyes and headaches, for which they are considered to be at high risk. According to the International Brain Injury Association, some concussed patients report indirect symptoms such as multi-tasking difficulties, dizziness, vertigo, and fatigue. Moreover, some concussed individuals experience photophobia for approximately 6 months or indefinitely. We present the case of a 23-year-old soldier who presented with severe photophobia after a mild traumatic head injury. His photophobia was alleviated after the administration of topical anaesthetic drops in the eyes in the absence of any ocular surface pathology. He was diagnosed with post-concussion syndrome light sensitivity and was managed successfully with rose-coloured special photophobia glasses tinted with FL-41. Photophobia is a common neurological symptom in military personnel that needs more attention as it affects body and mind. We have reported an uncommon pathway of photophobia, which may unveil an unrecognised mechanism that may play a role in post-concussion photophobia.
PubMed: 35273410
DOI: 10.1080/01658107.2021.1983612 -
Nutrients Dec 2021The aims of the study were to investigate the ability and effectiveness of an oral intake of a fixed combination of zinc, L-carnitine, elderberry extract, black currant... (Observational Study)
Observational Study Randomized Controlled Trial
A Pilot, Phase II, Observational, Case-Control, 1-Month Study on Asthenopia in Video Terminal Operators without Dry Eye: Contrast Sensitivity and Quality of Life before and after the Oral Consumption of a Fixed Combination of Zinc, L-Carnitine, Extract of Elderberry, Currant and Extract of...
The aims of the study were to investigate the ability and effectiveness of an oral intake of a fixed combination of zinc, L-carnitine, elderberry extract, black currant and Eleutherococcus extract in controlling the symptoms of eyestrain in videoterminal (VDT) users and to record its effects on contrast sensitivity. A single-center, phase II, observational, case-control, 1-month study in VDT workers without dry eye disease was carried out. Demographics and number of actual hours at VDT/day were taken into account. All subjects underwent a complete ophthalmic examination, including assessment of contrast sensitivity, and completed the computer vision symptom scale questionnaire at baseline and one month later. A total of 30 Caucasian subjects adhered to the required inclusion criteria and completed the study; 15 subjects were treated (T) and 15 were controls (C). All clinical data at baseline were similar in both groups ( 0.05): after one month, all subjects had stable visual acuity, refractive defect and intraocular pressure (IOP); screen exposure time was unchanged. Regarding symptoms, at randomization, the groups had a similar score: 33.1 ± 3.3 in T and 32.8 ± 5.6 in C. One month later, the computer vision symptom scale (CVSS) questionnaire score decreased by -14.1 ± 3, 1 ( 0.000) and -2.3 ± 1.8 ( 0.568), respectively. Regarding contrast sensitivity, in group C the values of spatial frequencies remained unchanged, while they improved in almost all the cycles per degree stimuli in the treated group. Oral intake of a fixed combination of zinc, L-carnitine, elderberry extract, black currant and eleutherococcus extract can significantly improve contrast sensitivity and symptoms in VDT workers with no signs of dry eye disease.
Topics: Administration, Oral; Adult; Asthenopia; Carnitine; Computer Terminals; Dry Eye Syndromes; Eleutherococcus; Female; Humans; Male; Middle Aged; Plant Extracts; Ribes; Sambucus; Visual Acuity; Zinc
PubMed: 34960000
DOI: 10.3390/nu13124449 -
The British and Irish Orthoptic Journal 2022Refractive, accommodative and vergence parameters and associated anomalies cause symptoms of asthenopia. Patients consult eye care practitioners mainly due to symptoms...
BACKGROUND
Refractive, accommodative and vergence parameters and associated anomalies cause symptoms of asthenopia. Patients consult eye care practitioners mainly due to symptoms they experience. To enhance targeted treatments from various anomalies, it is relevant to study symptoms with associating anomalies.
AIM
To determine the frequencies of refractive error, accommodative and vergence anomalies, and their associations with symptoms in sample of Black South Africans.
METHOD
This prospective, cross-sectional study comprised consecutive participants aged 10-40 years who attended the author's optometry practice in a Black population in South Africa. Visual acuity, refraction, accommodative and vergence tests were performed. Anomalies were classified as either single measure or syndromes based on the number of failed clinical signs.
RESULTS
Participants (n = 254) had mean age 22.6 ± 7.22 years. Ninety-four were male (37%) and 160 were female (63%). The frequencies of syndrome anomalies were accommodative insufficiency 17 [(6.6%) 95% CI 3.9-10.5%)], accommodative infacility 32 [(12.6%)] 8.7-17.3%] and convergence insufficiency 22 [(8.6%, 5.1-12.3%)]. Frequencies of coexisting anomalies were refractive error and accommodative 150 (60.0%), refractive error and vergence anomalies 136 (54.4%) and vergence and accommodative disorders 155 (62.0%). Most patients were symptomatic (70.9%). Headache was the most frequent symptom (41.1%).
CONCLUSION
Accommodative anomalies were more frequent than refractive error and vergence anomalies. The high frequency of anomalies suggests a high uptake of optometric services for asthenopia. Accommodative anomalies were the most symptomatic. The study highlights the need for diagnosing visual symptoms and coexisting anomalies. Establishment of validated study protocols for all accommodative and vergence anomalies is recommended.
PubMed: 35903147
DOI: 10.22599/bioj.267 -
Transactions of the American... 1894
PubMed: 25259168
DOI: No ID Found -
Journal of Healthcare Engineering 2022To explore the intervention effect of traditional Chinese medicine hot pressing combined with health education in adolescents with asthenopia, 92 adolescents with... (Randomized Controlled Trial)
Randomized Controlled Trial
To explore the intervention effect of traditional Chinese medicine hot pressing combined with health education in adolescents with asthenopia, 92 adolescents with asthenopia admitted to the outpatient department of Guangming Traditional Chinese Medicine Hospital in Pudong New Area from October 2019 to January 2021 were selected and randomly divided into two groups: the control group and the test group, each with 46 cases. Both received health education. The control group was given sodium hyaluronate eye drops, and the test group was given traditional Chinese medicine hot ironing technique intervention. After 2 courses of treatment, the scores of visual fatigue symptoms, clinical curative effect, and eye refractive power of the two groups were observed. The satisfaction of treatment was compared between the two groups. The scores of asthenopia of the two groups were compared at 6 months after intervention. After the intervention, the scores of visual fatigue symptoms in the control group and the test group were reduced after one or two courses of treatment (control group: = 4.167, 6.318, and =0.027, 0.010; test group: = 4.820, 6.834, and =0.013, <0.001). The scores of asthenopia symptoms of the trial group after the intervention for one and two courses were significantly lower than those of the control group ( < 0.05); the total clinical effective rate of the trial group was 93.48%, which was significantly higher than that of the control group (80.43%). The difference between the groups was statistically significant ( < 0.05); the left and right eyes of the control group did not change significantly before and after the intervention ( > 0.05). After the intervention, the left and right eyes of the paper group were significantly reduced ( < 0.05). After the intervention, the difference of the two groups in the refractive power of the left and right eyes was statistically significant ( < 0.05). After treatment, the satisfaction of the experimental group was significantly higher than that of the control group ( < 0.05). After 6 months, there was no significant change in the visual fatigue score of the experimental group, while the visual fatigue score of the control group increased significantly. The traditional Chinese medicine ironing combined with health education intervention can improve the symptoms of adolescents' asthenopia and improve the treatment efficiency. The method is safe, and the operation is convenient. It is worthy of clinical promotion.
Topics: Adolescent; Asthenopia; Health Education; Humans; Medicine, Chinese Traditional; Treatment Outcome
PubMed: 35360485
DOI: 10.1155/2022/2450197 -
Journal of Optometry 2024This review aimed to estimate the prevalence of computer vision syndrome (CVS) in the general population and subgroups. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
This review aimed to estimate the prevalence of computer vision syndrome (CVS) in the general population and subgroups.
METHODS
A search was conducted in the following the databases: PubMed, SCOPUS, EMBASE, and Web of Science until February 13, 2023. We included studies that assessed the prevalence of CVS in any population. The Joanna Briggs Institute's critical appraisal tool was used to evaluate the methodological quality. A meta-analysis of the prevalence of CVS was done using a random-effects model, assessing the sources of heterogeneity using subgroup and meta-regression analyses.
RESULTS
A total of 103 cross-sectional studies with 66 577 participants were included. The prevalence of CVS was 69.0% (95% CI: 62.3 to 75.3; I: 99.7%), ranging from 12.1 to 97.3% across studies. Point prevalence was higher in women than in men (71.4 vs. 61.8%), university students (76.1%), Africa (71.2%), Asia (69.9%), contact lens wearers (73.1% vs. 63.8%) in studies conducted before the COVID-19 pandemic (72.8%), and in those that did not use the CVS-Q questionnaire (75.4%). In meta-regression, using the CVS-Q scale was associated with a lower prevalence of CVS.
CONCLUSION
Seven out of ten people suffer from CVS. Preventive strategies and interventions are needed to decrease the prevalence of this condition which can affect productivity and quality of life. Future studies should standardize a definition of CVS.
Topics: Female; Humans; Male; Computers; Cross-Sectional Studies; Pandemics; Prevalence; Quality of Life; Syndrome; Asthenopia
PubMed: 37866176
DOI: 10.1016/j.optom.2023.100482 -
Hong Kong Medical Journal = Xianggang... Apr 2023This study explored the impact of online learning during the coronavirus disease 2019 (COVID-19) pandemic on asthenopia and vision impairment in students, with the aim...
INTRODUCTION
This study explored the impact of online learning during the coronavirus disease 2019 (COVID-19) pandemic on asthenopia and vision impairment in students, with the aim of establishing a theoretical basis for preventive approaches to vision health.
METHODS
This balanced panel study enrolled students from western rural China. Participant information was collected before and during the COVID-19 pandemic via questionnaires administered at local vision care centres, along with clinical assessments of visual acuity. Paired tests and fixed-effects models were used to analyse pandemic-related differences in visual status.
RESULTS
In total, 128 students were included (mean age before pandemic, 11.82 ± 1.46 years). The mean total screen time was 3.22 ± 2.90 hours per day during the pandemic, whereas it was 1.97 ± 1.90 hours per day in the pre-pandemic period (P<0.001). Asthenopia prevalence was 55% (71/128) during the pandemic, and the mean visual acuity was 0.81 ± 0.30 logarithm of the minimum angle of resolution; these findings indicated increasing vision impairment, compared with the pre-pandemic period (both P<0.001). Notably, asthenopia prevalence increased by two- to three-fold, compared with the pre-pandemic period. An increase in screen time while learning was associated with an increase in asthenopia prevalence (P=0.034).
CONCLUSION
During the COVID-19 pandemic, students spent more time on online classes, leading to worse visual acuity and vision health. Students in this study reported a significant increase in screen time, which was associated with increasing asthenopia prevalence and worse vision impairment. Further research is needed regarding the link between online classes and vision problems.
Topics: Humans; Child; Adolescent; COVID-19; Asthenopia; Pandemics; Prevalence; Students; China
PubMed: 37088700
DOI: 10.12809/hkmj219864 -
The American Journal of Clinical... Aug 2020With the frequent use of video display units, eye fatigue is becoming more common globally. An alternative nutritional strategy is needed to prevent the aggravation of... (Review)
Review
BACKGROUND
With the frequent use of video display units, eye fatigue is becoming more common globally. An alternative nutritional strategy is needed to prevent the aggravation of eye fatigue symptoms.
OBJECTIVES
The objective was to evaluate the protective effect of a novel botanical combination of lutein ester, zeaxanthin, and extracts of blackcurrant, chrysanthemum, and goji berry on adults with eye fatigue in a randomized, double-blind, placebo-controlled clinical trial.
METHODS
We randomly allocated 360 participants into 4 groups to receive placebo and 3 doses of our formula (chewable tablets, containing 6 mg, 10 mg, or 14 mg of lutein) once daily for 90 d. Each participant had 3 visits at baseline (V1), 45 d (V2), and 90 d (V3) during the study.
RESULTS
Intervention with the formula improved individual scores of eye fatigue symptoms, including eye soreness, blurred vision, dry eye, foreign body sensation, and tearing. Compared with placebo, the formula at all 3 doses significantly decreased the total score of eye fatigue symptoms and increased the visuognosis persistence time at both V2 and V3. According to the Schirmer test, both 10-mg and 14-mg lutein formula groups had improved tear secretion at V3 compared with the placebo. The keratography results indicated that the first tear break-up time, average tear break-up time, and tear meniscus height were significantly increased after formula intervention. The formula at all 3 doses significantly increased the macular pigment optical density at V2 and V3 compared with the placebo, whereas optical coherence tomography showed no significant difference in retinal thickness and retinal volume across all groups at both visits.
CONCLUSIONS
Our botanical formula improves eye fatigue, dry eye, and macular function without changing the retinal structure, and thus it could serve as an effective nutritional strategy in improving eye fatigue without causing serious side effects.Clinical Trial Registry: chictr.org.cn (ChiCTR1800018987).
Topics: Adult; Aged; Asthenopia; Chrysanthemum; Dietary Supplements; Double-Blind Method; Dry Eye Syndromes; Female; Humans; Lutein; Lycium; Male; Middle Aged; Plant Preparations; Ribes; Visual Acuity; Young Adult; Zeaxanthins
PubMed: 32542334
DOI: 10.1093/ajcn/nqaa139