Review ArticleMedical Students and Computer Vision Syndrome. A reviewEirini Solia1, Angelos Nikolaou1, Tzortzina Kotsira1, Dimitrios Filippou1,21 Research and Education Institute in Biomedical Sciences (REIBS), Pireaus-Athens, Greece2 School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceAbstract Aims: The increasing use of electronic gadgets from medical students raises awareness for related health disorders such as visual complaints. The aim of this review is to examine the association between medical students and computer vision syndrome (CVS). Methods: A research of the current literature was undertaken in PubMed using the terms: “medical students AND computer vision syndrome” in order to find related published articles referred to medical students. Studies written in English language and referred only to medical students were included. Results: Thirteen articles were found eligible and were included in the study. Additional sources of scientific associations were also taken into consideration. The majority of medical students suffered from visual and ocular problems. The most common symptoms were among other dryness, blurred vision including extra-ocular complaints such as headache, muscular pain and sleep disorders. The screen time varied and in some cases seemed to relate with the used device. Moreover, a considerable number of medical students had previous ocular disorders and most of them wore glasses.Conclusion: The prevalence of CVS should raise awareness. Rational use of screen time and the adoption of ergonomic practices should be encouraged in order to medical students revealed from such complaints.Introduction Electronic devices have a major role in our everyday lives. Undoubtedly, they have facilitated many aspects of our daily habits. Nevertheless, their extreme and careless use should raise awareness since they can potentially become harmful to our health, especially to our eyes. According to the American Optometric Association ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"OtoKMFxI","properties":{"formattedCitation":"\\super 1\\nosupersub{}","plainCitation":"1","noteIndex":0},"citationItems":[{"id":830,"uris":["http://zotero.org/users/10436186/items/35M45QUE"],"itemData":{"id":830,"type":"webpage","title":"Computer vision syndrome","URL":"https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y","author":[{"literal":"American Optometric Association (AOA)"}],"accessed":{"date-parts":[["2023",1,13]]}},"label":"page"}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 1 the vision and eye-related complaints due to the extensive use of electronic gadgets such as smartphones, tables and computers describe the computer vision syndrome (CVS) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"FSmIrrkr","properties":{"formattedCitation":"\\super 1\\nosupersub{}","plainCitation":"1","noteIndex":0},"citationItems":[{"id":830,"uris":["http://zotero.org/users/10436186/items/35M45QUE"],"itemData":{"id":830,"type":"webpage","title":"Computer vision syndrome","URL":"https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y","author":[{"literal":"American Optometric Association (AOA)"}],"accessed":{"date-parts":[["2023",1,13]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 1. It is well-known that medical students spend a lot of time in front of digital screens for their academic tasks. Sometimes, the increased screen time may lead to a variety of ocular complaints. The aim of this review is to examine the current literature concerning the association between medical students and CVS. Methods and Materials An advanced literature search was conducted in PubMed, using the following term: “medical students AND computer vision syndrome”. The resulting literature was consisted of 28 articles and was carefully screened by a single investigator. Only studies written in English were included. Additional search filters such as text availability, article type and publication date, were not applied. Further references from the initial articles with useful information related to the aim of the review were also screened. Current data from the official website of the American Optometric Association were also included. Studies referred to only medical students were included. Hence, a total of 14 references were included.ResultsThe literature retrieved six studies which examined the association between medical students and CVS. The data are categorized in Table 1. Wang et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"EBwM1bHo","properties":{"formattedCitation":"\\super 2\\nosupersub{}","plainCitation":"2","noteIndex":0},"citationItems":[{"id":782,"uris":["http://zotero.org/users/10436186/items/A8SWE5WN"],"itemData":{"id":782,"type":"article-journal","abstract":"Purpose: To compare the prevalence of computer vision syndrome in university students of different teaching modes during the SARS-CoV-2 outbreak period. Methods: A cross-sectional survey study using the validated Computer Vision Syndrome Questionnaire in Chinese medical students of Sichuan University who took classroom lectures and the same-grade foreign students from a Bachelor of Medicine and Bachelor of Surgery (MBBS) program who took online lectures with similar schedules. Results: A total of 137 responses from 63 Chinese students and 74 MBBS students were obtained. The highest frequency of digital screen time was 7-9 h (43.24%, 32/74) for MBBS students and 2-4 h (46.03%, 29/63) for Chinese students. The prevalence of computer vision syndrome among Chinese students and MBBS students were 50.79% and 74.32%, respectively (P = 0.004). The average numbers of reported symptoms were 5.00 ± 2.17 in Chinese students and 5.91 ± 1.90 in MBBS students (P = 0.01). The three most highly reported symptoms were \"heavy eyelids\" (53.97%), \"dryness\" (50.79%), and \"feeling of a foreign body\" (46.03%) in Chinese students and \"dryness\" (72.97%), \"feeling of a foreign body\" (62.16%), and \"heavy eyelids\" (58.11%) in MBBS students. The sum grades of computer vision syndrome had a moderate positive correlation with screen time (Spearman's correlation coefficient = 0.386, P < 0.001). The grades of symptoms of \"feeling of a foreign body,\" \"heavy eyelids,\" and \"dryness\" showed a weak positive correlation with screen time (Spearman's correlation coefficients were 0.220, 0.205, and 0.230, respectively). Conclusion: Online study may contribute to the prevalence of computer vision syndrome among university students.","container-title":"Frontiers in public health","DOI":"10.3389/fpubh.2021.696036","ISSN":"2296-2565","journalAbbreviation":"Front Public Health","language":"eng","license":"Copyright © 2021 Wang, Wei and Deng.","note":"publisher-place: Switzerland\nPMID: 34307289 \nPMCID: PMC8296301","page":"696036","title":"Computer Vision Syndrome During SARS-CoV-2 Outbreak in University Students: A Comparison Between Online Courses and Classroom Lectures.","volume":"9","author":[{"family":"Wang","given":"Lixiang"},{"family":"Wei","given":"Xin"},{"family":"Deng","given":"Yingping"}],"issued":{"date-parts":[["2021"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 2 in their cross-sectional, web-based survey compared Chinese medical students who attended classroom lectures and students from a Bachelor of Medicine and Bachelor of Surgery (MBBS) who took online courses. The results revealed that the occurrence of CVS was greater among MBBS students with a male predominance. The most common symptoms in MBBS students were dryness and the sense of a foreign body, 72.97% and 62.16% respectively, whereas in Chinese students the most common feeling was heavy eyelids (53.97%). Furthermore, the majority of MBBS students spent 7 to 9 hours per day in front of a screen and the most used devices were phones and computers. On the other hand, most of the Chinese students spent only 2 to 4 hours per day using mainly their phones.Another cross-sectional survey ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"65EQMJIM","properties":{"formattedCitation":"\\super 3\\nosupersub{}","plainCitation":"3","noteIndex":0},"citationItems":[{"id":790,"uris":["http://zotero.org/users/10436186/items/4VNYKBCD"],"itemData":{"id":790,"type":"article-journal","abstract":"PURPOSE: To determine the prevalence and factors associated with computer vision syndrome in medical students at a private university in Paraguay. METHODS: A survey study was conducted in 2021 in a sample of 228 medical students from the Universidad del Pacífico, Paraguay. The dependent variable was CVS, measured with the Computer Visual Syndrome Questionnaire (CVS-Q). Its association with covariates (hours of daily use of notebook, smartphone, tablet and PC, taking breaks when using equipment, use of preventive visual measures, use of glasses, etc.) was examined. RESULTS: The mean age was 22.3 years and 71.5% were women. CVS was present in 82.5% of participants. Higher prevalence of CVS was associated with wearing a framed lens (PR = 1.11, 95% CI: 1.03-1.20). In contrast, taking a break when using electronic equipment at least every 20 min and every 1 h reduced 7% (PR = 0.93, 95% CI: 0.87-0.99) and 6% (PR = 0.94, 95% CI: 0.89-0.99) the prevalence of CVS, respectively. CONCLUSION: Eight out of 10 students experienced CVS during the COVID-19 pandemic. The use of framed lenses increased the presence of CVS, while taking breaks when using electronic equipment at least every 20 min and every 1 h reduced CVS.","container-title":"Frontiers in public health","DOI":"10.3389/fpubh.2022.935405","ISSN":"2296-2565","journalAbbreviation":"Front Public Health","language":"eng","license":"Copyright © 2022 Coronel-Ocampos, Gómez, Gómez, Quiroga-Castañeda and Valladares-Garrido.","note":"publisher-place: Switzerland\nPMID: 35910871 \nPMCID: PMC9330381","page":"935405","title":"Computer Visual Syndrome in Medical Students From a Private University in Paraguay: A Survey Study.","volume":"10","author":[{"family":"Coronel-Ocampos","given":"Johanna"},{"family":"Gómez","given":"Jonathan"},{"family":"Gómez","given":"Alexis"},{"family":"Quiroga-Castañeda","given":"Pedro P."},{"family":"Valladares-Garrido","given":"Mario J."}],"issued":{"date-parts":[["2022"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 3 from Paraguay revealed that 82.5% of the participants were suffering from CVS. 138 of them spent up to 4 hours using their notebooks and the statistical difference was significant (p=0.049). Moreover, the results retrieved that 141 (61.8%) medical students had previous ocular disorders and most of them (59.2%) wore eye glasses. Patil et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Nh4WPx8q","properties":{"formattedCitation":"\\super 4\\nosupersub{}","plainCitation":"4","noteIndex":0},"citationItems":[{"id":781,"uris":["http://zotero.org/users/10436186/items/SFP5NCVS"],"itemData":{"id":781,"type":"article-journal","abstract":"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.","container-title":"Industrial psychiatry journal","DOI":"10.4103/ipj.ipj_93_18","ISSN":"0972-6748 0976-2795","issue":"1","journalAbbreviation":"Ind Psychiatry J","language":"eng","license":"Copyright: © 2019 Industrial Psychiatry Journal.","note":"publisher-place: India\nPMID: 31879450 \nPMCID: PMC6929228","page":"68-74","title":"Eyeing computer vision syndrome: Awareness, knowledge, and its impact on sleep quality among medical students.","volume":"28","author":[{"family":"Patil","given":"Ashwini"},{"family":"Bhavya","given":""},{"family":"Chaudhury","given":"Suprakash"},{"family":"Srivastava","given":"Smiti"}],"issued":{"date-parts":[["2019",6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 4 in their study described a male predominance in CVS (80.23% in males whereas 75.87% in females) even though it was not statistically significant. CVS deteriorates the sleep quality of the medical students (75.5%, p<0.001) concerning sleep duration and latency. Table 1. Relation between medical students and CVSResearchersType of studyOrigin of studyNo of MSGender of MSPrevalence of CVSSymptoms Screen timePrevious visual problems/use of glasses or lensesWang et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"8KRh4jQV","properties":{"formattedCitation":"\\super 2\\nosupersub{}","plainCitation":"2","noteIndex":0},"citationItems":[{"id":782,"uris":["http://zotero.org/users/10436186/items/A8SWE5WN"],"itemData":{"id":782,"type":"article-journal","abstract":"Purpose: To compare the prevalence of computer vision syndrome in university students of different teaching modes during the SARS-CoV-2 outbreak period. Methods: A cross-sectional survey study using the validated Computer Vision Syndrome Questionnaire in Chinese medical students of Sichuan University who took classroom lectures and the same-grade foreign students from a Bachelor of Medicine and Bachelor of Surgery (MBBS) program who took online lectures with similar schedules. Results: A total of 137 responses from 63 Chinese students and 74 MBBS students were obtained. The highest frequency of digital screen time was 7-9 h (43.24%, 32/74) for MBBS students and 2-4 h (46.03%, 29/63) for Chinese students. The prevalence of computer vision syndrome among Chinese students and MBBS students were 50.79% and 74.32%, respectively (P = 0.004). The average numbers of reported symptoms were 5.00 ± 2.17 in Chinese students and 5.91 ± 1.90 in MBBS students (P = 0.01). The three most highly reported symptoms were \"heavy eyelids\" (53.97%), \"dryness\" (50.79%), and \"feeling of a foreign body\" (46.03%) in Chinese students and \"dryness\" (72.97%), \"feeling of a foreign body\" (62.16%), and \"heavy eyelids\" (58.11%) in MBBS students. The sum grades of computer vision syndrome had a moderate positive correlation with screen time (Spearman's correlation coefficient = 0.386, P < 0.001). The grades of symptoms of \"feeling of a foreign body,\" \"heavy eyelids,\" and \"dryness\" showed a weak positive correlation with screen time (Spearman's correlation coefficients were 0.220, 0.205, and 0.230, respectively). Conclusion: Online study may contribute to the prevalence of computer vision syndrome among university students.","container-title":"Frontiers in public health","DOI":"10.3389/fpubh.2021.696036","ISSN":"2296-2565","journalAbbreviation":"Front Public Health","language":"eng","license":"Copyright © 2021 Wang, Wei and Deng.","note":"publisher-place: Switzerland\nPMID: 34307289 \nPMCID: PMC8296301","page":"696036","title":"Computer Vision Syndrome During SARS-CoV-2 Outbreak in University Students: A Comparison Between Online Courses and Classroom Lectures.","volume":"9","author":[{"family":"Wang","given":"Lixiang"},{"family":"Wei","given":"Xin"},{"family":"Deng","given":"Yingping"}],"issued":{"date-parts":[["2021"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 2 (2021)cross-sectional, observational, web-based surveyIndian (70.27%), Indonesian (12.16%), Sri Lankan (6.76%), Pakistan (6.76%), others (4.05%).137/171responders (83 Chinese students & 88 MBBS students)females: 33.33% of Chinese & 47.30% of MBBS responders 50.79% Chinese students 74.32% MBBS studentsChinese students:heavy eyelids (53.97%), dryness (50.79%), feeling of a foreign body (46.03%), colored halos around objects (7.94%)MBBS students: dryness (72.97%), feeling of a foreign body (62.16%), heavy eyelids (58.11%), colored halos around objects (2.70%)Chinese students:>12h: 1.59%10-12h: 4.76% 7-9h: 22.22%5-6h: 20.63%2-4h: 46.03%<2h: 4.76%MBBS students:>12h: 5.41%10-12h: 22.97%7-9h: 43.24%5-6h: 22.97%2-4h: 5.41%<2h: 0NACoronel-Ocampos et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"5usfpb7r","properties":{"formattedCitation":"\\super 3\\nosupersub{}","plainCitation":"3","noteIndex":0},"citationItems":[{"id":790,"uris":["http://zotero.org/users/10436186/items/4VNYKBCD"],"itemData":{"id":790,"type":"article-journal","abstract":"PURPOSE: To determine the prevalence and factors associated with computer vision syndrome in medical students at a private university in Paraguay. METHODS: A survey study was conducted in 2021 in a sample of 228 medical students from the Universidad del Pacífico, Paraguay. The dependent variable was CVS, measured with the Computer Visual Syndrome Questionnaire (CVS-Q). Its association with covariates (hours of daily use of notebook, smartphone, tablet and PC, taking breaks when using equipment, use of preventive visual measures, use of glasses, etc.) was examined. RESULTS: The mean age was 22.3 years and 71.5% were women. CVS was present in 82.5% of participants. Higher prevalence of CVS was associated with wearing a framed lens (PR = 1.11, 95% CI: 1.03-1.20). In contrast, taking a break when using electronic equipment at least every 20 min and every 1 h reduced 7% (PR = 0.93, 95% CI: 0.87-0.99) and 6% (PR = 0.94, 95% CI: 0.89-0.99) the prevalence of CVS, respectively. CONCLUSION: Eight out of 10 students experienced CVS during the COVID-19 pandemic. The use of framed lenses increased the presence of CVS, while taking breaks when using electronic equipment at least every 20 min and every 1 h reduced CVS.","container-title":"Frontiers in public health","DOI":"10.3389/fpubh.2022.935405","ISSN":"2296-2565","journalAbbreviation":"Front Public Health","language":"eng","license":"Copyright © 2022 Coronel-Ocampos, Gómez, Gómez, Quiroga-Castañeda and Valladares-Garrido.","note":"publisher-place: Switzerland\nPMID: 35910871 \nPMCID: PMC9330381","page":"935405","title":"Computer Visual Syndrome in Medical Students From a Private University in Paraguay: A Survey Study.","volume":"10","author":[{"family":"Coronel-Ocampos","given":"Johanna"},{"family":"Gómez","given":"Jonathan"},{"family":"Gómez","given":"Alexis"},{"family":"Quiroga-Castañeda","given":"Pedro P."},{"family":"Valladares-Garrido","given":"Mario J."}],"issued":{"date-parts":[["2022"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 3 (2022)cross-sectional surveyParaguay228163 (71.5%) females 65 (28.5%) males188 (82.5%)NAMS with CVSnotebook:≤ 4 h 50 (75.8%) ≥ 4 h 138 (85.2%) smartphone ≤ 4 h 21 (84.0%) ≥ 4 h 167 (82.3%) tablet ≤ 4 h 158 (85.4%) ≥ 4 h 30 (69.8%) PC/Laptop ≤ 4 h 154 (83.2%) ≥ 4 h 34 (79.1%)141 (61.8%) previous ocular disease135 (59.2%) lenses with frame 7 (3.1%) contact lenses Patil et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"wet4hK9g","properties":{"formattedCitation":"\\super 4\\nosupersub{}","plainCitation":"4","noteIndex":0},"citationItems":[{"id":781,"uris":["http://zotero.org/users/10436186/items/SFP5NCVS"],"itemData":{"id":781,"type":"article-journal","abstract":"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.","container-title":"Industrial psychiatry journal","DOI":"10.4103/ipj.ipj_93_18","ISSN":"0972-6748 0976-2795","issue":"1","journalAbbreviation":"Ind Psychiatry J","language":"eng","license":"Copyright: © 2019 Industrial Psychiatry Journal.","note":"publisher-place: India\nPMID: 31879450 \nPMCID: PMC6929228","page":"68-74","title":"Eyeing computer vision syndrome: Awareness, knowledge, and its impact on sleep quality among medical students.","volume":"28","author":[{"family":"Patil","given":"Ashwini"},{"family":"Bhavya","given":""},{"family":"Chaudhury","given":"Suprakash"},{"family":"Srivastava","given":"Smiti"}],"issued":{"date-parts":[["2019",6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 4 (2019)cross‑sectional, analytical studyIndia463/500 responders 177 (38.2%) males 286 (61.8%) females 359 (77.5%) boys (80.23%) girls (75.87%)poor sleep quality 75.49% ≤2 h: 156 (33.69%) >2 h: 307 (66.31%)NAKharel & Khatri ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"2cGR53eB","properties":{"formattedCitation":"\\super 5\\nosupersub{}","plainCitation":"5","noteIndex":0},"citationItems":[{"id":785,"uris":["http://zotero.org/users/10436186/items/NMFYQ5EE"],"itemData":{"id":785,"type":"article-journal","abstract":"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.","container-title":"Journal of Nepal Health Research Council","ISSN":"1999-6217 1727-5482","issue":"3","journalAbbreviation":"J Nepal Health Res Counc","language":"eng","note":"publisher-place: Nepal\nPMID: 30455488","page":"291-296","title":"Knowledge, Attitude and practice of Computer Vision Syndrome among medical students and its impact on ocular morbidity.","volume":"16","author":[{"family":"Kharel Sitaula","given":"Ranju"},{"family":"Khatri","given":"Anadi"}],"issued":{"date-parts":[["2018",10,30]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 5 (2018)descriptive cross-sectional surveyNepal236/299 responders76.2% males 23.8% females71.6%63.7% males 36.2% femalesheadache (50%) dry eyes (45%). 2-3 h/d: 37.2%Myopia: most common refractive error (31.2%) prevalence of orthoptic problem: 17.5% Almousa et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Q2fRcH9k","properties":{"formattedCitation":"\\super 6\\nosupersub{}","plainCitation":"6","noteIndex":0},"citationItems":[{"id":786,"uris":["http://zotero.org/users/10436186/items/E5QQF7ST"],"itemData":{"id":786,"type":"article-journal","abstract":"PURPOSE: To estimate the prevalence of computer vision syndrome (CVS) among university medical students in Riyadh, Saudi Arabia, after establishing remote learning during COVID-19 pandemic and to compare settings of electronic device usage and patterns of CVS protective measures applied by students before and during this pandemic. METHODS: This is an observational descriptive cross-sectional study which included 1st to 5th year medical students who were actively enrolled at the governmental colleges of medicine in Riyadh, Saudi Arabia, during the COVID-19 lockdown. The sample size was estimated to be 287 medical students. Participants were asked to volunteer and fill an electronic online questionnaire. RESULTS: A total of 300 medical students were included in this study. 94.0% reported at least one symptom of CVS, while 67% reported having more than three symptoms. The most frequently reported symptoms were musculoskeletal pain (84.3%), headache (71.1%) and dry eyes (68%). Thirty-eight percent of the students experienced more severe symptoms, while 48% experienced more frequent symptoms during the COVID-19 pandemic. Risk factors for having three or more symptoms were being a female (p < 0.001) and using electronic devices for longer periods (6.8 h ± 2.8) during COVID-19 lockdown (p < 0.001). CONCLUSION: CVS prevalence during COVID-19 era among medical students is high. This necessitates increasing the awareness of CVS and its preventive measures.","container-title":"International ophthalmology","DOI":"10.1007/s10792-022-02525-w","ISSN":"1573-2630 0165-5701","journalAbbreviation":"Int Ophthalmol","language":"eng","license":"© 2022. The Author(s), under exclusive licence to Springer Nature B.V.","note":"publisher-place: Netherlands\nPMID: 36153429 \nPMCID: PMC9510156","page":"1-9","title":"The impact of the COVID-19 pandemic on the prevalence of computer vision syndrome among medical students in Riyadh, Saudi Arabia.","author":[{"family":"Almousa","given":"Abdullah N."},{"family":"Aldofyan","given":"Munirah Z."},{"family":"Kokandi","given":"Bushra A."},{"family":"Alsubki","given":"Haneen E."},{"family":"Alqahtani","given":"Rawan S."},{"family":"Gikandi","given":"Priscilla"},{"family":"Alghaihb","given":"Shatha G."}],"issued":{"date-parts":[["2022",9,24]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 6 (2022)observational descriptive cross-sectional studySaudi Arabia300124 (41.3%) males 176 (58.7%) females94%musculoskeletal pain (84.3%)headache (71.1%) dry eyes (68%)burning eye sensation (66%)eye redness (50.7%)blurred vision (47%)pain in/around the eyes (45%)watery eyes (35.7%)double vision (18.3%)total hours of studying h/d:* pre-COVID19: 5.1 ± 2.1 (1–15), 5 (4–6) during COVID-19: 6.4 ± 2.7 (1–20), 6 (5–8) 161 (53.7%) corrective lens: 151 (93.8%) eye glasses 10 (6.2%) contact lensIqbal et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"FZNmuvc5","properties":{"formattedCitation":"\\super 7\\nosupersub{}","plainCitation":"7","noteIndex":0},"citationItems":[{"id":784,"uris":["http://zotero.org/users/10436186/items/KFUWSYQT"],"itemData":{"id":784,"type":"article-journal","abstract":"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.","container-title":"Journal of ophthalmology","DOI":"10.1155/2021/6630286","ISSN":"2090-004X 2090-0058","journalAbbreviation":"J Ophthalmol","language":"eng","license":"Copyright © 2021 Mohammed Iqbal et al.","note":"publisher-place: United States\nPMID: 33868724 \nPMCID: PMC8035040","page":"6630286","title":"Visual Sequelae of Computer Vision Syndrome: A Cross-Sectional Case-Control Study.","volume":"2021","author":[{"family":"Iqbal","given":"Mohammed"},{"family":"Said","given":"Omar"},{"family":"Ibrahim","given":"Ola"},{"family":"Soliman","given":"Ashraf"}],"issued":{"date-parts":[["2021"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 7 (2021)cross-sectional case-control studyEgypt733217 (39.0%) males340 (61.0%) females557 (76%)visual blur 40.9%) headache (46.8%) dry eyes, eye strain/fatigue, eye redness, double vision, refocusing difficulties, near vision difficulties, unclear objects, insomnia, depression, neck & joint pains, inability to hold objects, difficulty to writetotal daily 5.3 ± 1.9 screen-time 176 (31.6%) day 381 (68.4%) night 84 (15.1%) previous DED diagnosis 332 (59.6%) refractive errors/wearing 29 (5.2%) contact lenses*mean ± SD [range], median (IQR)Abbreviations: No = number; MS = medical students; CVS = computer vision syndrome; h = hour; h/d = hours per day; NA = not available; MBBS = Bachelor of Medicine and Bachelor of Surgery; DED = dry eye diseaseThe male predominance of CVS was also noticed in a descriptive, cross-sectional study ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"O5znDLyp","properties":{"formattedCitation":"\\super 5\\nosupersub{}","plainCitation":"5","noteIndex":0},"citationItems":[{"id":785,"uris":["http://zotero.org/users/10436186/items/NMFYQ5EE"],"itemData":{"id":785,"type":"article-journal","abstract":"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.","container-title":"Journal of Nepal Health Research Council","ISSN":"1999-6217 1727-5482","issue":"3","journalAbbreviation":"J Nepal Health Res Counc","language":"eng","note":"publisher-place: Nepal\nPMID: 30455488","page":"291-296","title":"Knowledge, Attitude and practice of Computer Vision Syndrome among medical students and its impact on ocular morbidity.","volume":"16","author":[{"family":"Kharel Sitaula","given":"Ranju"},{"family":"Khatri","given":"Anadi"}],"issued":{"date-parts":[["2018",10,30]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 5. Headache and dryness were noticed and myopia was the most common refractive disorder. Almousa et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ifAP4s5I","properties":{"formattedCitation":"\\super 6\\nosupersub{}","plainCitation":"6","noteIndex":0},"citationItems":[{"id":786,"uris":["http://zotero.org/users/10436186/items/E5QQF7ST"],"itemData":{"id":786,"type":"article-journal","abstract":"PURPOSE: To estimate the prevalence of computer vision syndrome (CVS) among university medical students in Riyadh, Saudi Arabia, after establishing remote learning during COVID-19 pandemic and to compare settings of electronic device usage and patterns of CVS protective measures applied by students before and during this pandemic. METHODS: This is an observational descriptive cross-sectional study which included 1st to 5th year medical students who were actively enrolled at the governmental colleges of medicine in Riyadh, Saudi Arabia, during the COVID-19 lockdown. The sample size was estimated to be 287 medical students. Participants were asked to volunteer and fill an electronic online questionnaire. RESULTS: A total of 300 medical students were included in this study. 94.0% reported at least one symptom of CVS, while 67% reported having more than three symptoms. The most frequently reported symptoms were musculoskeletal pain (84.3%), headache (71.1%) and dry eyes (68%). Thirty-eight percent of the students experienced more severe symptoms, while 48% experienced more frequent symptoms during the COVID-19 pandemic. Risk factors for having three or more symptoms were being a female (p < 0.001) and using electronic devices for longer periods (6.8 h ± 2.8) during COVID-19 lockdown (p < 0.001). CONCLUSION: CVS prevalence during COVID-19 era among medical students is high. This necessitates increasing the awareness of CVS and its preventive measures.","container-title":"International ophthalmology","DOI":"10.1007/s10792-022-02525-w","ISSN":"1573-2630 0165-5701","journalAbbreviation":"Int Ophthalmol","language":"eng","license":"© 2022. The Author(s), under exclusive licence to Springer Nature B.V.","note":"publisher-place: Netherlands\nPMID: 36153429 \nPMCID: PMC9510156","page":"1-9","title":"The impact of the COVID-19 pandemic on the prevalence of computer vision syndrome among medical students in Riyadh, Saudi Arabia.","author":[{"family":"Almousa","given":"Abdullah N."},{"family":"Aldofyan","given":"Munirah Z."},{"family":"Kokandi","given":"Bushra A."},{"family":"Alsubki","given":"Haneen E."},{"family":"Alqahtani","given":"Rawan S."},{"family":"Gikandi","given":"Priscilla"},{"family":"Alghaihb","given":"Shatha G."}],"issued":{"date-parts":[["2022",9,24]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 6 described a 94% prevalence of CVS among the enrolled medical students. The researchers reported visual and extra-ocular disorders such as musculoskeletal pain (84.3%) and headache (71.1%) and underlined that during COVID-19 pandemic the symptoms were more frequent and severe than the pre-pandemic era. Moreover, during the pandemic the screen time was also increased. In the cross-sectional, case control study of Iqbal et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"0EWVFNHS","properties":{"formattedCitation":"\\super 7\\nosupersub{}","plainCitation":"7","noteIndex":0},"citationItems":[{"id":784,"uris":["http://zotero.org/users/10436186/items/KFUWSYQT"],"itemData":{"id":784,"type":"article-journal","abstract":"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.","container-title":"Journal of ophthalmology","DOI":"10.1155/2021/6630286","ISSN":"2090-004X 2090-0058","journalAbbreviation":"J Ophthalmol","language":"eng","license":"Copyright © 2021 Mohammed Iqbal et al.","note":"publisher-place: United States\nPMID: 33868724 \nPMCID: PMC8035040","page":"6630286","title":"Visual Sequelae of Computer Vision Syndrome: A Cross-Sectional Case-Control Study.","volume":"2021","author":[{"family":"Iqbal","given":"Mohammed"},{"family":"Said","given":"Omar"},{"family":"Ibrahim","given":"Ola"},{"family":"Soliman","given":"Ashraf"}],"issued":{"date-parts":[["2021"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 7 CVS was reported in 76% of medical students and the most frequent complaints were blurred vision and headache. The severity of the syndrome seemed to be affected by refractive errors, increased screen time and close eye-screen distance. Discussion According to American Optometric Association (AOA) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ye42FIim","properties":{"formattedCitation":"\\super 1\\nosupersub{}","plainCitation":"1","noteIndex":0},"citationItems":[{"id":830,"uris":["http://zotero.org/users/10436186/items/35M45QUE"],"itemData":{"id":830,"type":"webpage","title":"Computer vision syndrome","URL":"https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y","author":[{"literal":"American Optometric Association (AOA)"}],"accessed":{"date-parts":[["2023",1,13]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 1 the most common symptoms of computer vision syndrome (CVS) include eyestrain, dryness, headache, blurred vision and musculoskeletal complaints such as neck and shoulder pain. Previous vision problems, poor lighting and posture, short eye to screen distance or the combination of these factors can lead to CVS. Eye examination confirms the diagnosis. Ergonomic practices are essential in order to relieve or even prevent the symptoms of CVS. AOA ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LG7JYqWO","properties":{"formattedCitation":"\\super 1\\nosupersub{}","plainCitation":"1","noteIndex":0},"citationItems":[{"id":830,"uris":["http://zotero.org/users/10436186/items/35M45QUE"],"itemData":{"id":830,"type":"webpage","title":"Computer vision syndrome","URL":"https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y","author":[{"literal":"American Optometric Association (AOA)"}],"accessed":{"date-parts":[["2023",1,13]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 1 suggests the location of the computer screen to be 15 to 20 degrees below the eye level and 20 to 28 inches away from the eyes. Mowatt et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"uc2I7znM","properties":{"formattedCitation":"\\super 8\\nosupersub{}","plainCitation":"8","noteIndex":0},"citationItems":[{"id":777,"uris":["http://zotero.org/users/10436186/items/CAIQBCUQ"],"itemData":{"id":777,"type":"article-journal","abstract":"AIM: To determine the prevalence of computer vision syndrome (CVS) and ergonomic practices among students in the Faculty of Medical Sciences at The University of the West Indies (UWI), Jamaica. METHOD: A cross-sectional study was done with a self-administered questionnaire. RESULTS: Four hundred and nine students participated; 78% were females. The mean age was 21.6 years. Neck pain (75.1%), eye strain (67%), shoulder pain (65.5%) and eye burn (61.9%) were the most common CVS symptoms. Dry eyes (26.2%), double vision (28.9%) and blurred vision (51.6%) were the least commonly experienced symptoms. Eye burning (P = .001), eye strain (P = .041) and neck pain (P = .023) were significantly related to level of viewing. Moderate eye burning (55.1%) and double vision (56%) occurred in those who used handheld devices (P = .001 and .007, respectively). Moderate blurred vision was reported in 52% who looked down at the device compared with 14.8% who held it at an angle. Severe eye strain occurred in 63% of those who looked down at a device compared with 21% who kept the device at eye level. Shoulder pain was not related to pattern of use. CONCLUSION: Ocular symptoms and neck pain were less likely if the device was held just below eye level. There is a high prevalence of Symptoms of CVS amongst university students which could be reduced, in particular neck pain and eye strain and burning, with improved ergonomic practices.","container-title":"International journal of clinical practice","DOI":"10.1111/ijcp.13035","ISSN":"1742-1241 1368-5031","issue":"1","journalAbbreviation":"Int J Clin Pract","language":"eng","license":"© 2017 John Wiley & Sons Ltd.","note":"publisher-place: India\nPMID: 28980750","title":"Computer vision syndrome and ergonomic practices among undergraduate university students.","volume":"72","author":[{"family":"Mowatt","given":"Lizette"},{"family":"Gordon","given":"Carron"},{"family":"Santosh","given":"Arvind Babu Rajendra"},{"family":"Jones","given":"Thaon"}],"issued":{"date-parts":[["2018",1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 8 found that visual symptoms were less frequent when the electronic device was below the eye level. Avoidance of glare with the appropriate computer position, the use of glare screen filters and the balance of light between computer screen and the surrounding are helpful. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LgGwj9vx","properties":{"formattedCitation":"\\super 1,9\\nosupersub{}","plainCitation":"1,9","noteIndex":0},"citationItems":[{"id":830,"uris":["http://zotero.org/users/10436186/items/35M45QUE"],"itemData":{"id":830,"type":"webpage","title":"Computer vision syndrome","URL":"https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y","author":[{"literal":"American Optometric Association (AOA)"}],"accessed":{"date-parts":[["2023",1,13]]}}},{"id":789,"uris":["http://zotero.org/users/10436186/items/JZGJUZSN"],"itemData":{"id":789,"type":"article-journal","abstract":"Computers have become to play an important role in people's lives throughout the world thus increasing the number of patients with ocular complaints. Also known as computer vision syndrome, accommodative asthenopia might be considered as a neglected occupational condition, but there is no consensus regarding diagnostic criteria, which leads to under-recognition and under-reporting. The aim of the study was to investigate the prevalence, early symptoms and specific preventive measures of accommodative asthenopia among computer-using medical students (n = 420), in a cross-sectional study. The most common early symptoms were: tired eyes/eye strain (86.1%), burning eyes (46.8%), migraines/headaches (46.8%), red-swollen eyes (43%), photophobia (41.8%), temporary blurred vision (35.4%), and eyelid spasms (32.9%). Our study identifies the most frequent early symptoms of accommodative asthenopia as a possible occupational disease, which might serve as a fundament for a future consensus strategy.","container-title":"Archives of environmental & occupational health","DOI":"10.1080/19338244.2019.1616666","ISSN":"2154-4700 1933-8244","issue":"4","journalAbbreviation":"Arch Environ Occup Health","language":"eng","note":"publisher-place: United States\nPMID: 31124406","page":"235-241","title":"Accommodative asthenopia among Romanian computer-using medical students-A neglected occupational disease.","volume":"75","author":[{"family":"Moldovan","given":"Horatiu-Remus"},{"family":"Voidazan","given":"Septimiu-Toader"},{"family":"Moldovan","given":"Gabriela"},{"family":"Vlasiu","given":"Maria-Ancuta"},{"family":"Moldovan","given":"Geanina"},{"family":"Panaitescu","given":"Roxana"}],"issued":{"date-parts":[["2020"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 1,9 Furthermore, comfortable seating position and blinking are recommended. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"pB2vCh0m","properties":{"formattedCitation":"\\super 1\\nosupersub{}","plainCitation":"1","noteIndex":0},"citationItems":[{"id":830,"uris":["http://zotero.org/users/10436186/items/35M45QUE"],"itemData":{"id":830,"type":"webpage","title":"Computer vision syndrome","URL":"https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y","author":[{"literal":"American Optometric Association (AOA)"}],"accessed":{"date-parts":[["2023",1,13]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 1 Another useful practice is the 20-20-20 rule. In other words, everyone should take a 20 second break to view something that is 20 feet away every 20 minutes. Some secondary preventive measures can be artificial tears, however, ethical issues arise. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LtbqNosR","properties":{"formattedCitation":"\\super 9\\nosupersub{}","plainCitation":"9","noteIndex":0},"citationItems":[{"id":789,"uris":["http://zotero.org/users/10436186/items/JZGJUZSN"],"itemData":{"id":789,"type":"article-journal","abstract":"Computers have become to play an important role in people's lives throughout the world thus increasing the number of patients with ocular complaints. Also known as computer vision syndrome, accommodative asthenopia might be considered as a neglected occupational condition, but there is no consensus regarding diagnostic criteria, which leads to under-recognition and under-reporting. The aim of the study was to investigate the prevalence, early symptoms and specific preventive measures of accommodative asthenopia among computer-using medical students (n = 420), in a cross-sectional study. The most common early symptoms were: tired eyes/eye strain (86.1%), burning eyes (46.8%), migraines/headaches (46.8%), red-swollen eyes (43%), photophobia (41.8%), temporary blurred vision (35.4%), and eyelid spasms (32.9%). Our study identifies the most frequent early symptoms of accommodative asthenopia as a possible occupational disease, which might serve as a fundament for a future consensus strategy.","container-title":"Archives of environmental & occupational health","DOI":"10.1080/19338244.2019.1616666","ISSN":"2154-4700 1933-8244","issue":"4","journalAbbreviation":"Arch Environ Occup Health","language":"eng","note":"publisher-place: United States\nPMID: 31124406","page":"235-241","title":"Accommodative asthenopia among Romanian computer-using medical students-A neglected occupational disease.","volume":"75","author":[{"family":"Moldovan","given":"Horatiu-Remus"},{"family":"Voidazan","given":"Septimiu-Toader"},{"family":"Moldovan","given":"Gabriela"},{"family":"Vlasiu","given":"Maria-Ancuta"},{"family":"Moldovan","given":"Geanina"},{"family":"Panaitescu","given":"Roxana"}],"issued":{"date-parts":[["2020"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 9The literature supported that CVS, also known as digital eye strain, has a high prevalence in medical students. This disorder affects other groups of students, for instance engineering students. Logaraj et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"DRJnYsp5","properties":{"formattedCitation":"\\super 10\\nosupersub{}","plainCitation":"10","noteIndex":0},"citationItems":[{"id":780,"uris":["http://zotero.org/users/10436186/items/7DH8JG2A"],"itemData":{"id":780,"type":"article-journal","abstract":"BACKGROUND: Almost all institutions, colleges, universities and homes today were using computer regularly. Very little research has been carried out on Indian users especially among college students the effects of computer use on the eye and vision related problems. AIM: The aim of this study was to assess the prevalence of computer vision syndrome (CVS) among medical and engineering students and the factors associated with the same. SUBJECTS AND METHODS: A cross-sectional study was conducted among medical and engineering college students of a University situated in the suburban area of Chennai. Students who used computer in the month preceding the date of study were included in the study. The participants were surveyed using pre-tested structured questionnaire. RESULTS: Among engineering students, the prevalence of CVS was found to be 81.9% (176/215) while among medical students; it was found to be 78.6% (158/201). A significantly higher proportion of engineering students 40.9% (88/215) used computers for 4-6 h/day as compared to medical students 10% (20/201) (P < 0.001). The reported symptoms of CVS were higher among engineering students compared with medical students. Students who used computer for 4-6 h were at significantly higher risk of developing redness (OR = 1.2, 95% CI = 1.0-3.1,P = 0.04), burning sensation (OR = 2.1,95% CI = 1.3-3.1, P < 0.01) and dry eyes (OR = 1.8, 95% CI = 1.1-2.9, P = 0.02) compared to those who used computer for less than 4 h. Significant correlation was found between increased hours of computer use and the symptoms redness, burning sensation, blurred vision and dry eyes. CONCLUSION: The present study revealed that more than three-fourth of the students complained of any one of the symptoms of CVS while working on the computer.","container-title":"Annals of medical and health sciences research","DOI":"10.4103/2141-9248.129028","ISSN":"2141-9248 2277-9205","issue":"2","journalAbbreviation":"Ann Med Health Sci Res","language":"eng","note":"publisher-place: India\nPMID: 24761234 \nPMCID: PMC3991936","page":"179-185","title":"Computer vision syndrome and associated factors among medical and engineering students in chennai.","volume":"4","author":[{"family":"Logaraj","given":"M."},{"family":"Madhupriya","given":"V."},{"family":"Hegde","given":"Sk"}],"issued":{"date-parts":[["2014",3]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 10 claimed that engineering students were at higher risk of developing CVS than medical students since they spent more hours per day in front of a screen. It should be underlined that COVID-19 pandemic played an important role in the development of CVS. Screen time increased during the pandemic ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jzFZyf7e","properties":{"formattedCitation":"\\super 11\\nosupersub{}","plainCitation":"11","noteIndex":0},"citationItems":[{"id":839,"uris":["http://zotero.org/users/10436186/items/49U7RKPN"],"itemData":{"id":839,"type":"webpage","abstract":"Introduction: The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic \naffected and altered several parts of our daily habits and lifestyle. Adolescents could not remain \nunaffected. The purpose of this review is to evaluate changes in health and daily habits of adolescents \nduring the COVID-19pandemic. \nMaterial and Methods: A detailed search of the literature was conducted in Pubmed to find \npublished articles related to changes in health, lifestyle and daily habits of adolescents during the \nCOVID-19 pandemic.\nResults: A total of 22 articles met the inclusion criteria and found suitable for this study. Additional \nresources from World Health Organization (WHO) and American Academy of Pediatrics (AAP) official \nwebsites provided useful information were also included. COVID-19 pandemic has caused changes in \nadolescents’ sleep habits and quality, such as increase in sleep duration and later bed time. Screen \ntime increased but physical activity decreased. Moreover, eating patterns were altered and there was \na tendency for weight gain. Adolescents’ mental health and behavior were also affected, and in many \ncases there an increase in mood changes, especially in depressive symptoms.\nConclusion: COVID-19 pandemic has unquestionably changed the adolescents’ everyday habits and \nlives. Considering that adolescence is the period in which physical and mental development of young \npeople take place, it should be kept in mind that the results of such effects might accompany them in \ntheir adult life.\nKey Words: health; lifestyle and habits; adolescents; COVID-19","title":"Changes in health quality, lifestyle and habits in adolescents that induced by COVID-19 pandemic. | Developmental and Adolescent Health","URL":"https://www.dah-journal.com/index.php/dah/article/view/18","author":[{"family":"Solia","given":"Eirini"},{"family":"Filippou","given":"Dimitrios"}],"accessed":{"date-parts":[["2023",2,5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 11 given that in person teaching was replaced with distance learning. The extended screen time use during pandemic increased the prevalence of ocular complaints. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"0Jvr6MVr","properties":{"formattedCitation":"\\super 12,13\\nosupersub{}","plainCitation":"12,13","noteIndex":0},"citationItems":[{"id":795,"uris":["http://zotero.org/users/10436186/items/WU4SVWJC"],"itemData":{"id":795,"type":"article-journal","abstract":"PURPOSE: Students spend extended hours using electronic devices due to online teaching. Digital eye strain (DES) and dry eye disease (DED) symptoms are both associated with prolonged screen exposure time and may co-occur. This study aimed to evaluate the correlation between DES and DED symptoms and determine the prevalence of DED according to the severity of DES. PATIENTS AND METHODS: This cross-sectional study was conducted among international students in Chinese universities. The survey was built using Wenjuan Mini Program and distributed using the WeChat platform. The questionnaire assessed participants' screen exposure, the 20-20-20 rule, ED practices, and DED awareness. Computer Vision Syndrome Questionnaire (CVS-Q) and Dry Eye Questionnaire (DEQ-5) were used to diagnose DES and DED symptoms, respectively. RESULTS: 498 students completed the survey, but 452 were considered for the study. Predictors of DES and DED symptoms were conjunctivitis, eye allergy, glares, tired eye, neck pain, back pain, PhD students, and daily spending > 9h on screen (P < 0.05 for all). We observed that an increase in DES scores also exponentially increases DED scores. Among students diagnosed with DES symptoms, 26.5% had mild to moderate DED symptoms, and 8.2% had severe DED symptoms. In contrast, only 8.4% and 0.9% of those with asymptomatic DES had mild to moderate and severe DED symptoms, respectively (P < 0.000). A strong and significant positive correlation (r = 0.695, P < 0.000) between DES and DED scores was found. CONCLUSION: We found an extremely high prevalence of DES and DED symptoms compared to the previous studies with a similar population group. We believe that the prevalence of DED may be underestimated in the young population. Training about proper ED practices is mandatory to prevent these deleterious ocular surface conditions.","container-title":"Risk management and healthcare policy","DOI":"10.2147/RMHP.S388331","ISSN":"1179-1594","journalAbbreviation":"Risk Manag Healthc Policy","language":"eng","license":"© 2022 Uwimana et al.","note":"publisher-place: England\nPMID: 36518997 \nPMCID: PMC9743979","page":"2311-2322","title":"Concurrent Rising of Dry Eye and Eye Strain Symptoms Among University Students During the COVID-19 Pandemic Era: A Cross-Sectional Study.","volume":"15","author":[{"family":"Uwimana","given":"Alexandre"},{"family":"Ma","given":"Cong"},{"family":"Ma","given":"Xiang"}],"issued":{"date-parts":[["2022"]]}}},{"id":783,"uris":["http://zotero.org/users/10436186/items/ZLUJUNPB"],"itemData":{"id":783,"type":"article-journal","abstract":"PURPOSE: To review students' perceived symptom-based computer vision syndrome (CVS) and its determinants and to suggest preventive measures. METHODS: This cross-sectional survey was conducted in 2021 at a university in Central Saudi Arabia. The presence and severity of symptoms related to CVS were investigated. The total CVS symptom score was the outcome variable. The CVS score was correlated to participants' demographics, visual habits when using digital devices, and knowledge about CVS. Due to skewed distribution, a nonparametric method was used for analysis. RESULTS: Overall, 521 students were surveyed. The prevalence of CVS based on at least one symptom was 96% (95% confidence interval 94.3-97.7). The median score was 8.0 (interquartile range 4.0-12.0). Of the 24 possible CVS scores, 42 students (8%) had scores of 18 or more (severe CVS). Being female (Mann-Whitney [MW] P < 0.001), being older (Spearman P < 0.001), refractive error (MW P < 0.001), the presence of dry eye (MW P < 0.001), using devices other than a desktop computer (KruskalWallis) P = 0.03), and more than 6 h constantly working with a device (MW P = 0.001) were correlated with a higher CVS score. Older age, female, refractive error, and using digital devices for more than 6 h were the independent and significant predictors of CVS in college students. CONCLUSION: Most of the students suffered from mild-to-moderate CVS symptoms. Health promotion for prevention and periodic ophthalmic consultations are recommended. Identified predictors should be the focus when implementing strategies to combat CVS in the adolescent Saudi population.","container-title":"Middle East African journal of ophthalmology","DOI":"10.4103/meajo.meajo_272_21","ISSN":"0975-1599 0974-9233","issue":"4","journalAbbreviation":"Middle East Afr J Ophthalmol","language":"eng","license":"Copyright: © 2022 Middle East African Journal of Ophthalmology.","note":"publisher-place: India\nPMID: 35719284 \nPMCID: PMC9198529","page":"252-256","title":"Magnitude and Determinants of Computer Vision Syndrome among College Students at a Saudi University.","volume":"28","author":[{"family":"AlDarrab","given":"Abdulrahman"},{"family":"Khojah","given":"Abdulaziz A."},{"family":"Al-Ghazwi","given":"Mohammed H."},{"family":"Al-Haqbani","given":"Yazeed J."},{"family":"Al-Qahtani","given":"Naif M."},{"family":"Al-Ajmi","given":"Mohammed N."},{"family":"Alenezi","given":"Saad H."},{"family":"Almasoud","given":"Mohammmed K."},{"family":"Al-Yahya","given":"Abdulaziz F."}],"issued":{"date-parts":[["2021",12]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 12,13 Alamri et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"2pfMFfIN","properties":{"formattedCitation":"\\super 14\\nosupersub{}","plainCitation":"14","noteIndex":0},"citationItems":[{"id":791,"uris":["http://zotero.org/users/10436186/items/KXKJVNWN"],"itemData":{"id":791,"type":"article-journal","abstract":"BACKGROUND: According to computer vision syndrome (CVS). Due to constant use of computers by the students, it has become one of the growing health risks associated with technology (cell phones and tablets). CVS is a combination of eye and vision disorders associated with activities that affect near vision and is experienced in relation to or during the use of computers. The main aim of the study was to find the risk factors of CVS, its symptoms, and other factors associated with CVS. MATERIALS AND METHODS: In this cross-sectional study, data was collected using a purposely constructed E-questionnaire. The questionnaire consisted of demographic items and items related to the usage of E-devices and the symptoms of eye problems. After data collection, data was coded and entered in the Statistical Package for the Social Sciences (SPSS) ver. 20 software for analyses. Descriptive statistics (mean and standard deviation, frequencies and percentages) were computed. To measure the significant differences, Chi-square test was used at 5% level of significance. RESULTS: The mean (SD) age of 400 respondents was 22.5 (11.5) years. We computed the internal consistency, and the overall Cronbach alpha was 0.81. Also, 40% of the respondents were females, while 60% were males. Results showed that 20% of the respondents had multiple symptoms of eye problems, while 9% had no symptoms, 9% had eye pain, 8% had dryness of eye, and 6% had watering of eyes and redness of eye symptoms. The rest of the symptoms was found in less than 5% of the respondents. CONCLUSION: This worldwide issue requires immediate attention. Long-term computer use has been linked to significant visual impairments, particularly in people who use computers and similar gadgets for extended periods of time.","container-title":"Journal of family medicine and primary care","DOI":"10.4103/jfmpc.jfmpc_1627_21","ISSN":"2249-4863 2278-7135","issue":"9","journalAbbreviation":"J Family Med Prim Care","language":"eng","license":"Copyright: © 2022 Journal of Family Medicine and Primary Care.","note":"publisher-place: India\nPMID: 36505560 \nPMCID: PMC9730965","page":"5110-5115","title":"Computer vision syndrome: Symptoms, risk factors, and practices.","volume":"11","author":[{"family":"Alamri","given":"Abdulrahman"},{"family":"Amer","given":"Khaled A."},{"family":"Aldosari","given":"Abdulrahman A."},{"family":"Althubait","given":"Basel M. S."},{"family":"Alqahtani","given":"Mushary S."},{"family":"Al Mudawi","given":"Abdulrahman A. M."},{"family":"Al Mudawi","given":"Bandar A. M."},{"family":"Alqahtani","given":"Faisal A. M."},{"family":"Alhamoud","given":"Nawaf S. Y."}],"issued":{"date-parts":[["2022",9]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 14 in their cross-sectional study compared the use of electronic devices before and during COVID-19 pandemic. The results revealed a significant increase in their use. Most students (49%) of their cross-sectional study used electronic devices for virtual classes and 20% of the responders had multiple symptoms of ocular complaints due to extended screen time. Moreover, Wang et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VA2vqTkW","properties":{"formattedCitation":"\\super 2\\nosupersub{}","plainCitation":"2","noteIndex":0},"citationItems":[{"id":782,"uris":["http://zotero.org/users/10436186/items/A8SWE5WN"],"itemData":{"id":782,"type":"article-journal","abstract":"Purpose: To compare the prevalence of computer vision syndrome in university students of different teaching modes during the SARS-CoV-2 outbreak period. Methods: A cross-sectional survey study using the validated Computer Vision Syndrome Questionnaire in Chinese medical students of Sichuan University who took classroom lectures and the same-grade foreign students from a Bachelor of Medicine and Bachelor of Surgery (MBBS) program who took online lectures with similar schedules. Results: A total of 137 responses from 63 Chinese students and 74 MBBS students were obtained. The highest frequency of digital screen time was 7-9 h (43.24%, 32/74) for MBBS students and 2-4 h (46.03%, 29/63) for Chinese students. The prevalence of computer vision syndrome among Chinese students and MBBS students were 50.79% and 74.32%, respectively (P = 0.004). The average numbers of reported symptoms were 5.00 ± 2.17 in Chinese students and 5.91 ± 1.90 in MBBS students (P = 0.01). The three most highly reported symptoms were \"heavy eyelids\" (53.97%), \"dryness\" (50.79%), and \"feeling of a foreign body\" (46.03%) in Chinese students and \"dryness\" (72.97%), \"feeling of a foreign body\" (62.16%), and \"heavy eyelids\" (58.11%) in MBBS students. The sum grades of computer vision syndrome had a moderate positive correlation with screen time (Spearman's correlation coefficient = 0.386, P < 0.001). The grades of symptoms of \"feeling of a foreign body,\" \"heavy eyelids,\" and \"dryness\" showed a weak positive correlation with screen time (Spearman's correlation coefficients were 0.220, 0.205, and 0.230, respectively). Conclusion: Online study may contribute to the prevalence of computer vision syndrome among university students.","container-title":"Frontiers in public health","DOI":"10.3389/fpubh.2021.696036","ISSN":"2296-2565","journalAbbreviation":"Front Public Health","language":"eng","license":"Copyright © 2021 Wang, Wei and Deng.","note":"publisher-place: Switzerland\nPMID: 34307289 \nPMCID: PMC8296301","page":"696036","title":"Computer Vision Syndrome During SARS-CoV-2 Outbreak in University Students: A Comparison Between Online Courses and Classroom Lectures.","volume":"9","author":[{"family":"Wang","given":"Lixiang"},{"family":"Wei","given":"Xin"},{"family":"Deng","given":"Yingping"}],"issued":{"date-parts":[["2021"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 2 reached similar results. They observed that MBBS students during COVID-19 pandemic spent a lot of hours in front of screens due to the virtual classes and the incidence and severity of CVS’s symptoms were more profound compared with students who took classroom lectures. These findings were confirmed by Almusa et al. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"J3kuF24p","properties":{"formattedCitation":"\\super 6\\nosupersub{}","plainCitation":"6","noteIndex":0},"citationItems":[{"id":786,"uris":["http://zotero.org/users/10436186/items/E5QQF7ST"],"itemData":{"id":786,"type":"article-journal","abstract":"PURPOSE: To estimate the prevalence of computer vision syndrome (CVS) among university medical students in Riyadh, Saudi Arabia, after establishing remote learning during COVID-19 pandemic and to compare settings of electronic device usage and patterns of CVS protective measures applied by students before and during this pandemic. METHODS: This is an observational descriptive cross-sectional study which included 1st to 5th year medical students who were actively enrolled at the governmental colleges of medicine in Riyadh, Saudi Arabia, during the COVID-19 lockdown. The sample size was estimated to be 287 medical students. Participants were asked to volunteer and fill an electronic online questionnaire. RESULTS: A total of 300 medical students were included in this study. 94.0% reported at least one symptom of CVS, while 67% reported having more than three symptoms. The most frequently reported symptoms were musculoskeletal pain (84.3%), headache (71.1%) and dry eyes (68%). Thirty-eight percent of the students experienced more severe symptoms, while 48% experienced more frequent symptoms during the COVID-19 pandemic. Risk factors for having three or more symptoms were being a female (p < 0.001) and using electronic devices for longer periods (6.8 h ± 2.8) during COVID-19 lockdown (p < 0.001). CONCLUSION: CVS prevalence during COVID-19 era among medical students is high. This necessitates increasing the awareness of CVS and its preventive measures.","container-title":"International ophthalmology","DOI":"10.1007/s10792-022-02525-w","ISSN":"1573-2630 0165-5701","journalAbbreviation":"Int Ophthalmol","language":"eng","license":"© 2022. The Author(s), under exclusive licence to Springer Nature B.V.","note":"publisher-place: Netherlands\nPMID: 36153429 \nPMCID: PMC9510156","page":"1-9","title":"The impact of the COVID-19 pandemic on the prevalence of computer vision syndrome among medical students in Riyadh, Saudi Arabia.","author":[{"family":"Almousa","given":"Abdullah N."},{"family":"Aldofyan","given":"Munirah Z."},{"family":"Kokandi","given":"Bushra A."},{"family":"Alsubki","given":"Haneen E."},{"family":"Alqahtani","given":"Rawan S."},{"family":"Gikandi","given":"Priscilla"},{"family":"Alghaihb","given":"Shatha G."}],"issued":{"date-parts":[["2022",9,24]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} 6 who observed that 38% of the enrolled students had more severe symptoms, and 48% experienced more frequent symptoms during the pandemic due to the extended use of digital devices. Consequently, COVID-19 pandemic led to extensive use of digital devices exacerbating symptoms of CVS or previous ocular problems.Our study is an up-to-date review concerning the association between CVS and medical students. The limitation of this study is that we excluded studies referred to other kinds of students along with medical students, for instance “health profession students” that included medical, nursing and pharmacy students, in order to have a homogeneous sample. Conclusion Take all the above into consideration, it is profound that CVS due its high prevalence is a worldwide health issue that requires awareness. Medical students should be informed about its symptoms and guided about daily measures that can be taken in order to minimize the complaints accompanying CVS. Hence, ergonomic practices are of paramount importance.References ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY 1.American Optometric Association (AOA). Computer vision syndrome. Accessed January 13, 2023. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y2.Wang L, Wei X, Deng Y. Computer Vision Syndrome During SARS-CoV-2 Outbreak in University Students: A Comparison Between Online Courses and Classroom Lectures. Front Public Health. 2021;9:696036. doi:10.3389/fpubh.2021.6960363.Coronel-Ocampos J, Gómez J, Gómez A, Quiroga-Castañeda PP, Valladares-Garrido MJ. Computer Visual Syndrome in Medical Students From a Private University in Paraguay: A Survey Study. Front Public Health. 2022;10:935405. doi:10.3389/fpubh.2022.9354054.Patil A, Bhavya, Chaudhury S, Srivastava S. Eyeing computer vision syndrome: Awareness, knowledge, and its impact on sleep quality among medical students. Ind Psychiatry J. 2019;28(1):68-74. doi:10.4103/ipj.ipj_93_185.Kharel Sitaula R, Khatri A. Knowledge, Attitude and practice of Computer Vision Syndrome among medical students and its impact on ocular morbidity. 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Computer vision syndrome and associated factors among medical and engineering students in chennai. Ann Med Health Sci Res. 2014;4(2):179-185. doi:10.4103/2141-9248.12902811.Solia E, Filippou D. Changes in health quality, lifestyle and habits in adolescents that induced by COVID-19 pandemic. | Developmental and Adolescent Health. Accessed February 5, 2023. https://www.dah-journal.com/index.php/dah/article/view/1812.Uwimana A, Ma C, Ma X. Concurrent Rising of Dry Eye and Eye Strain Symptoms Among University Students During the COVID-19 Pandemic Era: A Cross-Sectional Study. Risk Manag Healthc Policy. 2022;15:2311-2322. doi:10.2147/RMHP.S38833113.AlDarrab A, Khojah AA, Al-Ghazwi MH, et al. Magnitude and Determinants of Computer Vision Syndrome among College Students at a Saudi University. Middle East Afr J Ophthalmol. 2021;28(4):252-256. doi:10.4103/meajo.meajo_272_2114.Alamri A, Amer KA, Aldosari AA, et al. Computer vision syndrome: Symptoms, risk factors, and practices. J Fam Med Prim Care. 2022;11(9):5110-5115. doi:10.4103/jfmpc.jfmpc_1627_21Topics in Biomedical Research and EducationSolia E., et al.: The association between computer vision syndrome and medical students’ health PAGE \* MERGEFORMAT 2141227266269Microsoft Office Word0552156falseTitle1false78385falsefalse14.0000UserDimitrios Filippou22023-03-14T06:03:00Z2023-03-14T06:03:00Z<data data-version="3" zotero-version="6.0.18"><session id="Ul210naq"/><style id="http://www.zotero.org/styles/american-medical-association" hasBibliography="1" bibliographyStyleHasBeenSet="1"/><prefs><pref name="fieldType" value="Field"/><pref name="automaticJournalAbbreviations" value="true"/></prefs></data>