EC Ophthalmology

Background: Although digital devices are ubiquitous, their prolonged usage can strain the visual system and lead to asthenopic symptoms, a condition known as computer vision syndrome (CVS). CVS is typically induced by vergence anomalies, accommodative dysfunction and/or refractive errors. Full assessment of visual system needed to treat people suffering from CVS.

Purpose: This study aimed to investigate the association between CVS and refractive, accommodative, and vergence anomalies in young adults.

Methods: A total of 141 young adults aged 16 - 38 years who spend 2 - 3h on computer screens per day were included. The severity of CVS was determined using the CVS questionnaire. Based on the severity of CVS, three groups were identified: asymptomatic, moderately symptomatic, and severely symptomatic. The clinical measurements included refractive, accommodation, and vergence systems.

Results: No significant association was found between the time spent in front of the computer screen and the total CVS score for all participants. Spherical and astigmatic refractive errors were not associated with CVS. However, among all accommodative tests, the amplitude of accommodation was associated with the severity of CVS. In addition, the mean values for the near point of convergence were clinically significant and increased with the severity of CVS, although this was not statistically significant.

Conclusion: The amplitudes of accommodation and near point of convergence were found to be the best clinical measurements for predicting the occurrence and severity of CVS. This suggests a higher incidence of “accommodative and/or “convergence insufficiency” among individuals with CVS.

 Keywords: Computer Vision Syndrome; Refraction; Astigmatism; Accommodation; Vergence; Binocular Vision

1. Martin M. “Computer and internet use in the United States: 2018 American community survey reports” (2021).
2. Rideout VJ., et al. “Generation M2: Media in the Lives of 8 to 18 Year-Olds”. Ph.D. The Henry J Kaiser Family Foundation (2010).
3. Blehm C., et al. “Computer vision syndrome: A review”. Survey of Ophthalmology3 (2005): 253-262.
4. Sheppard AL and Wolffsohn JS. “Digital eye strain: Prevalence, measurement and amelioration”. BMJ Open Ophthalmology1 (2018): e000146.
5. Rosenfield M. “Computer vision syndrome: A review of ocular causes and potential treatments”. Ophthalmic and Physiological Optics5 (2011): 502-515.
6. Bodack MI., et al. “An analysis of vision screening data from New York city public schools”. Optometry 9 (2010): 476-484.
7. Jaiswal S., et al. “Ocular and visual discomfort associated with smartphones, tablets and computers: What we do and do not know”. Clinical and Experimental Optometry 5 (2019): 463-477.
8. Sheedy JE., et al. “Is all asthenopia the same?” Optometry and Vision Science11 (2003): 732-739.
9. Bhanderi DJ., et al. “A community-based study of asthenopia in computer operators”. Indian Journal of Ophthalmology 1 (2008): 51-55.
10. Mocci F., et al. “Psychological factors and visual fatigue in working with video display terminals”. Occupational and Environmental Medicine 4 (2001): 267-271.
11. Sánchez-Román FR., et al. “Risk factors for asthenopia among video display terminal operators”. Salud Pública de México 3 (1996): 189-196.
12. Wiggins NP and Daum KM. “Visual discomfort and astigmatic refractive errors in VDT use”. Journal of the American Optometric Association 9 (1991): 680-684.
13. Wiggins NP., et al. “Effects of residual astigmatism in contact lens wear on visual discomfort in VDT use”. Journal of the American Optometric Association 3 (1992): 177-181.
14. Wick B and Morse S. “Accommodative accuracy to video display monitors”. Optometry and Vision Science12 (2002): 218.
15. Watten RG., et al. “The influence of long-term visual near-work on accommodation and vergence: A field study”. Journal of Human Ergology (Tokyo)1 (1994): 27-39.
16. Seguí MDM., et al. “A reliable and valid questionnaire was developed to measure computer vision syndrome at the workplace”. Journal of Clinical Epidemiology 6 (2015): 662-673.
17. Tauste A., et al. “Effect of contact lens use on computer vision syndrome”. Ophthalmic and Physiological Optics2 (2016): 112-119.
18. Sirajudeen MS., et al. “Computer-related health problems among university students in Majmaah region, Saudi Arabia”. Biomedical Research11 (2018): 2405-2415.
19. Turkistani AN., et al. “Computer vision syndrome among Saudi population: An evaluation of prevalence and risk factors”. Journal of Family Medicine and Primary Care 6 (2021): 2313-2318.
20. Patil A., et al. “Eyeing computer vision syndrome: awareness, knowledge, and its impact on sleep quality among medical students”. Industrial Psychiatry Journal 1 (2019): 68-74.
21. Shrestha GS., et al. “Visual problems among video display terminal (VDT) users in Nepal”. Journal of Optometry 2 (2011): 56-62.
22. Heus P., et al. “Optical correction of refractive error for preventing and treating eye symptoms in computer users”. Cochrane Database of Systematic Reviews 4 (2018): CD009877.
23. Coles-Brennan C., et al. “Management of digital eye strain”. Clinical and Experimental Optometry 1 (2021): 18-29.
24. Ip JM., et al. “Prevalence of eye disorders in young children with eyestrain complaints”. American Journal of Ophthalmology 3 (2006): 495-497.
25. Tawil L Al and Aldokhayel S. “Prevalence of self-reported computer vision syndrome symptoms and its associated factors among university students”.‏ European Journal of Ophthalmology 1 (2020): 189-195.
26. Filon FL., et al. “Video display operator complaints: A 10-year follow-up of visual fatigue and refractive disorders”. International Journal of Environmental Research and Public Health14 (2019): 2501.
27. Parihar JKS., et al. “Computer and visual display terminals (VDT) vision syndrome (CVDTS)”. Medical Journal Armed Forces India 3 (2016): 270-276.
28. Wajuihian SO and Hansraj R. “Accommodative anomalies in a sample of black high school students in South Africa”. Ophthalmic Epidemiology5 (2016): 316-323.
29. Rosenfield M. “Computer vision syndrome: Accommodative and vergence facility” (2023).
30. Gall R and Wick B. “The symptomatic patient with normal phorias at distance and near: What tests detect a binocular vision problem?” Optometry5 (2023): 309-322.
31. Iribarren R., et al. “Effect of cumulative nearwork on accommodative facility and asthenopia”. International Ophthalmology 4 (2001): 205-212.
32. Tosha C., et al. “Accommodation response and visual discomfort”. Ophthalmic and Physiological Optics6 (2009): 625-633.
33. Collier JD and Rosenfield M. “Accommodation and convergence during sustained computer work”. Optometry-Journal of the American Optometric Association7 (2011): 434-440.
34. Rouse M., et al. “Frequency of convergence insufficiency in optometry clinic settings”.‏ Optometry and Vision Science2 (2023): 88-96.
35. Cooper J and Jamal N. “Convergence insufficiency-A major review”. Optometry4 (2012): 137-158.