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Indian Journal of Community Medicine

Visual Fatigue and Computer Use Among College Students

Author(s): A Rajeev, A Gupta, M Sharma

Vol. 31, No. 3 (2006-07 - 2006-09)

A Rajeev, A Gupta, M Sharma


Eyes have been rightly described as the ‘windows of the soul’. WHO has affirmed this by introducing the global initiative known as ‘VISION 2020’ for elimination of avoidable blindness1. Refractive errors especially myopia, have been increasingly becoming common with increase in close-up work being cited as one of the reasons. Video terminals are everyday accessories in modern life and computer usage is even part of education these days. Asthenopia (visual fatigue) has been proven to be an occupational hazard for people working on Video Display Terminals (VDT) and such work often leads to temporary myopia (myopization) in a remarkable percentage of operators2. Psychological issues have been proven to be having additive role in development of visual symptoms in occupations such as banking3. However, whether non-occupational use of computers can cause similar symptoms in a suitable population group such as college students was considered in this study.


The study was conducted using a questionnaire among the degree (M.Sc and M.A) students belonging to 3 streams viz. science, arts and commerce in a reputed college in Mangalore. The questionnaire contained items on the demographic information, scholastic background, extracurricular activities, habit patterns, vision complaints, use of spectacles/contact lenses and sibling history of myopia. Family history other than that of siblings was not reliably available from most of the subjects. The whole group was divided into 4 subgroups for analysis purpose. These were: 1) myopes who have had their refractive errors corrected using lenses and with a visual acuity of less than 6/9 using Snellen’s charts 2) severe asthenopes (severity defined as eye complaints such as eye irritation, headache, watering or redness of eyes, rubbing of eyes and blurring of vision etc. which necessitated a visit to an ophthalmologist) 3) mild asthenopes who have similar eye complaints but have not visited ophthalmologists and 4) asymptomatics who neither have any eye complaints nor have visited ophthalmologists as per history. Hypermetropia was not considered for the analysis unless associated with myopia. Appropriate statistical tests were applied where needed.


The total subjects studied were 229 including 36 girls with a median age of 19 years (range 18 -21 years). There were 39 myopes, 51 severe asthenopes, 61 mild asthenopes and 78 controls. Compared to the myopes, the severe asthenopic subjects who visited the ophthalmologists had more headache (χ2= 4.6, df = 3, p < 0.05) in addition to rubbing of eyes, blurred vision and less of watering of eyes. Only 2 (3.9%) of the severe asthenopic group had siblings with myopia whereas 9 (23.1%) of the myopic subjects had siblings with myopia. Among asymptomatics, history of siblings with myopia was a mere 2 (2.6%).

Table I: Salient History from the Study Groups

N= 51
Positive sibling
history of myopia
9 2 4 2 17.6
(23.1) (3.9) (6.6) (2.6) p < 0.001
Reading habits
Frequent 6 5 9 9  
  (15.4) (9.8) (14.8) (11.5) 6.74
Occasionally 20 21 18 28 p > 0.05
  (51.3) (41.2) (29.5) (35.9)  
Rare 13 25 34 41  
  (30.3) (49.0) (55.7) (52.6)  
close-up work
14 3 28 33 24.3
(35.9) (5.9) (45.9) (42.3) p < 0.0001
Lighting sources
Table lamp 3 4 5 5  
  (7.7) (7.9) (8.2) (6.4) (5.73)
Tube light 35 40 46 66 p > 0.05
  (89.7) (78.4) (75.4) (84.6)  
Light Bulb 1 7 10 7  
  (2.6) (13.7) (16.4) (9.0)  
Distance from Television
>5m 5 12 14 20  
  (12.8) (23.5) (22.9) (25.6) 4.88
  2-5 m 31 37 40 52
p > 0.05 (79.5) (72.6) (65.6) (66.7)  
<2m 3 2 7 6  
  (7.7) (3.9) (11.5) (7.7)  

(Percentages within brackets)

There was no difference in the type of lighting used by the different groups for studying (Table-I). There was no significant difference in the number of hours put in for studying or scholastic performance between the groups. Extra-reading habits did not differ among the groups but extracurricular activities involving close up work was significantly low in severe asthenopes (Table 1). Among the mild asthenopic group history of viewing of television at close distance was noticed in 7 (11.5%) which was relatively higher compared to the other groups (χ2 = 4.88, P > 0.05). The duration of TV viewing per day was similarly the highest in the mild asthenopic group which, however, was not statistically significant (Table 2). With regard to the duration of computer use per day, the severe asthenopic group had the largest mean value of 78 minutes, followed by the myopes with 76 minutes as compared to only 35 minutes among asymptomatics (Table)II.

Table II: Duration of Television Viewing and Computer use in Minutes per Day Among the Four Groups

  Myopes Severe Asthenopes Mild Asthenopes Asymptomatics
Mean SD Mean SD Mean SD Mean SD
Television viewing 141 88 148 78 153 84 123 65
Computer use 76* 95 78 ** 78 50 54 35 48
*versus Asymptomatics, p < 0.01; **versus Asymptomatics, p < 0.001

136 (59.4%) of the total student subjects studied were using computers quite regularly. Analysis of the groups in terms of the percentage of computer users among the four different groups shows the attributability of eye complaints among them to the use of computers. 39 (76.5%) of the severe asthenopic group used computers regularly whereas only 37 (47.4%) of the asymptomatics used those regularly and the odds ratio worked out to be 3.6 (95% C.I, 1.54-8.54).


Much concern has been raised by users of video display terminals about possible adverse health effects4. Visual fatigue, in working with video display terminals, characterized by splitting type of headache, eye irritation, dry eyes, redness of eyes, fatigue and difficulty in focusing the eyes and even backache and muscle spasms, probably occurs because a person’s vision is not suited for staring at a computer screen (video display terminal) for many hours.

However, our view is that students are different from occupational groups. Kinge et al5 proved that intensive near-work could initiate myopia or lead to its progression in young adults especially with regard to the time spent on near-work. In our study of students, the asymptomatic group used the computers for only about half an hour every day compared to the mildly symptomatic group which used those for 50 minutes and the severe asthenopes and myopes who used them for more than an hour per day. Myopia obviously served as a physiological accelerator for the visual fatigue and even provided a higher chance of precipitating the diagnosis of myopia in similar groups of college students by presenting earlier to the ophthalmologists. Our study also lends credence to the theory that the VDTs could lead to troublesome asthenopia. The mild asthenopic group, in comparison, had maximum duration of television viewing suggesting a strong second role of that medium in generating eye problems among the student community.


We thank the Principal, St. Aloysius College, Mangalore for his whole-hearted consent and support for conducting this study in his institution.


  1. Gilbert C & Foster A. Childhood blindness in the context of VISION 2020 – The Right to Sight. Bull World Health Organ 2001; 79(3):
  2. Gobba FM, Broglia A, Sarti R, Luberto F, Cavalleri A. Visual fatigue in video display terminal operators: objective measure and relation to environmental conditions. Int Arch Occup Environ Health 1988; 60(2):81-7.
  3. Mocci F, Serra A, Corrias GA. Psychological factors and visual fatigue in working with video display terminals. Occup Environ Med 2001; 58(4):267-71.
  4. Anonymous. Health effects of video display terminals. Council on Scientific Affairs. JAMA 1987; 257(11) :1508-12.
  5. Kinge B, Midelfart A, Jacobsen G, Rystad J. The influence of near-work on development of myopia among university students. A three-year longitudinal study among engineering students in Norway. Acta Ophthalmol Scand. 2000; 78(1):26-9.

Deptt. of Community Medicine, Kasturba Medical College,
Mangalore – 575001.
E-mail: [email protected]

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