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The purpose of this study was to subjectively examine the degree of visual fatigue in children attending online classes during the pandemic and objectively evaluate accommodation and vergence of these children. The study was undertaken from July-August 2020 and recruited 46 children presenting with asthenopia (31 females, 15 males aged 14.47 ±1.95 years); 56.5% were emmetropic. All were attending online classes and 50% for over four hours daily. Mean duration of online classes was 3.08 ±1.68 hours / day; significantly higher than pre-pandemic (0.58 ±0.71). Mean convergance insufficiency symptom survery (CISS) score was 21.73 ±12.81 for children using digital devices for less than four hours and 30.34 ±12.0 for those using digital devices for greater than four hours. Mean values of near exophoria, near fusional vergence, negative relative accommodation and accommodative amplitude were significant different between the two groups at 2.13 ±4.89 vs. 5.21 ±5.13PD, 9.04 ±2.23 vs. 10.51 ±2.02PD, 1.84 ±0.63 vs. 2.23 ±0.72 and 8.95 ±0.96 vs. 9.78 ±0.95 respectively. Duration of online classes greater than four hours was the only significant risk factor for symptomatic CISS score. There was a marked decrease in outdoor activity during the pandemic: 0.58 ±0.88 hours. The authors acknowledge their small sample size and recommend further study. However, they recommend a cautious and restricted duration of digital use for children.

Binocular accommodative and vergence dysfunction in children attending online classes during the covid-19 pandemic: digital eye strain in kids (DESK) study-2.
Mohan A, Sen P, Shah C, et al.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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