The visual consequences of virtual school: acute eye symptoms in healthy children

Hamburger, Jordan; Lavrich, Judith B.; Rusakevich, Alexander M.; Leibowitz, Jillian A.; Zhitnitsky, Michael; Zhang, Qiang; Makkena, Ajay C.; Liu, Catherine K.; Oh, Glenn J; Sharpe, James; Gunton, Kammi B.

doi:10.1016/j.jaapos.2021.10.003

Cited by 6 publications

(14 citation statements)

References 20 publications

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“…Four studies reported accommodation and vergence dysfunction (see table 2, Glossary) secondary to near work and increased screen use time 13 26 29 33. Two studies focused on binocular accommodation in a sample of 156 children aged 10–17 years and reported a significant increase in Convergence Insufficiency Symptom Survey (CISS) scores after exposure to longer screen time during online classes 11 29.…”

Section: Resultsmentioning

confidence: 99%

“…Emerging visual symptoms were identified in six studies with populations ranging from 8 to 20 years old. The studies reported worsening of visual symptoms such as vision impairment, asthenopia, dryness, scratchiness, headache, eye redness, eye strain and light sensitivity, among others 14 16 18 25 26 33…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, Hamburger et al evaluated ocular symptoms in 110 children who attended virtual school during the COVID-19 pandemic. They found that 61% of the children reported a significant increase in convergence insufficiency, as evidenced by a higher CISS score after attending online classes 33…”

Section: Discussionmentioning

confidence: 99%

“…They found that 61% of the children reported a significant increase in convergence insufficiency, as evidenced by a higher CISS score after attending online classes. 33 …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, an increased asthenopia score was identified after online classes in more than half of the children evaluated. 33 Likewise, Li et al identified a positive association between screen time and the risk of asthenopia in approximately 25 000 students aged 8–20 years, and attributed a higher risk of asthenopia to conditions such as myopia, astigmatism and mechanical factors like distance from the screen. 25 …”

Section: Discussionmentioning

confidence: 99%

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Effects of remote learning during the COVID-19 lockdown on children’s visual health: a systematic review

et al. 2022

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ObjectivesIncreased exposure to digital devices as part of online classes increases susceptibility to visual impairments, particularly among school students taught using e-learning strategies. This study aimed to identify the impact of remote learning during the COVID-19 lockdown on children’s visual health.DesignSystematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesScopus, PubMed and ScienceDirect databases from the year 2020 onwards.Eligibility criteriaWe included cross-sectional, case–control, cohort studies, case series and case reports, published in English, Spanish or French, that approached the effects of remote learning during the COVID-19 lockdown on visual health in neurotypical children.Data extraction and synthesisWe included a total of 21 articles with previous quality assessments using the Joanna Briggs checklist. Risk of bias assessment was applied using the National Institutes of Health quality assessment tool for before-and-after studies with no control group; the tool developed by Hoy et al to assess cross-sectional studies; the Murad et al tool to evaluate the methodological quality of case reports and case series; and the Newcastle-Ottawa Scale for cohort studies.ResultsAll but one study reported a deleterious impact of the COVID-19 lockdown on visual health in children. Overall, the most frequently identified ocular effects were refractive errors, accommodation disturbances and visual symptoms such as dry eye and asthenopia.ConclusionsIncreased dependence on digital devices for online classes has either induced or exacerbated visual disturbances, such as rapid progression of myopia, dry eye and visual fatigue symptoms, and vergence and accommodation disturbances, in children who engaged in remote learning during the COVID-19 lockdown.PROSPERO registration numberCRD42022307107.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…They found that 61% of the children reported a significant increase in convergence insufficiency, as evidenced by a higher CISS score after attending online classes. 33 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effects of remote learning during the COVID-19 lockdown on children’s visual health: a systematic review

et al. 2022

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Refractive Error Changes Due to COVID-19 Pandemic Confinement in Children from Puerto Rico: A Retrospective Study

Rodriguez,

Acevedo,

Torres

et al. 2023

Optom Vis Sci

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Significance The progression of myopia increased in children after the pandemic confinement. A myopic shift in the refractive error of the Hispanic population was found regardless of the refractive status of the school-aged children studied. Purpose This study aimed to evaluate the refractive error in Puerto Rican children before and after the COVID-19 pandemic. We were interested in whether there was a significant change in refractive error attributed to online learning during the pandemic lockdown. Methods A retrospective record review of children aged 7 to 18 years that underwent a comprehensive visual evaluation between 2018 and 2021 at the Inter American Eye Institute in Puerto Rico. The spherical equivalent pre- and post-lockdown were compared. The study excluded the best corrected visual acuities worse than 20/40, any corneal or retinal disease, and amblyopia. Results In total, 801 records were included in this study. The mean age was 12.7 ± 3.2, with (50.3%) males and (49.7%) females. The mean spherical equivalent for the right and left eyes was similar (r = .93, P ≤ .001). A significant difference in the mean spherical equivalent was found pre and post-lockdown (0.22 ± 0.59 D, t(800) = 10.44 P ≤ .001). A myopic shift post-lockdown was significant for all ages except those in the seven (0.13 ± 0.79 D, t(28) = 0.84, P = .40) and 8-year-old range (0.12 ± 0.65 D, t(40) = 1.22, P = .23), respectively. No significant change was found between genders pre (0.16 ± 0.12 D; t(799) = 1.38, P = .16) and post (0.15 ± 0.13 D; t(799) = 1.19 P = .23) confinement. Conclusions The current study revealed a significant myopic shift in Hispanic school-aged children as a result of the pandemic confinement.

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Temporal Variations in Convergence Insufficiency Symptomatic Status among University Students before and after COVID-19: A Longitudinal Analysis from 2018 to 2023

Pena-Verdeal,

Noya-Padin,

Garcia-Queiruga

et al. 2024

Life

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The present study aimed to assess the symptomatic status of Convergence Insufficiency (CI) in university students from 2018 to 2023 considering the educational environment pre- and post-COVID-19 pandemic confinements. A Convergence Insufficiency Symptom Survey (CISS) was conducted annually from 2018 to 2023, excluding 2020, in an initial group of 217 third-year Optics and Optometry degree university student participants. In the final group (178 participants), the statistical differences in CISS scores between years were analysed, both overall and by questionnaire subgroup, along with associations between CISS diagnostic categories before and after 2020. Significant differences were found between years in the subscale and total score analyses (Kruskal–Wallis, both p ≤ 0.049). Pairwise comparisons showed significant differences for the performance subgroup in 2021 vs. 2019 and 2018 (Mann–Whitney, both p ≤ 0.004), while in terms of the total score, there was a statistical difference in 2021 vs. 2018 (Mann–Whitney, p < 0.001). The distribution analysis indicated a significant difference between groups (Chi, p = 0.004), with participants from 2021 or later more likely to exhibit higher CISS scores (OR = 3.47, 95%CI 1.04–8.58). The present study shows significant temporal increments in symptomatic status related to CI among university students from 2018 to 2023, indicating a potential impact of the COVID-19 pandemic educational landscape on these outcomes.

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The visual consequences of virtual school: acute eye symptoms in healthy children

Cited by 6 publications

References 20 publications

Effects of remote learning during the COVID-19 lockdown on children’s visual health: a systematic review

Effects of remote learning during the COVID-19 lockdown on children’s visual health: a systematic review

Refractive Error Changes Due to COVID-19 Pandemic Confinement in Children from Puerto Rico: A Retrospective Study

Temporal Variations in Convergence Insufficiency Symptomatic Status among University Students before and after COVID-19: A Longitudinal Analysis from 2018 to 2023

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