computer vision syndrome 1

8/2/2019 Computer Vision Syndrome 1

1/10

Computer Vision Syndrome: Management through Eye Relaxation Practices

Computer Vision Syndrome: Management through Eye

Relaxation PracticesLekshmi.K, Research Scholar, University of Kerala, Trivandrum. & Dr. Asha Balagangadharan, Principal,

Sree Narayana Guru College, Coimbatore.

AbstractComputer Vision Syndrome is a condition among those working

on computers for long periods of time. It is characterized byblurred vision, eye aches and pains, dryness or excessive watering

of the eye and musculoskeletal discomforts. In view of the greater

prevalence of computer vision syndrome among the prolongedusers of computers, in the present study an attempt is being made

to device strategies for alleviating the visual problems through a

set of practices involving relaxing of the eyes. The sample

included 30 myopic (blurred distant vision) patients, 15 in theexperimental group (constituted individuals working on computers

for 5 or more hours per day) and the remaining 15 served as thecontrol group. The experimental and control group were decidedupon as per the principles of matched control group design. The

intervention involved eye relaxation exercises. Analysis of results

indicated improvement in visual acuity in both the groups, withexperimental group taking a more favorable turn. Associated

symptom (astigmatism) also is found to have reduced

considerably.

Key words: Computer usage, Myopia, Relaxation, Visual strain.

Introduction

Vision and eye related problems at computer displays are very common and havecollectively been named computer vision syndrome (Sheedy & Shaw Mc Minn, 2003). The

prevalence of eye symptoms ranges from 25% to 93% as reported by various investigators.

Self report questionnaires by data operators in UK reveal 25% visual strain symptoms(Woods, 2001). Temporary myoptization was observed among 64% Italian video display

terminal workers during assessment of vision at the culmination of a shift (Leberto, F.,

Gobba, F. & Broglia, A., 1988). Survey on visual and musculoskeletal symptomsconducted in Japan reveal a prevalence of eye strain or pain of 72% (Iwakiri, K., Mori, I.,

Sotoyama, M., Horiguchi, K., Ochiai, T., Jonai, H. & Saito S., 2004). A study on the

association between asthenopia and psycho physiological indicators of visual strain

conducted in Lithuania indicates 86% of the workers complained various visual disorders

(Ustinaviciene, R. & Januskevicius, V., 2006). A study in Sweden indicates that occurrenceof eye discomfort is seen to increase in relation to the number of hours spend in video

display terminal (Bergqvit, U.O., Knave, B.G., 1995).Study on 209 Italian video display terminal workers with myopia across a period of 6 to 9

years revealed a variation from 46% to 50%, but the variation does not differ from the

natural progression of myopia (Basso, A., Di Lorenzo, L., Gamarossa, A. A., Corfiati, M.,Ria, W., Bellino, R., Givellini, S., Lofrumento, M. & Soleo L., 2006). The study reveals

1


2/10


that induced myopia is similar to normally occurring myopia and positive results may lead

from relaxation.

Conventional maintenance of computer vision syndrome includes optical intervention,surgery and administration of medication for dryness of the eye. Many studies have pointed

to the fact that relaxation also helps in the management of myopia. Blurred vision can also

be described as a pattern of pronounced tension in the forehead, jaws, neck, shoulders,upper arms and lower back. It can be described as a reduced peripheral awareness and

prolonged fixation time or staring (Schneider, M., Larkin, M. & Schneider, D., 1994). A

combination of yoga practices administered on 146 Indian computer professional reveal animprovement in self rated discomforts (Telles, S. , Naveen, K.V., Dash, M., Deginal, R. &

Manjunath, N.K., 2006). A study conducted using holistic methods on a patient with

myopia proved an effective cure (Bambridge, A., 2002).

A study conducted among the medical students in Denmark suggested that physicalactivities have a protective effect on development and progression of myopia (Jacobsen,

N., Jensen, H. & Goldschmidt E., 2008). A study conducted to compare the prevalence of

myopia among 6 and 7 year old Chinese school children in Sydney and Singapore indicated

lower prevalence in Sydney, associated with the increased hours of outdoor activities(Rose, K.A., Morgan, I.G., Wayne, S., Burlutsky, G., Mitchell, P., & Saw, S., 2008).

A study on Australian school children revealed that more than the hours spend on nearwork the intensity of the work was seen to have significant effect on the progression of

myopia (Ip, J.M., Saw, S., Rose, K.A., Morgan, I.G., Kifley, A., Wang, J.J., & Mitchell, P.,

2008).Visual acuity was observed to improve in 29 patients who under went visual training

(Rosen, R.C., Schiffman, H.R. & Mayers, H., 1984). Qi-Qong ocular exercise training on

accommodation demonstrated slight improvement in amplitude (Shih, Y.F., Lin, L.L. &

Hwang, C.Y., 1995). A study on 17 patients with myopia and astigmatism under goingcomputer based visual training incorporating biofeedback for an average 35 session

revealed an average visual acuity change of 3.4 lines and 2.12D (Balliet, R., Clay, A. &

Blood, K., 1982).Theory formulated in 1900s by an ophthalmologist Dr. William Bates states that oblique

muscles of the eye play a significant role in vision, strengthening of which can be achieved

through certain relaxation techniques. He further stressed on the fact that eyesight is 10%physiological and 90% psychological. Strain reduced vision and relaxation promotes vision

(Bates, W., 1912). Gottlieb used Bates method of exercises to cure his own myopia

(Gottlieb, R.L., 1982). A comparative study on 80 patients with myopia trained in Bates

method of treatment with a control group of 60 patients revealed that 93% of the patientshad improvement in visual acuity in the experimental group and 98% of the patients had

loss in visual acuity (Berens, C., Girard, L.J., Fonda, G. & Sells, S.B., 1957). The

effectiveness of Bates method on 54 patients with myopia of -0.5D to -3.00D, found 22%improved one to two lines in Snell ens chart, 55% showed no change in visual acuity and

22% showed questionable improvement of one line or less in Snell ens chart (Hildreth,

H.R., 1947). The results of an optometric training technique in 103 myopic patients shows29% showed small improvement in visual acuity, 30% inconsistent improvement in visual

acuity, 31% had no change in visual acuity and 9% had a decrease in visual acuity (Woods,

A.C., 1946).

2


3/10


The above research studies advocate eye exercises, muscle relaxation techniques,

biofeedback, eye patches, eye massages, alone or in combinations and may also be

recommend under corrected prescription lenses and nutritional supplements forenhancement of visual acuity.

Aim: The aim of the study is to assess the effectiveness of relaxation techniques on myopiaand associated symptoms among computer users.

Methodology:

A. Sample: 30 myopic patients constitute the sample of the present study, 15 subjects in

experiment group and 15 subjects in control group. The allotment of which was based on

matched control group design. The matching variables were gender, number of years ofusing spectacles, age, refractive condition, associated complaints, and initial visual acuity.

An associated symptom included in the study is astigmatism (6 subjects in experimental

group and 6 in control group). Astigmatism is a condition were a point of light cannot be

made to produce a punctuate image up on the retina by any spherical correcting lens. Itproduces defect in visual acuity and causes the worst form of eye strain. The strain is

usually worse in lower degrees of astigmatism. Aching of the eyes and head aches are

common symptoms. Detailed sample distribution is provided in Table (1).

B. Tools and Techniques

1. Optic lenses:This consists of a series of lenses, both concave and convex, of varying

gradation starting from 0.25D. This is used to assess the visual capacity of the subjectbefore the intervention. The minimum power of lens required to attain 6/6 and F14 vision is

noted. The power of the lens is assessed with the assistance of an optician.

2. Snell ens test chart for distant vision:The chart consists of a series of letters arranged in

lines each diminishing in size. A person with average visual acuity will be able to read the

top letter at 60 meters, the second line at 36 meters, the third line at 24 meters, fourth lineat 18 meters, fifth line at 12 meters, sixth line at 9 meters and the last line at 6meters.

Vision is checked by seating the subject 6 meters away from the chart and is asked to read

the chart. Depending on the number of lines the subject is able to read, the vision is graded

at 6/60, 6/36, 6/24, 6/18, 6/12, 6/9, 6/6, here 6/6 vision represents normal eyesight. In ourstudy two versions of Snell ens chart are provided, one to do the exercises and other to

record vision ( this is to avoid familiarity to the chart).

3. Fine print booklet:The letters of the fine print booklet is of the same size as the smallest

letters in the Fundamental test type (F14). This is one of the eye relaxation exercises. It

helps in promoting attention, imagination and mobility of the eyes. The fine print is readboth in candle light and bright light.

4. Ohm chart: Ohm chart has an ohm written on the centre; around it is a circle with

angular projections around it. The subject is made to follow the lines in these projections

3


4/10


very slowly and blink at each intersection. This also promotes attention and mobility of the

eyes.

Intervention

Eye relaxation practices constitute a group of exercises involving, stimulation andrelaxation of eye muscles. It is a blend of Yoga and meditation. The method alternately

requires concentration and relaxation on the part of the subjects. The package of exercises

includes:a) Attention to - Strokes in pictures, Words or letters, Candle flame.

b) Imagination of Pictures, Letters

c) Mobility of the eye Side wise movement, Upward and downward movement,

Diagonal movementd) Relaxation of the eye achieved using Splashing of water, Palming, Vapor, Cold pack

The subjects are asked to focus on counting during the relaxation phase. This is to ensure

that the mind is in a neutral state and not influenced by positive or negative thoughts. Eachpractice is individually explained to the subject and monitored to ensure the correctness of

performance. The subject is instructed to stop the exercises immediately if any discomfortis felt.

C. Procedure

The initial visual acuity of the subjects is recorded using Snell ens chart and optic lenses,

with and without the aid of spectacles, and then exercises are administered under

supervision. One hour each in the morning and evening and are asked specifically to avoidany change in their daily routine. At the culmination of ten sessions the visual acuity is

measured again.

D. Data analysis

The collected data were tabulated, processed and subjected to analysis using SPSS.

t- Tests reveal that no significant variation is observed between the experiment and control

group in the present sample regarding gender or improvement in visual acuity.

Table: 2. t- Test representing the variation in improvement in visual acuity regarding

the presence of associated symptoms

Significant variation is revealed between the subjects in the visual acuity in the left eye

regarding the presence of associated symptom. The mean and standard deviation scores

indicate that the right eye of the subjects with astigmatism and the left eye of the subjectswithout associated symptoms are more benefited through the practices. Studies (Banquet, J.

1973) indicate that meditation induces a shift in the dominance from the left hemisphere to

the right hemisphere of the brain allowing the intuitive word less thinking to express itself

4


5/10


and stimulations from the left side of the body to have a better representation in the brain,

which leads to enhanced visual acuity in the left eye.

Taking the variation regarding the presence of associated symptoms into consideration thesample is further analyzed in two groups: subjects with astigmatism and subjects without

associated complaints.

Table: 3. t- Test representing the variation in improvement in visual acuity in the

group with astigmatism regarding experimental group and the control group

Significant variation is observed in the experimental group regarding the visual acuity of

the right eye. The mean and the standard deviation scores indicate that the experimentalgroup is more benefited by the practices regarding both right and left eye. It can be

assumed that the strain on the experiment group by working on computers can be reduced

through the eye relaxation practices. Studies indicate that the right eye acts as the dominant

eye in 70% of the population (McManus, 2002) and transient changes in myopia arecommon among those working on computer. Yeow and Taylor (1989) showed a myopic

shift on the average of -0.12D in a group of computer workers, whereas no shift occurred ina control group of non- computer workers. Transient myopia was also reported by Watten

and Lie (1992). This transient change might have been overcome through the relaxation

practices, which contributed to the marked enhancement of vision in the dominant righteye.

Table: 4. Correlations representing the relationship among improvement in visual

acuity, age and years of using spectacles in the group with associated symptom

(astigmatism)

Significant positive correlation is indicated between age and the years of using spectacles(0.647* at 0.05 level of significance). Studies have shown that myopia naturally progress

with age (Basso, A. et al, 2006). Improvement in visual acuity in right eye and left eye

shows a negative correlation to age, indicating that early detection and treatment throughrelaxation is more beneficial in myopia. The number of years of using spectacles indicates

a positive correlation to the improvement of visual acuity of right eye and a negative

correlation to the improvement in visual acuity of left eye. Stress is seen to have a positive

correlation to age (Mroczek & Almeida, 2004) and stress induced visual strain naturallysubsides through relaxation. Improvement in visual acuity in right eye indicates positive

correlation to improvement in visual acuity in left eye indicating that both the eyes are

benefited through the practice.


acuity, age and years of using spectacles in the group with no associated symptoms

Significant positive correlation is observed between the number of years of using

spectacles and the improvement of visual acuity in the right eye (.504* at 0.05 level of

5


6/10


significance), studies indicate that stress is seen to have a positive correlation to age

(Mroczek & Almeida, 2004); and a negative correlation to the improvement of visual

acuity in the left eye. Age indicates positive correlation to the number of years of usingspectacles and negative correlation to the improvement of visual acuity in both right and

left eyes. Improvement of visual acuity in the right eye indicates a positive correlation to

the improvement of visual acuity of the left eye.The results in the above correlation indicate similar trends as indicated in the correlation

shown in the subjects with associated symptom (astigmatism).

Conclusion

Myopia is a commonly occurring refractive condition conventionally managed through

ocular interventions like use of spectacles or surgery. It has a tendency to progress with age

and visual strain. Early detection and administration of relaxation practices facilitateseffective management of myopia. The use of computers is seen to aggravate the strain on

the eyes. The administration of eye relaxation practices has initiated visual acuity

improvement in both the experimental and control group subjects. The rate of improvement

is seen to be more in the experiment group in both the eyes. The strain resulting fromcomputer usage is seen to have affected both the eyes and the dominant right eye is seen to

recover more rapidly through eye relaxation practices. It can be concluded that Myopiaamong computer users and non computer users can be effectively managed through eye

relaxation practices.

Acknowledgement

Heartfelt appreciation goes to the staff and management of Aurobindo School for Perfect

Eyesight. Special thanks to all the participants.

References

Bambridge, A. (2002), Approaching Myopia Holistically: A case study and Theoretical

Exploration. The Journal of Alternative and Complementary Medicine, 8 (3), 371-377.

Balliet, R., Clay, A. & Blood, K. (1982), The training of visual acuity in Myopia.

Journal of American Optometric Association, 1982, 53, 719 24.

Banquet, J. (1973), Spectral analysis of EEG in meditation.Electroenchalography and

Clinical Neurophysiology, 35, 143- 151.

Basso, A., Di Lorenzo, L., Gamarossa, A. A., Corfiati, M., Ria, W., Bellino, R., Givellini,S., Lofrumento, M. & Soleo, L. (2006), Evaluation of Myopia in a group of people working

with Video Terminals: first results. G Italy. Med. Lav. Ergon., Apr- Jun, 28 (2), 207-9.

Bates, W.(1912), Eye training for cure of functional Myopia.British Psychological

Society, 78, 1029 - 32.

6


7/10


Berens, C., Girard, L.J., Fonda, G. & Sells, S.B. (1957), Effects of Tachistoscopic training

on Visual functions of Myopic patients.American Journal of Ophthalmology, 44: 25 47.

Bergqvit, U.O. & Knave, B.G. (1994), Eye Discomfort and Work with Visual Display

Terminals. Scand Journal Work Environment Health, Feb; 20 (1):27 33.

Gottlieb RL.(1982), Neuropsychology of Myopia.Journal of Optometry and Visual

Development, 13 (1), 3 27.

Hildreth, H.R., Meinberg, W.H. & Milder, B. (1947), The Effects of Visual Training

on Existing Myopia.American Journal of Ophthalmology, 30, 1563 - 76.

Ip, J.M., Saw, S., Rose, K.A., Morgan, I.G., Kifley, A., Wang, J.J. & Mitchell, P. (2008),Role of Near Work in Myopia: Findings in a Sample of Australian School Children.

Investigative Ophthalmology and Visual Science, 49, 2903 2910.

Iwakiri, K., Mori, I., Sotoyama, M., Horiguchi, K., Ochiai, T., Jonai, H. & Saito, S. (2004),Survey on Visual and Musculoskeletal Symptoms in VDT Workers.

Sangyo Eiseigaku Zarshi, Nov, 46 (6), 201-12.

Jacobson, N., Jensen, H. & Goldschmidt, E. (2008), Does the Level of Physical Activity

in University Students Influence Development and Progression of Myopia? A 2 -yearProspective Cohort Study.Investigative Ophthalmology and Visual Science, 49, 1322

1327.

Luberto, F., Gobba, F. & Broglia, A. (1989), Temporary Myopia and Subjective Symptomsin Video Display Terminal Operators.Med Lav., March- April, 80(2), 155 -63.

McManus, C. (2002), RIGHT HAND, LEFT HAND. The Origins of Asymmetry inBrains, Bodies, Atoms and Cultures. London, Weidenfeld & Nicolson.

Mroczek, D.K. & Almeida, D.M. (2004), The effect of daily stress, personality and age ondaily negative effect. Journal of Personality, Apr, 72(2), 355 78.

Rose, K.A. Morgan, I.G. Wayne, S. Burlutsky, G. Mitchell, P. & Saw, S. (2008), Myopia

Lifestyle and Schooling in Students of Chinese Ethnicity in Singapore and Sydney.Arch

Ophthalmology, 126(4), 527- 530.

Rosen, R.C., Schiffman, H.R. & Mayers, H. (1984), Behavioral Treatment of Myopia:Refractive error and Acuity changes in Relation to Axial length and Intra ocular pressure.

American Journal of Ophthalmic Physiological Ophthalmology, 61,100 5.

Schneider, M., Larkin, M. & Schneider, D. (1994), The Handbook of Self-Healing.

London: Penguin Arakana.

7


8/10


Sells, S.B. & Fixott, S. (1957), Evaluation of research on effects of Visual training on

Visual functions.American Journal of Ophthalmology, 44, 230 - 6.

Sheedy, J.E. & Shaw McMinn, P.G. (2003), Diagnosing and Treating Computer- Related

Vision Problems. USA, Butterworth Heinemann.

Shih, Y.F., Lin, L.L. & Hwang, C.Y. (1995), The Effects of Qi-Qong ocular exercises on

accommodation. Chin Journal of Physiology, 38, 35 42.

Telles, S., Naveen, K.V., Dash, M., Deginal, R. & Manjunath, N.K. (2006), Effect of Yoga

on Self rated Visual Discomfort in Computer users.Head Face Medicine, 2,46.

Thompson, W.D. (1995), Effect of exercises on aspects of visual function. Ophthalmic

Physiological Ophthalmology, 15, 5-12.

Ustinaviciene, R. & Januskevicius, V. (2006), Association between Occupational

Asthenopia and Psycho- Physiological Indicators of Visual Strain in Workers using VideoDisplay Terminals.Med. Sci. Monit, Jul; 12 (7), CR 296- 301.

Watten, R.G. & Lie, I. (1992), Time factors in VDT- induced myopia and visual fatigue: an

experimental study.Journal of Human Ergol(Tokyo), 21(1), 13- 20.

Woods, A.C. (1946), Report from the Wilmer Institute on the results obtained in the

treatment of Myopia by Visual Training.American Journal of Ophthalmology, 29, 28 - 57.

Woods, V. (2005), Musculoskeletal Disorders and Visual Strain in Intensive DataProcessing Workers. Occupational Medicine, 55, 2.

Yeow, P.T. & Taylor, S.P. (1989), Effects of short-term VDT usage on visual functions.Optometry and Visual Science, 66(7), 459- 466.

Authors:

1. Lekshmi.K.

Official Address:

Research Scholar,

University Library,Thiruvananthapuram.

Ph: 0471 230366, 09249557222.

2. Dr. Asha. Balagangadharan.

Official Address:

Principal,

8


9/10


Sree Narayana Guru College,

Coimbatore.

Ph: 0471 2443108, 09387802284

Table: 1. Sample distribution on the basis of matching variables

Gender Associated complaint Group

Astigmatism No complaint Experiment group Control group

Male 10 14 12 12

Female 2 4 3 3

Total 12 18 15 15

Table: 2. t- Test representing the variation in improvement in visual acuity regarding

the presence of associated complaints

Improvement invisual acuity

Astigmatism No associatedcomplaints

t- values Sig.

Mean SD Mean SD

Right eye 2.50 .798 2.17 .985 .976 .563

Left eye 3.00 1.279 3.83 3.502 -.786 .038

Table: 3. t- Test representing the variation in improvement in visual acuity in the

group with astigmatism regarding experimental group and the control group

Improvement in

visual acuity

Experimental group Control group t- values Sig.

Mean SD Mean SD

Right eye 2.83 .408 2.17 .983 1.534 .014

Left eye 3.50 1.378 2.50 1.049 1.414 .687

Table: 4.Correlations representing the relationship among improvement in visual

acuity, age and years of using spectacles in the group with associated symptom(astigmatism)

Variables Age Number of yearsof using spectacles

Improvement invisual acuity in

right eye

Improvement invisual acuity in left

eye

Age .647* -.041 -.248

9


10/10


Improvement in visual

acuity in right eye

.647* .249 -.345


acuity in left eye

-.041 .249 .356

Improvement in

associated symptoms

-.248 -.345 .356

* Correlation is significant at the 0.05 level (2-tailed).


acuity, age and years of using spectacles in the group with no associated symptoms

Variables Age Number of years

of using spectacles

Improvement in

visual acuity in

right eye

Improvement in

visual acuity in left

eye

Age .354 -.052 -.226


acuity in right eye

.354 .504* -.024


acuity in left eye

-.052 .504* .298

Improvement inassociated symptoms

-.226 -.024 .298

* Correlation is significant at the 0.05 level (2-tailed).

10

computer vision syndrome 1

Documents