J Pediatr Ophthalmol Strabismus. 2021 Jul-Aug;58(4):224-231. doi: 10.3928/01913913-20210217-02. Epub 2021 Jul 1.
To subjectively evaluate the degree of visual fatigue in children attending online classes during the coronavirus 2019 (COVID-19) pandemic and objectively evaluate accommodation and vergence dysfunction in these children.
Children aged between 10 and 17 years with recent onset of asthenopia symptoms were included. Symptoms were evaluated using the Convergence Insufficiency Symptom Survey (CISS) questionnaire. A CISS score of 16 or greater was considered symptomatic. Binocular vergence and accommodation parameters were objectively evaluated. For ease of comparison, children were divided into two groups: children using digital devices for less than 4 hours/day and children using digital devices for 4 hours/day or more.
A total of 46 children with a mean age of 14.47 ± 1.95 years were evaluated. The mean duration of online classes during the COVID-19 pandemic was 3.08 ± 1.68 hours/day, which is higher than before the COVID-19 pandemic (0.58 ± 0.71 hours/day, < .00001). The mean CISS scores were 21.73 ± 12.81 for children using digital devices less than 4 hours/day and 30.34 ± 13.0 for children using digital devices for 4 hours/day or more ( = .019). Mean near exophoria ( = .03), negative fusional vergence ( = .02), negative relative accommodation ( = .057), and accommodation amplitude ( = .002) were different between the two groups. The Spearman correlation between the symptomatic CISS score and the duration of online classes showed a linear association (coefficient r = 0.39; = .007). In the multivariate analysis, only the duration of online classes longer than 4 hours was a significant risk factor ( = .07) for the symptomatic CISS score.
Online classes longer than 4 hours were more detrimental to abnormal binocular vergence and accommodation parameters than online classes shorter than 4 hours. .
主观评估新冠肺炎疫情期间上网课儿童的视觉疲劳程度，并客观评估这些儿童的调节和聚散功能障碍。
纳入最近出现视疲劳症状且年龄在 10 至 17 岁之间的儿童。使用集合不足症状调查（CISS）问卷评估症状。CISS 评分 16 分或以上被认为有症状。客观评估双眼聚散和调节参数。为便于比较，将儿童分为两组：每天使用数字设备不足 4 小时的儿童和每天使用数字设备 4 小时或以上的儿童。
共评估了 46 名平均年龄为 14.47 ± 1.95 岁的儿童。在新冠肺炎疫情期间，在线课程的平均时长为 3.08 ± 1.68 小时/天，高于疫情前（0.58 ± 0.71 小时/天， <.00001）。每天使用数字设备不足 4 小时的儿童的 CISS 平均得分为 21.73 ± 12.81，每天使用数字设备 4 小时或以上的儿童的 CISS 平均得分为 30.34 ± 13.0（ =.019）。两组间近外隐斜（ =.03）、负融像性聚散（ =.02）、负相对调节（ =.057）和调节幅度（ =.002）存在差异。症状性 CISS 评分与在线课程时长的 Spearman 相关性呈线性关联（系数 r = 0.39； =.007）。在多变量分析中，只有在线课程时长超过 4 小时是症状性 CISS 评分的显著危险因素（ =.07）。
与 4 小时以内的在线课程相比，4 小时以上的在线课程对异常双眼聚散和调节参数的影响更大。
