Six ways to get a grip on computer vision syndrome in medical school examinations

Introduction: This study aimed to discover and document the potential of visual and ocular sequelae of computer vision syndrome (CVS) among medical students. Methods: This cross-sectional case-control study was conducted on medical students (n=4030) of five universities in Egypt. All students completed a specially designed and validated CVS questionnaire survey (CVS-F3). Students with ≥5 CVS symptoms constituted a risk group (n=352), while students with 1-4 CVS symptoms constituted a low-symptoms group (n=3067). Students from the control and risk groups were examined using objective methods, such as visual acuity, subjective refraction, dry eye disease tests, and anterior segment and fundus examinations. Students who complained of visual blur underwent multifocal electroretinography mfERG examinations (mfERG group). Results: The CVS-F3 indicated that 84.8% of students had complaints that might be related to CVS, however, our ophthalmic examination group revealed only a 56% CVS prevalence rate. The most common single screen type used by 70.4% of students was the smartphone, and the most common complaint was headache (50.2%). Multivariate logistic regression analysis revealed that CVS was significantly associated with increased screen-hours, including >2 screen-hours daily (odds ratio [OR], 2.48; P<0.0001), >2 screen-hours at night (OR, 1.79; P=0.003), and ≥3 screen-years (OR, 1.69; P=0.006). In the mfERG group, 37% demonstrated reduced amplitudes of mfERG rings and quadrants, indicating reduced foveal responses. Conclusion: CVS-questionnaires overestimate the true CVS prevalence and sequelae, which could be accurately detected by objective ophthalmic examination. Smartphones primarily caused CVS among students, with CVS severity increasing in correlation with shorter eye-to-screen distance and frequent use. Contact lens wearing doubled the risk of CVS development and augmented its severity. CVS might affect macular integrity with screen-induced foveal dysfunction. Clinical Trials Registration: PACTR201811618954630.

Introduction: Prolonged computer use will lead to a group of symptoms such as dryness of eyes, tired, headache and others called Computer Vision Syndrome (CVS). The decrease of Mucin 5 AC (MUC5AC) level could be one of the signs of dry eye disease on persons with CVS.Objective: The purpose of this study is to describe the Mucin 5AC level in medical faculty students of Udayana University, Bali, Indonesia with CVS.Method: It is an observational cross-sectional analytic study at Medical Faculty Udayana University on October 2018. Thirty four subject selected  by purposive sampling and examined with Schirmer I test, Tear Break Up time (TBUT) test, and Mucin 5AC test. All of the subject then divided into CVS group and non-CVS group. Mucin 5AC level which less than 186.33 ng/mL categorized as low mucin, while more than 186.33 ng/mL categorized as normal mucin level. Data was analyzed by crosstabulation table and chi-square test with significant value p < 0.05.Result: Most of the students who diagnosed with CVS had lower mucin 5AC levels as much as 77,3% and 33,3% students with CVS had normal mucin 5AC level.  This study analyses found there is significant association between level of mucin 5AC with CVS. The students with low level of mucin 5AC had 6,8 higher risk tend to be CVS (OR=6,8; CI 95%= 1,42-32,37; p=0,012).Conclusion: Low level of mucin 5AC has association with the risk of CVS in the medical students with prolonged computer use.

Background:Computer vision syndrome (CVS) encompasses a constellation of ocular and extraocular symptoms in computer users who either habitually or compulsively use computers for long periods of time. Electronic devices such as computers, smart phones, and tablets emit blue light (400–490 nm) from their light-emitting diodes and produce electromagnetic fields, both of which interfere with the circadian rhythm.Aim:This study aims to assess the awareness, knowledge, and impact on sleep quality of CVS among medical students.Materials and Methods:This study included 500 medical students. All participants anonymously filled up a pro forma including sociodemographic details and three questionnaires that (a) tested for awareness and knowledge about CVS, (b) tested for CVS, and (c) the Pittsburgh sleep quality index (PSQI), respectively. Data from 463 complete questionnaires were analyzed.Results:The mean (±standard deviation) age of the 463 individuals was 19.55 (±1.04) years. The prevalence of CVS was 77.5%. The prevalence was higher in boys (80.23%) compared to girls (75.87%), but the difference was not statistically significant. Only 34.1% of the medical students were aware of CVS. Good knowledge regarding various aspects of CVS was observed in 22.46% individuals, while 53.99% and 23.56% had average and poor knowledge, respectively. Poor sleep quality was present in 75.49% of individuals with CVS compared to 50.96% of students without CVS; the difference was statistically significant (odd's ratio [95% confidence interval]: 0.338 [0.214–0.531]). All the components of PSQI score, except components 1 and 6, had statistically significantly (P < 0.05) higher values in individuals with CVS as compared to individuals without CVS.Conclusions:There is high prevalence but low level of awareness and knowledge about CVS among medical students. CVS is significantly associated with poor sleep quality in medical students.

Background: The COVID-19 pandemic has had many impacts on various aspects of life, one of which is education. The education system has changed from face-to-face to online learning methods. Online learning methods make students more likely to use digital media such as computers, laptops or mobile phones. The use of digital media that occurs continuously and without being balanced with sufficient knowledge can certainly have impacts on eye health. One form of eye health problems that often arise due to the use of digital media is computer vision syndrome (CVS). Purposes: Therefore, it is necessary to conduct a study to see the picture of students' knowledge about this disorder. Methods: The method used in this research is cross-sectional descriptive. Result: The mean age of the respondents was 19.91±1.648 years. A total of 82.7% of respondents complained of having more than 5 symptoms and as many as 98.5% had CVS. 90.6% of respondents complained about fatigue eyes, followed by 80.5% complained about eye strain symptoms and 80.5% complained about headaches, 42.9% of respondents have a lack of knowledge about CVS and only 15.4% of respondents have a good level of knowledge about CVS. Conclusion: It can be concluded that respondents’ lack of knowledge about CVS is the cause of the high prevalence of CVS in students, so they don’t know how to prevent this CVS. Therefore, it is necessary to take actions to increase students' knowledge about this disorder, so that it doesn’t cause negative impacts on eye health in the future.

The American Optometric Association defines computer vision syndrome (CVS), also known as digital eye strain, as "a group of eye- and vision-related problems that result from prolonged computer, tablet, e-reader and cell phone use". We aimed to create a well-structured, valid, and reliable questionnaire to determine the prevalence of CVS, and to analyze the visual, ocular surface, and extraocular sequelae of CVS using a novel and smart self-assessment questionnaire. This multicenter, observational, cross-sectional, descriptive, survey-based, online study included 6853 complete online responses of medical students from 15 universities. All participants responded to the updated, online, fourth version of the CVS questionnaire (CVS-F4), which has high validity and reliability. CVS was diagnosed according to five basic diagnostic criteria (5DC) derived from the CVS-F4. Respondents who fulfilled the 5DC were considered CVS cases. The 5DC were then converted into a novel five-question self-assessment questionnaire designated as the CVS-Smart. Of 10 000 invited medical students, 8006 responded to the CVS-F4 survey (80% response rate), while 6853 of the 8006 respondents provided complete online responses (85.6% completion rate). The overall CVS prevalence was 58.78% (n = 4028) among the study respondents; CVS prevalence was higher among women (65.87%) than among men (48.06%). Within the CVS group, the most common visual, ocular surface, and extraocular complaints were eye strain, dry eye, and neck/shoulder/back pain in 74.50% (n = 3001), 58.27% (n = 2347), and 80.52% (n = 3244) of CVS cases, respectively. Notably, 75.92% (3058/4028) of CVS cases were involved in the Mandated Computer System Use Program. Multivariate logistic regression analysis revealed that the two most statistically significant diagnostic criteria of the 5DC were ≥2 symptoms/attacks per month over the last 12 months (odds ratio [OR] = 204177.2; P <0.0001) and symptoms/attacks associated with screen use (OR = 16047.34; P <0.0001). The CVS-Smart demonstrated a Cronbach's alpha reliability coefficient of 0.860, Guttman split-half coefficient of 0.805, with perfect content and construct validity. A CVS-Smart score of 7-10 points indicated the presence of CVS. The visual, ocular surface, and extraocular diagnostic criteria for CVS constituted the basic components of CVS-Smart. CVS-Smart is a novel, valid, reliable, subjective instrument for determining CVS diagnosis and prevalence and may provide a tool for rapid periodic assessment and prognostication. Individuals with positive CVS-Smart results should consider modifying their lifestyles and screen styles and seeking the help of ophthalmologists and/or optometrists. Higher institutional authorities should consider revising the Mandated Computer System Use Program to avoid the long-term consequences of CVS among university students. Further research must compare CVS-Smart with other available metrics for CVS, such as the CVS questionnaire, to determine its test-retest reliability and to justify its widespread use.

Background: The computer has become an indispensable part of our lives, and daily computer use has a negative impact on our health, particularly our vision, causing symptoms such as eyestrain, redness, itchy eyes, dryness, blurred vision, and eye fatigue, all of which are known as computer vision syndrome (CVS). Objectives: The purpose of this study was to assess the prevalence of computer vision syndrome and its risk variables among Saudi medical students attending Taif University. Methods: The study&amp;apos;s target population consisted of medical students from Taif University in Saudi Arabia. Result: The study included 201 medical students, with an average age of 20.2 years old. CVS affects 85.1% of pupils or 171 out of 201, the majority of them are female. The most common CVS symptoms are copious tears (26.9%), red eyes (17.5%), and twitching of the eyelids (15.8%). CVS risk variables included female gender, increased computer use, and the use of light bulbs as a source of light. Conclusion: According to this study, CVS is very widespread among Taif University&amp;apos;s undergraduate medical students. The most commonly reported CVS ocular symptom was considerable tears. Female students complained about CVS more often than their male classmates. Medical students must be more aware of computer-related health dangers.

Background: Computer vision syndrome is a common global problem among millions of computer users including medical students. Medical students are preferring soft copies rather than textbooks. The aim of this study was to assess the knowledge, attitude, and practice of MBBS students about Computer vision syndrome, and to identify its ocular morbidity among them.Methods: A descriptive cross-sectional survey based on the questionnaire was conducted among 1st- 4th year MBBS students of the Institute of Medicine and 80 students underwent detailed ocular evaluation. Results: A complete survey response was received from 236 students out of 299 students (Response Rate 80%). The mean age of MBBS students was 21.38 years ± 1.328 years and the range were 19-22 years; 76.2% were male and 23.8% were female. The majority (37.2%) spent 2-3 hours/day on the computer and had a higher risk (p-0.0001) of developing Computer vision syndrome. About 69.5% students used a computer at the level of the eye but there was a significant reduction in Computer vision syndrome (p-0.0001) among those who had computer screen below the eye level. Association between taking breaks (p-0.0001) and frequent blinking (p-0.0411) during computer use and relief of symptoms was significant. Only 22.9% had pre-existing knowledge of Computer vision syndrome and only 25.5% of them were practicing the ideal viewing distance.Among 80 medical students randomly selected for detail eye examinations (63.7% male;36.2% female), the prevalence of Computer vision syndrome was 71.6%. The commonest ocular complaint was a headache (50%) and dry eyes (45%). Myopia was the commonest refractive error (31.2%) and the orthoptic problem was prevalent among 17.5% students.Conclusions: The survey showed that Computer vision syndrome is relevant among MBBS students but the knowledge, attitude, and practice of Computer vision syndrome among them is poor.Keywords: Attitude; computer vision syndrome; eyestrain; headache; knowledge; practice; medical students.

Purpose To assess the visual, ocular, extraocular, and multifocal electroretinography (mfERG) outcomes of computer vision syndrome (CVS) among medical students. Methods This study was designed as a cross-sectional case-control study that included 733 medical students. All students completed a specially designed and validated CVS questionnaire survey (CVS-F3). Students from the control (No-CVS) and CVS groups underwent comprehensive ophthalmic examinations including the mfERG examinations. Our main outcome measures included uncorrected and corrected distance visual acuity (UDVA and CDVA, resp.) measurements, subjective and cycloplegic refractions, slit-lamp examination, intraocular pressure measurement, pupillary reflexes tests, ocular movements' tests, dry eye disease tests, and fundus and mfERG examinations. Results The CVS-F3 identified that 87.9% of students had complaints that might be related to CVS. We documented a 76% prevalence rate in students undergoing an ophthalmologic exam. The most common ocular and extraocular complaints included visual blur and headache (40.9% and 46.8%, resp.). Statistical logistic and linear regression analyses showed that refractive errors, prolonged screen-hours, close eye-screen distance, improper gaze angle, poor screen-resolution, and screen-glare were risk factors for developing CVS and influencing its severity. In the mfERG subgroup, 42.5% demonstrated reduced amplitudes of mfERG rings and quadrants, indicating reduced foveal responses. Conclusion Surveys cannot yield an accurate CVS prevalence. However, they help to identify subjects at risk who should be comprehensively assessed to confirm or exclude CVS diagnosis. Smartphone misuse primarily caused CVS among users. Our mfERG findings might be a sign of potential CVS visual sequelae; however, future studies are warranted. Clinicians need to understand these sequelae to appropriately identify and treat CVS.

Background: Since the Covid-19 Pandemic hit Indonesia, college students have had many eye health complaints; one is Computer Vision Syndrome (CVS). Factors that can increase the risk of CVS are decreased sleep quality, high computer/laptop use duration, and a non-ergonomic position. This study aimed to prove the relationship between sleep quality, visibility, and screen time on the incidence of CVS in medical students of Diponegoro University.Method: This cross-sectional study, including 147 medical students was conducted using primary data from questionnaires of Wendy Strouse Watt, Thomas H Murphy, Hospitality Eye Care Center, and vsp.com to gain data on respondent identity, visibility, and screen time. Sleep quality data were taken from the PSQI and CVS data through the CVS-Q questionnaire. Chi-square, Mann-Whittney, and logistic regression of multivariate analysis were used to analyze the data.Results: From 147 subjects, 108 were CVS (73.5%), and 39 were Non-CVS (26.5%). Variables of sleep quality and screen time (total) showed a significant relationship with CVS, which had p-values of p=0.001 and p=0.009 (p&lt;0.05). As for the visibility to CVS, there was no relationship with p=0.863. In the multivariate test, sleep quality (p=0.000; ExpB=4.342) and total screen time (p=0.006; ExpB=3.913) were the most influential variables. The results showed that Computer Vision Syndrome is ubiquitous among Diponegoro University's final-year medical students. Sleep quality and total screen time can increase the risk of CVS by four times. This study also shows that CVS still appears in the post-pandemic era.

Introduction: Computers are something that is needed nowadays. Computers are not only used to make work easier but also for entertainment. The use of computers in various ways will cause health problems for computer users. Computer Vision Syndrome (CVS) is a group of eye symptoms caused by prolonged use of computers or other electronic devices. Objective: Determine the frequency of CVS incidents in medical faculty students at the Indonesian Muslim University in the Class of 2020. Method: This study employed a descriptive design with a cross-sectional approach. Primary data were collected using the Computer Vision Syndrome Questionnaire (CVS-Q), which was distributed to medical students at Universitas Muslim Indonesia via Google Forms. The data were analyzed using Microsoft Excel and SPSS software. Results: The CVS incidence rate was 116 people (50.9%). Based on gender, the largest number was women, 95 people (91.9%). Based on the use of glasses, CVS was higher among students who did not use glasses, 66 respondents (56.9%). Based on the duration of computer, the highest duration of heavy use was found by 62 people (53.4%). Based on the frequency of rest, &lt;10 minutes more often experienced CVS, namely 89 people (76.7%). Based on viewing distance, there were more respondents with a distance of &lt;50 cm, with 78 people (67.2%). Conclusion: The most common gender who experienced CVS was female, CVS was more prevalent students who did not use glasses with a heavy duration with a rest frequency of &lt;10 minutes and a viewing distance of &lt;50 cm.

ObjectiveIncreased screen time has resulted in widespread computer vision syndrome (CVS) in the digital era. Medical students, who rely heavily on digital screens, are particularly at risk. Our study aims...

Computer Vision Syndrome (CVS) is a group of visual and extraocular symptoms associated with the continuous use of visual display terminals caused by the use of devices with a long-time intensity. This study was conducted to determine the description of the knowledge of undergraduate medical students of the Faculty of Medicine, Udayana University Class of 2020 regarding Computer Vision Syndrome (CVS) and the complaints they feel. This study used a cross-sectional descriptive method in collecting data. The research subjects were selected using a simple random sampling technique, consisting of 83 students enrolled in the Undergraduate Medical Study Program, Faculty of Medicine, Udayana University, Class of 2020. Data collection was carried out by distributing quizzes online to assess knowledge about Computer Vision Syndrome (CVS). The collected data were analyzed using SPSS software version 27. The study found that 45 subjects (54.2%) had a good level of knowledge, 32 subjects (38.6%) had a sufficient level of knowledge, and 6 subjects (7.2%) had a poor level of knowledge. The description of the knowledge of undergraduate medical students of the Faculty of Medicine, Udayana University, Class of 2020 regarding Computer Vision Syndrome (CVS) is mostly in the good category. Education through lectures, seminars or workshops needs to be carried out in order to increase awareness and the importance of Computer Vision Syndrome (CVS) and treatment efforts need to be implemented. Keywords: Computer Vision Syndrome, CVS, knowledge, medical students

Computer vision syndrome is a common global problem among millions of computer users including medical students. Medical students are preferring soft copies rather than textbooks. The aim of this study was toassess the knowledge, attitude, and practice of MBBS students about Computer vision syndrome, and to identify its ocular morbidity among them. A descriptive cross-sectional survey based on the questionnaire was conducted among 1st-4th yearMBBS students of the Institute of Medicine and 80 students underwent detailed ocular evaluation. A complete survey response was received from 236 students out of 299 students (Response Rate 80%). The mean age of MBBS students was 21.38 years ± 1.328 years and the range were 19-22 years; 76.2% were male and 23.8% were female. The majority (37.2%) spent 2-3 hours/day on the computer and had a higher risk (p-0.0001) of developing Computer vision syndrome. About 69.5% students used a computerat the level of the eye but there was a significant reduction in Computer vision syndrome (p-0.0001)among those who had computer screen below the eye level. Association between taking breaks (p-0.0001) and frequent blinking (p-0.0411) during computer use and relief of symptoms was significant. Only 22.9% had pre-existing knowledge of Computer vision syndrome and only 25.5% of them were practicing the ideal viewing distance. Among 80 medical students randomly selected for detail eye examinations (63.7% male;36.2% female), the prevalence of Computer vision syndrome was 71.6%. The commonest ocular complaint was a headache(50%) and dry eyes (45%). Myopia was the commonest refractive error (31.2%) and the orthoptic problem was prevalent among 17.5% students. The survey showed that Computer vision syndrome is relevant among MBBS students but the knowledge, attitude, and practice of Computer vision syndrome among them is poor.

Dear editor, As the use of electronic devices continues to escalate, computer vision syndrome is becoming increasingly prevalentarrange, especially among medical students. One of the most effective strategies to manage computer vision syndrome (CVS) is the 20-20-20 rule, in which the person shifts his focus from the electronic device to an object placed at 20 feet for 20 seconds every 20 minutes. CVS is characterised by headache, blurred vision, neck pain, eyestrain, itchy eyes, diplopia, and trouble focusing the eyes.1 Computer vision syndrome is a growing concern among medical students as more and more students are transition to using electronic devicesfor study instead of using traditional books. The academic demands, extensive courses, and sleep deprivation make medical students one of the most important communities vulnerable to CVS. However, according to a recent study, only 34.1% of medical students are aware of CVS and the strategies to manage it; preventive strategies such as the 20-20-20 rule.2 CVS is caused by a decreased blink reflex, which occurs when individuals work on a computer for long periods. The normal blinking frequency is substantially reduced from 16-20 times per minute to 6-8 times per minute in people who use computers.3 The 20-20-20 rule is an effective method for reducing the symptoms of CVS. This method has been found to reduce the severity and incidence of CVS among medical students.3 According to a study, taking a short break when using electronic equipment every 20 minutes reduces the prevalence of CVS by 7%.4 These findings underscore the need for strategies that reduce continuous screen use through frequent breaks, rather than solely limiting screen time.5 In contrast to more complex approaches, the 20-20-20 rule stands out for its ease of implementation, minimal effort, and is just a matter of developing a habit. This method ultimately helps to increase student's productivity, alleviate eyestrain, and reduce neck pain and headache. In order to implement the 20-20-20 rule effectively, certain measures should be taken such as setting up a reminder on the laptop to take regular breaks, choosing a specific distant object to focus on, and placing the laptop at a proper viewing distance. In conclusion, there is a need to create awareness about this useful technique among medical students to safeguarding ocular healthand increase productivity in the long run. Therefore, awareness sessions and workshops should be organise in medical colleges to educate students about the 20-20-20 rule.

PurposeThe purpose of this study was to evaluate Computer Vision Syndrome (CVS) in undergraduate and medical students since transitioning to online learning during the COVID-19 pandemic.Patients and MethodsThis was a cross-sectional single center survey-based study using a validated CVS questionnaire (CVS-Q). The survey was distributed to 20,080 undergraduate students and 680 medical students at the University of Illinois at Chicago. The primary outcome measures were prevalence of CVS (based on CVS severity score of 6 or more), frequency of CVS and intensity of CVS symptoms.ResultsThe survey was completed by 2300 undergraduate students (11.4% response rate) and 154 medical students (22.6% response rate). The prevalence of CVS was 77.1% in undergraduate students and 69.1% in medical students. CVS-Q severity scores were highest for headaches and eye dryness, with over half of students reporting worsening of symptoms since March 2020. Increased time spent on online learning (undergraduate: P <0.001, medical: P = 0.018), blue light glasses usage (undergraduate: P <0.001, medical: P = 0.0015), and increased number of device usage were associated with higher CVS severity scores (undergraduate: P <0.001, medical: P = 0.0032).ConclusionCVS among undergraduate and medical students has increased since the start of the COVID-19 pandemic. More focus should be placed on the management of CVS for students in higher education. Physicians should be cognizant of the consequences of online learning and be proactive about providing advice regarding preventative measures.