Prevalence of Self-Reported Symptoms of Computer Vision Syndrome and Associated Risk Factors among School Students in China during the COVID-19 Pandemic

ABSTRACT

Purpose

To determine the prevalence and risk factors of self-reported symptoms of Computer Vision Syndrome (CVS) in school students during COVID-19 pandemic.

Methods

In this cross-sectional study in Nanjing, China, students (grades 1–12) from six randomly selected schools self-administered the online survey questionnaire about hours on electronic devices, outdoor activities, frequency and intensity of 17 CVS symptoms during virtual learning period of COVID-19 pandemic.

Results

Among 2363 invited students, 2005 (84.8%) completed the survey. Mean (SD) age was 12 (3.0) years, 51% were male, 53% wore glasses, 56% did not know the 20-20-20 rule (take a 20 second break every 20 min of close work and gaze at objects at least 20 feet away) and 6.5% knew but never followed the 20-20-20 rule. Mean (SD) hours/day was 4.6 (3.4) for screen time and 1.2 (1.0) for outdoor activities. Total of 1543 (77.0%) students reported at least one CVS symptom (median = 4) with eye dryness and itching the most common (48%). In multivariable analysis, CVS score 4 or more was independently associated with older age (adjusted odds ratio (aOR) = 1.05 for per-year increase, p = 0.02), children with myopia not wearing glasses (aOR = 2.12, p = 0.0003), astigmatism (aOR = 1.37, p = 0.04), other ocular diseases (aOR = 1.59, p = 0.005), not complying 20-20-20 rule (aOR = 2.13, p = 0.04), more screen time (aOR = 1.53 for >6 vs. ≤2 hours, p = 0.0001) and less outdoor activities (aOR = 1.37 for ≤0.6 vs. ≥1.9 hours, p = 0.005).

Conclusions

During COVID-19 pandemic, self-reported CVS symptoms occurred in more than three-quarters of students. Besides pre-existing ocular diseases, children with myopia not wearing glasses, excessive time on screens, non-compliance of the 20-20-20 rule and reduced outdoor activities were associated with higher risk of CVS.

KEYWORDS:

• COVID-19
• Computer Vision Syndrome
• school students
• prevalence
• risk factors

Disclosure statement

The authors report no competing interests.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

Statement

This submission has not been published anywhere previously and it is not simultaneously being considered for any other publication.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This research was supported by grants of the National Natural Science Foundation of China (Grant No. 81673198; No. 81803258).