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  • 8/2/2019 Computer Vision Syndrome 1


    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


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


    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


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    Computer Vision Syndrome: Management through Eye Relaxation Practices

    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).


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    Computer Vision Syndrome: Management through Eye Relaxation Practices

    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.


    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 bookl