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Prevalence of Computer Vision Syndrome (CVS) Symptoms on Osteopathic Medical Students
Espares, J. K. [2]
Edimo, C. O. [2]
Bupathi, S. K. [2]
Falus, N. A. [2]
Jung, M.K. [12]
Heller, M. [3]

Journal: The Journal of the American Osteopathic Association Date: 2020/12, 120(12):Pages: e84-e85. doi: Subito , type of study: clinical trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2020.157/html)

Keywords:

clinical trial [660]
computer vision syndrome [1]
eyes [22]
medical students [647]
osteopathic medicine [2025]
screen time [2]
USA [1656]

Abstract:

Statement of Significance: The American Optometric Association describes Computer Vision Syndrome as a group of eye and vision-related problems that result from prolonged computer, tablet, e-reader and cell phone use. Increased computer usage can lead to a decreased blink rate, and those who develop CVS will likely have reduced efficiency and productivity of work. The NYIT College of Osteopathic Medicine as an institution specifically takes pride in its integration of technology into the medical education curriculum and provides school-issued iPads to students when they first start medical school. Consequently, this emphasis on technology inadvertently places its students at increased risk of manifesting CVS or symptoms related to it. Research Methods: This clinical trial was reviewed and approved by NYIT IRB (IRB number: BHS-1325). Participants were first and second year medical students matriculated at New York Institute of Technology College of Osteopathic Medicine. The study was conducted over one full academic year, with data collected on three separate occasions in August 2019, February 2020, and April 2020. For each of the three data collection times, students scheduled to meet in person with the research team to provide screen time data, gauge their visual acuity via a Snellen chart, and answer a questionnaire to screen for CVS symptoms. The amount of screen time was recorded using RescueTime, a program that provided quantitative data on how much screen time was spent on Apple and Windows devices. Participants downloaded RescueTime at the beginning of the study, and the screen time data was obtained during the 2nd and 3rd visits via reports that were exported from the application. Once installed, RescueTime silently ran in the background of their devices and did not interfere with the participant's normal activities. Documentation of screen time was automated, reducing the risk for human error if participants were to estimate their screen time. The application also allowed for screen time data to be exported via print or email. All data from the questionnaire was entered into REDCap, a secure web application and HIPAA-compliant database designed for clinical and translational research. Data Analysis: CVS symptom incidence and frequency obtained from a reliable and validated questionnaire were exported from REDCap as a Microsoft Excel document, which were then plotted as a graph to illustrate results and to draw comparisons between the first and second visits. Results: A total of 27 participants completed all of the administered questionnaires. Regarding the CVS symptoms, 16 symptoms were monitored throughout the study, and study participants indicated the presence or absence of the symptom as well as the frequency and severity of their symptom if it was indeed present. The symptoms that were asked in the questionnaire are the following: burning in eyes, itching in eyes, feeling of a foreign body, tearing of eyes, excessive blinking, eye redness, eye pain, heavy eyelids, eye dryness, blurred vision, double vision, difficulty focusing for near vision, increased sensitivity to light, colored halos around objects, feeling that sight is worsening, and headache. The questionnaire also asked participants if they had undergone any change in their ocular prescription between visits (ex. Getting a new pair of glasses). The data that we obtained showed an increase in prevalence of the following symptoms on the second visit compared with the first visit: Burning in eyes (59.3% vs 44.4%), Itching in eyes (63% vs 59.3%), Excessive blinking (33.3% vs 25.9%), Heavy eyelids (63% vs 44.4%), Eye dryness (76.8% vs 59.2%), Increased sensitivity to light (37% vs 25.9%), and Headache (70.4% vs 51.8%). The percentage values noted above represent the number of participants who confirmed that they experienced that specific symptom. At the second visit, 18.5% of participants indicated that they had undergone a change in their ocular prescription since their last visit. Conclusion: Based on the results, the most common symptoms reported by the study participants were headache and dry eyes, which were present in more than 70% of the study pool during the second visit. The study is limited by a small sample size and loss to follow-up. A total of 33 participants were enrolled at the beginning of the study, and that number dropped to 27 by the end of the academic year. Participants were considered to have been lost to follow-up when they did not attend an in-person visit and thus did not take the questionnaire administered by the research team. Also, the study protocol had originally planned for three questionnaires (one per visit); due to COVID-19 restrictions that were enacted in March 2020, all on-campus research-related activities were suspended prior to the participants’ 3rd visit. Therefore, the final visit (scheduled for April 2020) was conducted in a virtual manner. While screen time data was obtained from most study participants, we were unable to administer the questionnaire for participants to fill out. Due to the high prevalence of CVS symptoms in osteopathic medical students as demonstrated by this study, it would be appropriate to educate incoming students on preventative measures and draft an osteopathic treatment protocol to mitigate the incidence of these symptoms. Further investigation on the effects of screen time on visual acuity is warranted as COVID-19 restrictions have placed an increased demand for screen time in medical education.

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