Digital device usage has increased significantly in last decade among all age groups, both for educational and recreational purposes. Computer vision syndrome (CVS), also known as digital eye strain (DES), represents a range of ocular, musculoskeletal, and behavioral conditions caused by prolonged use of devices with digital screens. This paper reviews the principal environmental, ocular, and musculoskeletal causes for this condition. Due to the high prevalence of DES and frequent usage of digital devices, it is important that eye care practitioners be able to provide advice and management options based on quality research evidence.

Objective. Analysis of ophthalmological and musculoskeletal changes secondary to the use of electronic devices with digital screen, such as smartphones, laptops, computers or tablets. Material and Methods. This paper represents is a prospective observational study of 35 participants with ages between 6 and 17. The ophthalmological exam was carried out for all participants in the Ophthalmological Clinic of “Sf. Spiridon” Emergency Hospital, Iaşi, and the exam of musculoskeletal disorders took place at “Sf. Maria” Pediatrics Hospital, Iaşi. A questionnaire including 14 questions was also distributed for the symptoms caused by the use of digital screen electronic devices. Results. The mean age of participants was 11,29 ± 3,54 years, predominantly female children (62,9%). Convergence insufficiency has been identified in all patients with accommodative disorders and in 18.2% of the children with amblyopia (p = 0.001). The frequency of cases with dry eye syndrome (DES) was 9.1% in the patients with accommodative disorders and 18.2% in the patients with amblyopia. In the entire studied group of patients, the smartphone was the most frequently used electronic device, being found in 77.1% of the cases. As for the gender, about 54% of the boys spent more than 5 hours on electronic devices, while 54.5% of the girls spent between 3 to 5 hours. Among the symptoms that occur during the use of gadgets, pain in the neck, shoulders and back was found most often, being identified in 29 participants. Conclusion. Pre-existent ophthalmological symptoms can be exacerbated by prolonged use of digital screen electronic devices. Musculoskeletal symptoms were encountered in high numbers in all participants, which suggests that musculoskeletal changes must be treated with great importance in Computer Vision Syndrome. Also, the symptomatology determined by the use of gadgets was more frequently associated with males than females. Abbreviations: CVS = computer vision syndrome, VA = visual acuity, VDT= visual display terminals, DES = dry eye syndrome

Thromboembolic (TE) risk scores used for atrial fibrillation (AF) patients do not include mitral annular calcification (MAC) as a potential indicator of vascular disease. This research evaluated the correlation between MAC and TE risk scores (CHADS2 and CHA2DS2-VASc). We compared TE risk score values and clinical and echocardiographic data in patients with and without MAC. We included, prospectively, 103 patients: 40.8% with AF, 83.5% with hypertension, 30.1% with type II diabetes mellitus, 79.6% with chronic heart failure, and 7.8% with a history of stroke. We identified MAC in 50.5% of patients. The mean CHADS2 and CHA2DS2-VASc scores were 2.56 ± 1.135 and 4.57 ± 1.61, respectively. In MAC patients, both scores tended to increase significantly compared with the control (2.88 ± 1.114 versus 2.24 ± 1.06, p = 0.005, and 5.21 ± 1.51 versus 3.92 ± 1.46, p < 0.001, respectively). The left ventricular ejection fraction negatively correlated with the presence of MAC (r = −0.254, p = 0.01). The presence of MAC was a risk factor for vascular disease (OR = 2.47, χ2 = 34.32, p < 0001). Conclusions: The presence of MAC is associated with greater TE risk scores and a higher risk of vascular disease. It appears that adding MAC as a vascular disease parameter to TE risk scores may have benefits for patients by improving their predictive value.