Computer vision syndrome

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NURSING SERVICES DEPARTMENT FEDERAL TEACHING
HOSPITAL GOMBE

• TOPIC COMPUTER VISION SYNDROME
• PRESENTERUSMAN ABDULWAHAB(NOI)
• DATE 14TH OCTOBER, 2015
• VENUE FEDERAL TEACHING HOSPITAL GOMBE CONFERENCE
  HALL

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OUTLINE

• INTRODUCTION
• DEFINITION
• BRIEF A P OF LACRIMAL APPARATUS
• FACTS ON CVS
• AETIOLOGY OF CVS
• CLINICAL MANIFESTATION
• DIAGNOSIS
• TREATMENT OF CVS
• CVS AND WORKER PRODUCTIVITY
• RECOMMENDATIONS
• CONCLUSION

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INTRODUCTION

• Computers have become part and parcel of our
  lives. Today, in every corporate office , on the
  desk of every secretary and executive , sits a
  computer that allows us to write, design,
  compute , research and communicate faster than
  we could before.
• Yet this conveniences has not come without a
  price to our health and general comfort.
• Carpal Tunnel syndrome has become universally
  known term, not so widely known is the computer
  vision syndrome(CVS) which in fact is far more
  widespread.
• Computer vision syndrome describe a group of eye
  and vision related problems that result from
  prolonged computer use.

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DEFINITION

• Computer vision syndrome (CVS) is described as a
  group of eye and vision-related problems that
  results from prolonged computer use (AOA,2009)

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BRIEF ANATOMY AND PHYSIOLOGY

• THE LACRIMAL APPARATUS
• The lacrimal apparatus consist of
• Lacrimal gland
• Accessory lacrimal glands
• Lacrimal ducts
• Puncta
• Canaliculi
• Lacrimal sac
• Nasolacrimal duct

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TEAR FILM

• The tear film covers the normal ocular surface.
  It comprise of the following 3 layers
• A superficial thin lipid layer (0.11 µm) This
  layer is produced by the meibomian glands, and
  its principal function is to retard tear
  evaporation and to assist in uniform tear
  spreading
• A middle thick aqueous layer (7 µm) This layer
  is produced by the main lacrimal glands as well
  as by the accessory lacrimal glands of Krause and
  Wolfring
• An innermost hydrophilic mucin layer (0.02-0.05
  µm) This layer is produced by both the
  conjunctiva goblet cells and the ocular surface
  epithelium

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FUNCTIONS OF TEAR FILM

• Keeps the cornea and conjunctiva moist.
• Provides nourishment to the corneal epithelium.
• Washes away debris and noxious irritants.
• Prevent infection due to presence of
  antibacterial substance.
• Facilitates movement of the lids over the globe.

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AETIOLOGY/RISK FACTORS

• The main cause of CVS is prolonged hours of
  computer use .
• 1. Environmental Factors
• Temperature, chemicals, ventilation fans and
  ergonomics are
• some of the environmental factors that can
  predispose one to
• develop CVS.
• 2. Reduced Blink Rate
• Most individuals normally blink between 1016
• times per minute. Studies have shown that the
  blink
• rate at the computer is significantly less than
• normal. A reduced blink rate contributes
• to a poor tear film quality and temporarily
  stresses the
• cornea.

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• 3. Increased Exposure
• The reading of text on paper is normally
  performed
• while looking downwards. This results in the
• eyelid covering a substantial portion of the
  anterior
• surface of the eye, thus minimizing the
  evaporation of
• tears. On the contrary, computer users usually
  view
• their reading material in a horizontal gaze. This
  results
• in a wider palpebral fissure and an increased
• surface area exposed to the effects of
  evaporation.

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• 4. Sex
• The prevalence of dry eye is slightly greater in
• females than males.
• 5. Age
• Tear production normally decreases with age.
  Although
• dry eye can occur at any age in both men
• and women, post-menopausal women represent the
• group of individuals most affected by dry eye.

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• 6. Systemic Diseases
• Dry eye is associated with various systemic
  diseases.
• A general review of the patients entire medical
• history aids in establishing a complete
  diagnosis.
• Autoimmune diseases such Sjogren syndrome and
• rheumatoid arthritis have an association with dry
  eye.

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• 7. Systemic Medications
• There are several systemic medications
  contributing
• to dry eyes. The most prevalent medications
• include diuretics, anti-histamines,
  psychotropics, and
• anti-hypertensives.

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• 8. Ocular Conditions
• Localized dysfunctions of the glands, which
  produce
• the ocular tear film, can also contribute to dry
• eye. The most common disorder, anterior
  blepharitis,
• is an inflammation of the eyelids, affecting the
• meibomian glands that secrete the lipid layer of
• the ocular surface. The lack of an adequate lipid
• layer contributes to rapid evaporation of the
  water
• component of the tear film.

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• 9.Cosmetics
• Poorly applied cosmetics can block the openings
• of the oil-secreting meibomian glands. This in
  turn
• contributes to a rapid evaporation of the water
• component of the tear film.
• 10. Contact lens
• Computer users suffer more ocular and vision
• disturbance if they are also contact lens users.

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FACTS ON CVS

• CVS holds the distinction of being called the
  number one occupational hazard of the 21st
  century.( American Optometrist Association
  (AOA),2014)
• About 88 of all computer users will develop CVS
  at some time in their lives.( National Institute
  of Occupational Safety and Health(NIOSH),2009).
• Operating a computer may lead to visual ,
  muscular or mental fatigue( Occupational Safety
  and Health Administration(OSHA),2004).
• CVS affects productivity by 4-19.(UAB,2010)
• Globally, Nigeria ranks number 8 with a
  population of 83,362,814 internet users (
  NCC,2015).

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CLINICAL MANIFESTATION

• Eye strain

• Dry eyes

• Red eye

• Photosensitivity

• Blurred vision

• Headaches

• Back and neck pain

• Fatigue

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DIAGNOSING CVS

• Visual acuity test

• History taking

• General examination

• Ocular examination

• Refraction test

• Schirmers test

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TREATMENT

• Treatment may consist of
• Treating the underlying systemic or ocular
  condition
• Topical tears supplement
• Computer glasses
• Vision therapy

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PREVENTION TIPS

• Move the location of your computer screen so that
  your eyes are looking downward---about 10-20
  degrees below eye level and 20-26 inches away
  from the eyes.
• Place any reference material directly next to
  your computer screen, so you dont need to move
  your head to look from the document to your
  computer screen
• Adjust your chair height and position so that
  your arms are parallel to the ground when typing,
  and your feet are flat on the floor.

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• Minimize glare on your computer screen by closing
  windows or shades during the day and using
  anti-glare screens can decrease the amount of
  light reflected on the computer.
• Adjust the brightness and contrast on your
  computer screen by making sure the brightness of
  the white is neither too bright nor too dull ,
  also ensure the contrast between the screen
  background and the onscreen characters is high.
• Adjust the text size and color for comfort,
  especially when reading or composing long
  documents. Usually , black print on a white
  background is the best combination.

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• Avoid sitting in front of a fan or something like
  that while working on a computer.
• Take frequent breaks, if possible rest your eyes
  by stopping and looking into the distance for at
  least 10 minutes after an hour of continuous
  computer use.
• Use the 20-20-20 rule, look away from your
  computer at least every 20 minutes and gaze at a
  distant object that is at least 20 feet away for
  at least 20 seconds.

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CVS AND WORKER PRODUCTIVITY

• If you use a computer at work, you probably
  already know that a long day of staring at your
  screen can lead to eye strain, tired eyes,
  headache, muscle aches and other symptoms of CVS.
  But you may not know that CVS also can lead to
  increase errors and reduce productivity.
• And if you own a company, you might be interested
  to know that studies suggest you can increase
  profits by providing your employees vision care
  and computer glasses to help boost productivity
  and decrease errors.

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EMPIRICAL STUDY

• A study conducted by Kent Daum(2009) at the
• University of Alabama at Birmingham (UAB) School
  of
• Optometry, examined the relationship between the
• vision of computer workers and their productivity
  in the
• workplace.
• The study found
• A direct correlation between proper vision
  correction and productivity. This relationship
  particularly is evident with complex and/or
  repetitive computer tasks such as data entry.

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• A direct correlation between proper vision
  correction and the time required for a computer
  worker to perform a task. Computer-related tasks
  took much longer when the subjects wore glasses
  with less than the optimum correction.
• Reduced productivity even among computer users
  who were unaware they had vision problems.
  Computer users with small refractive errors may
  not notice any vision discomfort. But without
  proper vision correction, their performance on a
  specific task can suffer significantly by as
  much as 20 percent

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• The study strongly suggest that improving the
  visual status of workers using computers results
  in greater productivity in the workplace, as well
  as improved visual comfort.

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CHALLENGES

• Lack of awareness
• Lack of government policies
• High cost of computer glasses

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RECOMMENDATIONS

• Eye care professionals should endeavor to probe
  patients that attend the clinic about the history
  of computer use and spend time to discuss about
  CVS during consultation.
• Eye care professionals should alert builders and
  office designers on the need to integrate
  internal decorations that will mitigate the
  incidence of CVS which are related to the
  workplace physical design and lightening system.

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• Training institutions and health educators should
  increase the level of awareness of CVS among
  computer users thereby reducing the effects and
  occurrence of CVS.
• Training on computer health related and safety
  measures should be part of the curriculum of
  computer training.
• Companies and institutions with large number of
  computer users should establish ergonomics
  guidelines to protect computer users from ocular
  hazards.

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• As practiced in the United kingdom, the Nigerian
  government should also establish a legislation
  to protect computer operators by setting out
  legal requirements of employers for their
  computer operators.
• More studies need to be carried out on CVS to
  provide an evidence-based information to the
  little literature available on CVS in Nigeria.

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CONCLUSION

• CVS can be an insidious occupational health
  problem. However , with heightened client and
  employer awareness , it can be easily prevented
  and treated.
• The health professionals can serve as diagnostic
  clinicians, educators, advocates and workplace
  liaison to help combat CVS.

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REFERENCE

• http//en.wikipedia.org/wiki/Computer_vision_syndr
  ome
• http//www.aoa.org
• http//www.webmd.com/eye-health/computer-vision-sy
  ndrome
• http//www.emedicine.medscape.com
• http//www.computervisionsyndrome.net
• http//library.thinkquest.org
• http//www.emedicinehealth.com/dry_eye_syndrome

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THANK YOU FOR LISTENING
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