Computer vision syndrome (CVS) is the combination of eye and vision problems associated with the use of computers. In modern western society the use of computers for both vocational and avocational activities is almost universal. However, CVS may have a significant impact not only on visual comfort but also occupational productivity since between 64% and 90% of computer users experience visual symptoms which may include eyestrain, headaches, ocular discomfort, dry eye, diplopia and blurred vision either at near or when looking into the distance after prolonged computer use. This paper reviews the principal ocular causes for this condition, namely oculomotor anomalies and dry eye. Accommodation and vergence responses to electronic screens appear to be similar to those found when viewing printed materials, whereas the prevalence of dry eye symptoms is greater during computer operation. The latter is probably due to a decrease in blink rate and blink amplitude, as well as increased corneal exposure resulting from the monitor frequently being positioned in primary gaze. However, the efficacy of proposed treatments to reduce symptoms of CVS is unproven. A better understanding of the physiology underlying CVS is critical to allow more accurate diagnosis and treatment. This will enable practitioners to optimize visual comfort and efficiency during computer operation.
Visual symptoms associated with computer use occur frequently in the general population producing discomfort for extended periods of time. They are strongly associated with ocular surface disease. Therapeutic regimens need to be developed for this widespread condition.
The mean font size for both conditions was comparable with newspaper print, although some subjects viewed text that was considerably smaller. However, the mean working distances were closer than the typical near working distance of 40 cm for adults when viewing hardcopy text. These close distances place increased demands on both accommodation and vergence, which could exacerbate symptoms. Practitioners need to consider the closer distances adopted while viewing material on smart phones when examining patients and prescribing refractive corrections for use at near, as well as when treating patients presenting with asthenopia associated with nearwork.
Whereas CVS symptoms are associated with a reduced blink rate, the completeness of the blink may be equally significant. Because instructing a patient to increase his or her blink rate may be ineffective or impractical, actions to achieve complete corneal coverage during blinking may be more helpful in alleviating symptoms during computer operation.
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