Indian Journal of Clinical and Experimental Ophthalmology

Print ISSN: 2395-1443

Online ISSN: 2395-1451

CODEN : IJCEKF

Indian Journal of Clinical and Experimental Ophthalmology (IJCEO) is open access, a peer-reviewed medical journal, published quarterly, online, and in print, by the Innovative Education and Scientific Research Foundation (IESRF) since 2015. To fulfil our aim of rapid dissemination of knowledge, we publish articles ‘Ahead of Print’ on acceptance. In addition, the journal allows free access (Open Access) to its content, which is likely to attract more readers and citations of articles published in IJCEO. Manuscripts must be prepared in more...

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Get Permission Chaurasiya and Gupta: Ocular and systemic symptoms in digital devices users: A comparative study between pre and post COVID era


Introduction

With the advancement of time and technology, the use of digital devices like mobiles, tablets, laptops has been increased in past few years.1 This digital devices required to be kept at near or intermediate distances for performing any task, thereby causing strain on visual system. With the reference to the guidelines of World Health Organization (WHO), nationwide lockdown was implemented by Indian Government as preventive measure by restricting people’s movement due to increase in number of COVID-19 cases.2 According to American Optometric Association (AOA), eye and vision related problem can arise with minimum two hours of continuous using of digital devices.3 Apart from ocular and visual symptoms, systemic symptoms such as shoulder pain, neck pain and wrist pain was also prevalent in digital devices user.4, 5 Due to closure of educational institute from March 2020 in view of novel coronavirus disease (COVID 19) pandemic, the traditional teaching method using blackboard/whiteboard has changed to online classroom.6 In a study, the online classroom was also found to be most effective as traditional classroom.7 Similarly, another study8 also concluded that the use of digital devices was more frequent in pandemic era during lockdown in children.

Taking above facts into consideration, this study aims to find the various ocular, visual and systemic symptoms associated with the duration of using digital devices before and during lockdown

Materials and Methods

A questionnaire based cross-sectional study was carried among 220 individuals between 20-25 years of age. Individuals having past ocular history of retinal pathology, Contact lens uses, Glaucoma were excluded from the study. An online survey was designed using Google forms that consist of four sections: demographic information of respondents, information about digital devices followed by pretested questionnaire9 consisting of questions related to ocular and systemic symptoms. The questionnaire was distributed on social platforms (whatsApp, facebook, Instagram) among targeted individuals. Participants were given short idea about the aim of the study in the questionnaire form along with the consent statement and confidentiality assurance.

The data collected from the respondents were exported from Google form in to excel form. The respondent were divided into groups depending on hours of using digital devices (0-2 hours, 2-4 hours, 4-6 hours, > 6 hours), number of digital devices used (one devices, two devices and more than two devices) for further analysis.

Statistical analysis

Statistical analysis was performed using SPSS software (IBM SPSS, version 25; IBM Corp., Armonk, NY, USA). Descriptive analysis was done to summarize the result in mean and Standard deviation. One way analysis of Variance (ANOVA) was performed to find the differences between the mean symptoms score with the hours of using digital devices during lockdown with significant value of P < 0.05. Similarly, Paired t-test was conducted to compare the mean symptoms score before and during lockdown. The association between mean symptom scores with the duration and number of digital devices used were analysed by using Pearson’s correlation test with significance level of P < 0.05.

Results

A total number of 220 responses were recorded for analysis. The response rate noted was 62.85% (220 responses out of 350 questionnaire sent). The ratio between male and female were 0.41:1. The descriptive statistics is represented in Table 1. 108 respondent were using one digital devices, 88 were using two digital devices and 24 were using more than 2 digital devices (Figure 1).

Figure 1

Percentage of number of digital devices used during lockdown

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/39c7d8d8-f427-472f-ada1-683f397382df/image/9596b0a9-2883-4ed2-ae0b-6cf39392ab8b-uimage.png

Table 1

Descriptive analysis

Parameters

Particulars

Age [Mean ± SD]

21.98 ± 2.407 years

Gender [n (%)]

Male

64 (29.1%)

Female

156 (70.9%)

Occupation [n (%)]

Students

184 (83.6%)

Practitioner

20 (9.1%)

Faculty

6 (2.7%)

Entrepreneur

10 (4.5%)

Hours of using digital devices [n (%)] Before lockdown

0-2 hours

54 (24.5%)

2-4 hours

100 (45.5%)

4-6 hours

40 (18.2%)

>6 hours

26 (11.8%)

During lockdown

0-2 hours

18 (8.2%)

2-4 hours

58 (26.4%)

4-6 hours

76 (34.5%)

>6 hours

68 (30.9%)

Number of digital devices used [n (%)]

One

108 (49.1%)

Two

88 (40.0%)

More than two

24 (10.9%)

Table 2

Comparison between symptom scores with hours of digital devices used during lockdown

Hours of digital devices used per day

n

Mean ± SD

F

P-value

Watering eyes

0-2 hours

18

1 ± 0.00

3.532

.017

2-4 hours

58

1.28 ± 0.45

4-6 hours

76

1.37 ± 0.48

>6 hours

68

1.56 ± 0.61

Itching eyes

0-2 hours

18

1.11 ± 0.33

1.974

.122

2-4 hours

58

1.34 ± 0.48

4-6 hours

76

1.55 ± 0.64

>6 hours

68

1.47 ± 0.50

Red eyes

0-2 hours

18

1.33 ± 0.50

0.442

.723

2-4 hours

58

1.17 ± 0.38

4-6 hours

76

1.18 ± 0.39

>6 hours

68

1.24 ± 0.43

Dry eyes

0-2 hours

18

1.33 ± 0.70

3.775

.013

2-4 hours

58

1.10 ± 0.31

4-6 hours

76

1.45 ± 0.68

>6 hours

68

1.62 ± 0.69

Painful eyes

0-2 hours

18

1.11 ± 0.33

2.713

.049

2-4 hours

58

1.31 ± 0.47

4-6 hours

76

1.32 ± 0.52

>6 hours

68

1.59 ± 0.65

Blurring of vision

0-2 hours

18

1.22 ± 0.44

3.065

.031

2-4 hours

58

1.21 ± 0.41

4-6 hours

76

1.29 ± 0.56

>6 hours

68

1.59 ± 0.65

Double vision

0-2 hours

18

1.00 ± 0.00

0.428

.734

2-4 hours

58

1.10 ± 0.31

4-6 hours

76

1.08 ± 0.27

>6 hours

68

1.12 ± 0.32

Shoulder pain

0-2 hours

18

1.44 ± 0.52

3.019

.033

2-4 hours

58

1.45 ± 0.50

4-6 hours

76

1.53 ± 0.64

>6 hours

68

1.88 ± 0.76

Neck pain

0-2 hours

18

1.33 ± 0.50

6.803

.000

2-4 hours

58

1.24 ± 0.43

4-6 hours

76

1.58 ± 0.59

>6 hours

68

1.88 ± 0.68

Back pain

0-2 hours

18

1.33 ± 0.50

2.208

.091

2-4 hours

58

1.55 ± 0.63

4-6 hours

76

1.61 ± 0.67

>6 hours

68

1.85 ± 0.61

Headache

0-2 hours

18

1.67 ± 0.70

2.197

.093

2-4 hours

58

1.55 ± 0.57

4-6 hours

76

1.89 ± 0.55

>6 hours

68

1.85 ± 0.61

Table 3

Comparison between mean symptoms score before and during lockdown

Mean value

t - value

P-value

Before lockdown

During lockdown

Watering eyes

1.31

1.38

-2.145

0.034

Itching eyes

1.41

1.44

-0.773

0.441

Red eyes

1.25

1.21

1.156

0.250

Dry eyes

1.37

1.40

-0.773

0.441

Painful eyes

1.32

1.38

-1.352

0.179

Blurring of vision

1.32

1.35

-1.156

0.250

Double vision

1.09

1.09

0.000

1.000

Shoulder pain

1.59

1.61

-0.407

0.685

Neck pain

1.61

1.56

1.043

0.299

Back pain

1.60

1.65

-1.295

0.198

Headache

1.78

1.77

0.228

0.820

The individual using digital devices for more than 6 hours per day showed marked increase in ocular symptoms including watering eyes, dry eyes and painful eyes, which were statistically significant during lockdown with P value less than 0.05. Similarly, Visual symptoms score that includes blurring of vision was statistically significant (P = 0.031) during lockdown. Regarding musculoskeletal symptoms, neck pain and shoulder pain during lockdown were found to have statistically significant differences with P value less than 0.05 (Table 2).

While comparing with the symptoms score of the individual before lockdown with the symptoms score during lockdown, only one ocular symptom i.e watering eye (P = 0.034) was found to have statistical significant differences (Table 3).

Positive correlation was established between symptoms score consisting watery eyes (r = 0.294, P = 0.002), painful eyes (r = 0.243, P = 0.011), dry eyes (r = 0.261, P = 0.006), neck pain (r = 0.376, P = 0.000) and shoulder pain (r = 0.247, P = 0.009) and hour of using digital devices during lockdown. Similarly, there was positive correlation between number of digital devices used and the symptoms scores that includes blurring of vision(r = 0.188, P = 0.049), neck pain (r = 0.381, P = 0.000), shoulder pain (r = 0.277, P = 0.003), headache (r = 0.236, P = 0.013) and back pain (r = 0.213, P = 0.026).

Discussion

Several literatures observed that the use of digital devices is most frequent in young age population during lockdown for various purposes.8, 9, 10 Mohan et al11 found that the hour spent on digital devices increased during lockdown period as compared with pre-COVID era. Similarly, Gauri et al9 and Mohan et al11 also observed that young population spent more than 6 hours/day on digital devices cause headache. A similar pattern was observed in the present study with respondents using more than 6 hours on digital devices during lockdown as compared with pre-lockdown situation.

In a study, the male respondents was found to have greater impact on digital devices use. 11 The result in our study showed that the maximum number of female respondents used digital devices but this findings can be due to minimal participation of male respondents.

Smartphones/mobiles continued to be the most used digital devices among population11, 12, 13, 14 of different ages before COVID era and during COVID era which was also observed in the present study. Apart from mobiles, this study also noticed that more than half of respondents used two and/or more than two digital devices that includes laptops, tablets.

In a study,15 there was positive association of dry eye symptoms and vision fluctuation with increasing hours of digital devices use. A similar observation was seen in our study where watering eyes, dry eyes and blurring of vision were found statistically significant with increasing hours of using the digital devices. Moreover, red eyes was also found to have more frequent and common symptoms in prolong hour of using digital devices in past study.10, 11, 16, 17 Though this question was included in our study, we did not find any statistically significant differences for this symptoms.

Musculoskeletal symptoms including shoulder pain, back pain, headache and neck pain was found to be more frequent in the individual who spent more hours on digital devices.17, 18 Similar finding was noted in our study except for headache and back pain.

Several studies have concluded that headache and itching were the most common experienced symptoms found in population with higher amount of digital devices use during lockdown.3, 9, 11 The present study found that headache, neck pain and back pain were the most common and positively associated symptoms with increased number of digital devices use during lockdown. Similarly, Iwariki et al17 found positive association between neck pain and multiple digital devices. The similar finding reflects in our study where the neck pain was found to be the highly associated systemic symptoms with number of digital devices use.

Conclusion

Respondents spent maximum hours on digital devices during lockdown as compared to pre-lockdown situations. Mobiles were the most used digital devices during lockdown. More than fifty percent of respondents used two and/or more than two digital devices. Ocular symptoms like watering eyes, dry eyes, and painful eyes were found to be most common symptoms in digital devices users. Similarly, systemic symptoms like neck pain and shoulder pain were found to be most common complaints. The ocular, visual and systemic symptoms were found to get significantly aggravated during lockdown which indicates that proper education and preventive measures need to be taken on the frequency and number of using digital devices.

Source of Funding

None.

Conflict of Interest

None.

References

1 

AL Sheppard JS Wolffsohn Digital eye strain: prevalence, measurement and ameliorationBMJ Open Ophthalmol201831e000146

4 

DJ Kim CY Lim N Gu CY Park Visual fatigue induced by viewing a tablet computer with a high&#8209;resolution displayKorean J Ophthalmol 201731538893

5 

BG Knave RI Wibom M Voss LD Hedstrom UO Bergqvist Work with video display terminals among office employees: I. Subjective symptoms and discomfortScand J Work Environ Health198511645766

7 

RK Chaurasiya Satisfaction on Online Classroom for an Optometry Students202010.2139/ssrn.3621623

8 

K Subrahmanyam P Greenfield R Kraut E Gross The impact of computer use on children's and adolescents' developmentJ Appl Dev Psychol2001221730

9 

GS Shrestha FN Mohamed DN Shah Visual problems among video display terminal (VDT) users in NepalJ Optom2011425662

10 

J Kim Y Hwang S Kang M Kim TS Kim J Kim Association between exposure to smartphones and ocular health in adolescentsOphthal Epidemiol201623426976

11 

A Mohan P Sen C Shah E Jain S Jain Prevalence and risk factor assessment of digital eye strain among children using online e-learning during the COVID-19 pandemic: Digital eye strain among kids (DESK study-1)Indian J Ophthalmol2021691140

12 

ST Gonzalez L Ortiz-Hernandez S Martinez-Alcántara I Méndez-Ramírez Health hazards associated with the use of video display terminalsSalud Pública de México200345317180

13 

AA Alamri N Alhibshi M Alnefaie W Alzhrani A Almaymuni M Mosli Patterns of digital device usage and its related health effects on elementary and middle school students: An instrument development and regression analysisElectron Physician201810733340

14 

JK Parihar VK Jain P Chaturvedi J Kaushik G Jain AK Parihar Computer and Visual display terminals (VDT) Vision syndrome (CVDTS)Med J Armed Forces India20167232706

15 

J Harthan L O'Dell JT Kwan MM Hom SG Hauswirth A Schachter Dry eye symptoms and visual function with digital device useInvest Ophthalmol Vis Sci201657122843

16 

JH Moon MY Lee NJ Moon Association between video display terminal use and dry eye disease in school childrenJ Pediatr Ophthalmol Strabismus20145128792

17 

K Iwakiri I Mori M Sotoyama K Horiguchi T Ochiai H Jonai Survey on visual and musculoskeletal symptoms in VDT workersSangyo Eiseigaku Zasshi200446620112

18 

HK Falkenberg TR Johansen HM Thorud Headache, eyestrain, and musculoskeletal symptoms in relation to smartphone and tablet use in healthy adolescentsScand J Optom Vis Sci2020132814



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Article type

Original Article


Article page

358-362


Authors Details

Ritesh Kumar Chaurasiya*, Akansha Gupta


Article History

Received : 26-03-2022

Accepted : 12-07-2022


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