Symptoms associated with VDT use

Symptoms associated with the eyes were recorded by a group of 92 video display terminal (VDT) users over five days. A diary was maintained for the symptoms and other task related factors such as the type of work performed. Diary entries were recorded approximately every two hours. Symptoms were classified as either ocular (a range of discomfort symptoms), visual (blur or double vision) and systemic (headache or postural symptoms). Tired eyes and headaches were the most frequently reported symptoms. Comparing the symptoms reported during VDT work sessions and the clerical (non-VDT) work sessions, there was a small but consistent trend towards more frequent symptoms during VDT sessions. Almost all types of symptoms showed a significant increase in frequency over the day (time of day effect).     

VDT操作者双眼视功能参数的测定及其与视疲劳的关系

目的 探讨双眼视功能中与视频显示终端（VDT）视疲劳的发生有关系的眼动参数。设计 前瞻性比较性病例研究。 研究对象 141例经常进行VDT操作的成年受试者。方法 141例成年受试者在获得知情同意后,完成连续1小时的计算机Word文档阅读任务（VDT操作）。操作前进行屈光不正矫正下的各眼动参数的测量,包括调节幅度（AA）、集合近点、调节性集合与调节比值（AC/A）、远近距离水平隐斜、正相对调节（PRA）、负相对调节（NRA）和立体视检测（Titmus立体视检测图,>60"为立体视异常）。操作后进行视疲劳问卷调查,将具有主觉问卷调查表中有2个或以上症状判断为VDT视疲劳。对能反映双眼视功能的各项眼动参数进行单因素和多因素分析,确定影响VDT视疲劳的指标。主要指标 眼动参数,包括AA、集合近点、AC/A、远近距离水平隐斜、PRA、NRA和立体视及问卷调查。结果 141例受试者发生VDT视疲劳者43例（30.50％）,其中女性32例（36.78%）多于男性11例（20.37%）（χ2=4.597,P=0.032）。视疲劳者的调节幅度（3.98±1.52）D、AC/A值（2.47±0.84）均低于无症状的被试者（P=0.003）;视疲劳者较无症状者集合近点（9.87±1.76）cm远移（P<0.001）;两组间近距离隐斜、PRA和NRA比较,差异均有统计学意义（P均=0.001）;提示视疲劳组存在辐辏和调节不足,看近时存在更高的外隐斜。立体视异常受试者（51例）较正常立体视受试者（90例）更易出现VDT性视疲劳（P=0.002）。Logistic回归分析显示较大的近距离隐斜（P=0.001,OR=1.694;95％CI：0.895-3.204）是VDT性视疲劳发病的相关危险因素;正常范围内较高的AC/A（P=0.032,OR=0.100;95％CI：0.012-0.821）、立体视正常（P=0.009,OR=0.178;95％CI：0.048-0.656）和较高的PRA（P=0.049,OR=0.509;95％CI：0.107-0.868）是VDT性视疲劳发病的保护因素。结论 较低的AC/A、较大的近距离隐斜度数、较低的PRA和异常立体视是VDT视疲劳发病的独立危险因素。（眼科,2016,25：110-114）     

视屏终端综合征的病理生理研究进展

过度使用计算机会出现视频终端（VDT）综合征。VDT综合征的病理生理机制主要包括屈光与调节机制（波前像差改变、调节痉挛等）、眼表机制（泪膜功能异常）和眼外机制（人体工程学）。基于VDT综合征病理生理学的研究,出现了一些新的治疗方法,如微环境镜片（MEGS）、泪液替代、减反射膜（AR-films）等。就VDT综合征的病理生理学及治疗的研究进展做一综述。     

Meibomian gland dysfunction and ocular discomfort in video display terminal workers

PURPOSE: Meibomian gland dysfunction (MGD) is one of the most common ocular disorders encountered in clinical practice. The clinical manifestations of MGD are related to the changes in the tear film and ocular surface with symptoms of ocular discomfort. In recent years, many surveys have evaluated symptoms associated with the use of Video Display Terminals (VDT), and VDT use is recognized as a risk factor for eye discomfort.The aim of the present study was to determine if the presence of MGD contributes to the signs and symptoms of ocular discomfort during the use of VDT. METHODS: In course of a routine health surveillance programme, a group of 70 subjects fulfilled the inclusion criteria and responded to a questionnaire about symptoms of ocular discomfort. The following ocular tests were performed: tear break-up time, fluorescein corneal stain, and basal tear secretion test. RESULTS: A total of 52 subjects out of 70 (74.3%) had MGD. A statistically significant correlation between the symptoms of ocular discomfort and hours spent on VDT work was observed in the total population (r=0.358; P=0.002; 95% CI 0.13-0.54) and in the group of subjects with MGD (r=0.365; P=0.009; 95% CI 0.103-0.58). Such correlation was not shown in subjects without MGD. CONCLUSIONS: The high prevalence of MGD among the subjects with symptoms of ocular discomfort suggests that this diagnosis should be considered when occupational health practitioners encounter ocular complaints among VDT operators. It appears that MGD can contribute to the development of ocular discomfort in VDT operators.     

渐进多焦点眼镜对缓解视屏终端操作者视疲劳症状临床观察

目的:了解渐进多焦点眼镜缓解视屏终端(visual display terminal,VDT)操作者视疲劳的效果。方法:有视疲劳症状且屈光不正的VDT操作者98例,按自愿原则分为2组,其中一组配戴普通单光眼镜,共52例;另一组配戴渐进多焦点眼镜,共46例,经1a随访,分析两组屈光状态及其缓解视疲劳的效果。结果:所有98例患者中,44例存在未矫正、屈光矫正不足和过矫正;视物不能持久、眼部酸胀2种症状在两组中的差异有极显著性统计学意义(P<0.01),眼痛、眼干和眼睑沉重3项在两组中无统计学意义。结论:渐进多焦点眼镜对缓解轻中度近视VDT操作者视疲劳有效。     

电脑终端病与视功能障碍

目的 本文旨在探索电脑终端病与视功能障碍之间的关系,寻求可能的病因,为日益增长的电脑病患者提供可能的治疗方法。方法 分别对１２１例电脑终端病患者进行了眼科一般检查、泪膜破裂时间测定、屈光状态分析、调节灵活性测定、隐科视及ＦＣＣ测定。结果 １２１例患者中,调节灵活性明显降低者４７例,占３９％;ＦＣＣ检查调节滞后者６６例,占５５％;未矫正老视者５３例,占４３．８％;泪膜破裂时间〈１０ｓ者６５例,占５３     

Asthenopia and monitor characteristics

An epidemiological survey on 30,000VDT operators has been carried out to evaluate the relationship between asthenopia and monitor characteristics. A VDU operator has been classified as asthenopeic if he complained about at least two of the following ten symptoms: headache, tearing, eye smarting, blurred vision, double vision, ocular itching, photophobia, blinking, nausea, eye heaviness. Visual discomfort has been related to 1) the presence of flicker; the possibility to regulate, 2) brightness, 3) height; and 4) inclination of monitor. Asthenopia has resulted statistically correlated to the presence of flicker and to the impossibility of regulating height and inclination of monitor for both sexes. The possibility to regulate monitor brightness has not determined a reduction of visual discomfort either in men or in women.     

长期VDT对视网膜视神经影响的观察

目的视屏显示终端(video display terminal,VDT)是一类与计算机使用有关的视觉综合征。眼部的症状包括视疲劳、调节与集合反应异常、眼干等。本研究通过评价VDT在视功能方面的影响从而提供可能的防治方法。方法选择45名(45眼)志愿者,年龄(27.27±2.23)岁。根据每日视频操作时间分为三组,Ⅰ组VDT每天作业时间≤2h;Ⅱ组VDT每天作业时间2～4h;Ⅲ组VDT每天作业时间>4h。并分析在三组从事VDT工作后0.5a、1.0a、2.0a、2.5a每位志愿者眼部情况、视疲劳、视觉诱发电位、视野、黄斑中央厚度的差异。结果在同一组内和不同组间,操作VDT时间越长,视疲劳等眼部不适症状的受试者相应增多,但是视觉诱发电位振幅、潜伏期和OCT检查黄斑中央厚度在不同时间点差异均未有统计学意义(均为P>0.05)。所有受试者不同时间点均未发现暗点等视野异常。结论 VDT作业对视功能有一定负作用,因此,我们应该预防VDT对眼部的影响。     

Status of eye health among tribal school children in South India

Purpose:Global trends show a high prevalence of refractive errors among children. The prevalence of vision impairment due to uncorrected refractive errors among school children is increasing and the need for management of other ocular conditions is also reported. This study presents the status of eye health and pattern of daily activities among the school children of a tribal location in Tamil Nadu, South India.Methods:A cross-sectional study was conducted in 13 schools of Karumandurai cluster, Salem district in Tamil Nadu, India. A three-phased comprehensive school screening protocol was conducted to understand the prevalence of vision impairment, refractive error, and other ocular conditions along with a survey about the daily activities of the children at school and home.Results:Among the 3655 children screened, the prevalence of vision impairment was found to be 0.62% (n = 23, 95% confidence interval [CI] 0.42–0.94) and prevalence of refractive error was 0.30% (n = 11, 95%CI 0.17–0.54), among which 0.11% (n = 4) were already wearing spectacles. A total of 44 children (1.20%; 95%CI 0.90–1.61) were found to have other ocular problems and among them, 14 (0.38%) had visual acuity less than 20/30 (6/9). Almost 84% of children required surgical or specialty eye care services. Vision impairment was more in children with other ocular conditions compared to refractive errors (P < 0.001).Conclusion:The prevalence of vision impairment and refractive errors in this tribal area was less. Ocular conditions were more prevalent than refractive errors in this tribal region with the majority of children needing specialty or surgical eye care services. This implies the need for access to secondary or tertiary eye care centers.     

七叶洋地黄双苷滴眼液治疗VDT综合征的有效性和临床安全性研究

目的:探讨七叶洋地黄双苷滴眼液对视屏显示终端(visual display terminal,VDT)综合征的有效性和临床安全性。方法:采用自身对照。单独应用七叶洋地黄双苷滴眼液点眼,观察用药前后VDT综合征相关症状,包括:近距离工作不能持久、眼及眼睑周围疼痛、异物感、眼睑沉重、视物模糊复视、眼红、干涩流泪、头痛、恶心呕吐、眩晕共10项。结果:患者VDT综合征明显改善,观察期间未发现局部及全身不良反应。结论:七叶洋地黄双苷滴眼液可有效地缓解VDT综合征,临床应用安全。     

Visual and ocular effects from the use of flat-panel displays

AIM: To evaluate the prevalence of eye symptoms in a non-presbyopic population of video display unit (VDU) users with flat-panel displays. METHODS: One hundred and sixteen VDU users with flat-panel display from an urban population participated in the study; their ages ranging from 20 to 34y. There were 60 females and 56 males. An eye examination to rule out the presence of significant uncorrected refractive errors, general binocular dysfunctions and eye conditions was carried out. In order to determine and quantify the type and nature of eye symptoms, participants were asked to answer written questionnaire and the results were grouped by gender, age and number of hours a day spent using a VDU. RESULTS: Seventy-two percent of participants reported eye symptoms related to VDU use. Eye symptoms from moderate-to-severe were found in 23% of participants. The main symptom was moderate-to-severe tired eyes (14%); followed by sensitivity to bright lights (12%), blurred vision at far distances (10%), eyestrain or dry eye or irritated or burning eyes (9%), difficulty in refocusing from one distance to another or headache (8%) and blurred vision at near or intermediate distances (<4%). Eye symptoms were greater among females (P=0.005) and increased with VDU use, markedly above 6h spent using a VDU in a typical day (P=0.01). CONCLUSION: Significant eye symptoms relate to VDU use often occur and should not be underestimated. The increasing use of electronic devices with flat-panel display should prompt users to take appropriate measures to prevent or to relieve the eye symptoms arising from their use.     

Prevalence of eye disorders in young children with eyestrain complaints

PURPOSE: To determine whether eyestrain symptoms predict eye conditions in 6-year-old children. DESIGN: Cross-sectional population-based study. METHODS: Reports of eyestrain symptoms were sought in parental questionnaires; 1740 children (79% response) underwent eye examinations (visual acuity, cover testing, cycloplegic autorefraction, and fundus examination). RESULTS: Eyestrain information was available for 1448 children; 220 (15.2%) reported eyestrain symptoms, including 60 (3.4%) who reported near work-associated headaches. Most children (82.3%) had a normal eye examination, while refractive errors, amblyopia, and strabismus were found in 15.0%, 3.6%, and 7.3%, respectively. Corresponding rates for children without eyestrain were 9.9%, 1.4%, and 1.8%, respectively. Moreover, 78.7% of children with refractive errors, 68% with amblyopia, and 58% with strabismus reported no eyestrain. CONCLUSIONS: Most children complaining of eyestrain had a normal eye examination; whereas most children with refractive error, amblyopia, or strabismus were free of eyestrain, making this complaint a poor marker of eye conditions in young children.     

智障儿童眼部筛查结果与分析

目的 通过对温州地区特殊学校就读的智障儿童进行眼部健康筛查,了解智障儿童的眼部健康问题,分析相关因素,以提供相应的视觉矫正和治疗措施,及探索如何为智障儿童的眼部健康提供有效的服务.方法 调查研究.对在温州地区特殊学校就读的342名智障儿童进行眼部健康筛查,内容包括：一般信息、视力检查、眼位检查、色觉检查、眼前段检查、内眼检查以及屈光不正检查.采用Excel软件对数据进行整理、归纳和求百分比.并针对存在的视觉问题作出相应的分析和医学处理.结果 筛查患儿智力残疾为轻度至中度,心理与情绪等适应能力轻度或中度障碍,能参与部分社区活动.眼科检查发现,正视眼占46.6%,屈光不正均以低度屈光不正状态为主,大部分能通过眼镜矫正达到5.0 眼位检查显示正位眼占67.2%,隐斜视占12.9% 色觉正常者占81.9%,色觉存在明显异常者占6.4% 外眼及眼前段检查未发现明显异常者占92.7% 内眼检查未发现明显异常者占81.1%.这些患儿眼部的异常主要是眼球震颤（占50.0%）和白内障（占28.3%）.结论 智障儿童的眼部问题现患率比普通儿童高,但还是以屈光不正、眼球震颤、白内障等为主,大多为可矫正和可康复的,可以通过眼镜、手术或视觉康复等提高视功能.     

109例视频终端用户视觉障碍的原因对比分析

目的对比调查视频终端用户视疲劳产生原因的特点,探讨如何注意劳动保护。方法收集我院门诊就诊、有眼疲劳主观感受的患者185例,其中视频终端用户109例,其他行业工作者76例,详细询问病史和眼部检查,进行病因分析。定量资料组问比较采用t检验,定性资料组间比较采用检验,等级资料采用秩和检验。结果年龄、性别、主观症状、眼位功能、配镜情况两组差别无统计学意义,日作业时间、屈光检查、泪液分泌功能两组间差别有统计学意义。结论视频终端用户组日视作业时间高于其他行业组;屈光检查结果显示,视频终端用户组屈光不正高于其他行业组;视频终端用户组泪液分泌功能障碍更严重。     

视屏终端综合征的研究进展

视屏终端(visual display terminal,VDT)综合征,是由于长时间使用VDT操作而影响眼睛和身心健康所产生的一组疾病,又称技术紧张性眼病或电脑视力综合征。VDT综合征的病因主要包括屈光与调节机制(调节痉挛)、眼表机制(泪膜功能异常)和眼外机制(显示器视觉效应)。基于VDT综合征多种病因的研究,治疗具有多向性,不仅对视疲劳进行对症治疗,也要对不良的工作环境和生活习惯行对因治疗。我们就VDT综合征的病因及治疗的研究进展做一综述。     

显微镜工作者近视和双眼视力障碍的患病率分析

目的：测定临床显微镜工作者屈光和双眼视力状态。

方法：这是一项以医院为基础的观察性和横断面研究。研究包括103位在特里布文教学医院工作的显微镜工作者。受试者均行全面的眼部检查,包括静态检影,动态检影和视轴评估。收集受试者显微镜下视觉状态信息。

结果：该组显微镜工作者屈光不正患病率为69.90%。68.93%受试者近视,平均近视误差为-1.58±1.89 D。研究发现61.20%受试者汇聚功能不全。调节不足与调节功能不全的发病率分别为41.30% 和40.06%。研究人群的融合性转向也有所降低。

结论：研究发现,临床显微镜工作者屈光不正尤其是近视的患病率增加。其中大多数有转斜和调节不足。大多数受试者视疲劳症状与其显微镜工作有关,这可能会影响他们的工作效率。     

视屏显示终端对操作者眼的影响

对118名视屏显示终端(VDT)工作人员的眼部调查,发现VDT作业可致近视力减退,休息后可恢复.发现VDT作业,可使角膜上皮受到损害,损害的程度与近视力减退的程度成正比.注视VDT的时间越长,对近视力及角膜上皮的影响越严重.VDT作业对调节功能和眼压无明显的影响.     

Retrospective analysis of refractive errors in children with vision impairment.

PURPOSE: Emmetropization is the reduction in neonatal refractive errors that occurs after birth. Ocular disease may affect this process. We aimed to determine the relative frequency of ocular conditions causing vision impairment in the pediatric population and characterize the refractive anomalies present. We also compared the causes of vision impairment in children today to those between 1974 and 1981. METHODS: Causes of vision impairment and refractive data of 872 children attending a pediatric low-vision clinic from 1985 to 2002 were retrospectively collated. As a result of associated impairments, refractive data were not available for 59 children. An analysis was made of the causes of vision impairment, the distribution of refractive errors in children with vision impairment, and the average type of refractive error for the most commonly seen conditions. RESULTS: We found that cortical or cerebral vision impairment (CVI) was the most common condition causing vision impairment, accounting for 27.6% of cases. This was followed by albinism (10.6%), retinopathy of prematurity (ROP; 7.0%), optic atrophy (6.2%), and optic nerve hypoplasia (5.3%). Vision impairment was associated with ametropia; fewer than 25% of the children had refractive errors < or = +/-1 D. The refractive error frequency plots (for 0 to 2-, 6 to 8-, and 12 to 14-year age bands) had a Gaussian distribution indicating that the emmetropization process was abnormal. The mean spherical equivalent refractive error of the children (n = 813) was +0.78 +/- 6.00 D with 0.94 +/- 1.24 D of astigmatism and 0.92 +/- 2.15 D of anisometropia. Most conditions causing vision impairment such as albinism were associated with low amounts of hyperopia. Moderate myopia was observed in children with ROP. CONCLUSIONS: The relative frequency of ocular conditions causing vision impairment in children has changed since the 1970s. Children with vision impairment often have an associated ametropia suggesting that the emmetropization system is also impaired.     

Visual discomfort and astigmatic refractive errors in VDT use

The purpose of this study was to evaluate the effects of small amounts of uncorrected astigmatism on the visual comfort of video display terminal (VDT) users. We hypothesized that these small errors produce visual discomfort in the use of these devices even though visual acuity is relatively unaffected. Eight subjects (ages 23-35 years) with corrected visual acuities of 20/20 participated. Our double-masked cross-over experiment included two 25-minute periods during which the subject read from a VDT. The subjects were randomly assigned to wear either the test lens pair (+0.50 D x 090) or a control lens pair (+0.12 DS) over their best correction during the first period and the alternative pair during the second period. A questionnaire was used to obtain ratings of visual discomfort. Our analysis of the data indicated greater reported eyestrain for the test lens pair (Wilcoxon signed-rank test, p = 0.01). These results suggest careful consideration be given to the correction of small amounts of astigmatic errors for VDT users.