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Sun M, Tang J, Zhao Y, Sun S, Liu Z, Zhao S, Huang Y. Analysis of Factors Associated with Anterior Location of Marx's Line. Curr Eye Res 2024; 49:691-697. [PMID: 38717137 DOI: 10.1080/02713683.2024.2324432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 02/24/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE The study aimed to investigate the factors associated with anterior location of Marx's line in ocular surface and living habits, especially in tear film. MATERIALS AND METHODS This cross-sectional study enlisted 483 participants with meibomian gland dysfunction, who were divided into two groups: 160 participants with mild anterior location of Marx's line and 323 participants with moderate-to-severe anterior location. Participants completed a survey of demographic characteristics (sex, age, length of visual terminal use, sleep duration, skin property), and the Ocular Surface Disease Index and Standard Patient Evaluation of Eye Dryness questionnaires. They also underwent slit-lamp examinations of the lids, and measurements of non-invasive tear break up time, tear meniscus height, fluorescein tear break up time, lipid layer thickness, partial blink rate, lid wiper epitheliopathy, and meibomian gland dropout. RESULTS The tear meniscus height (mild:0.21(0.18-0.25), moderate-to-severe:0.19(0.16-0.23), p = 0.004), fluorescein tear break up time(mild:3(2-4),moderate to severe:2(1-3), p = 0.000), max LLT(mild:87(62-100), moderate-to-severe:99(69-100), p = 0.04), average LLT(mild:64.5(47.5-96.75), moderate-to-severe:74(53-100), p = 0.012), min LLT(mild:52(38-75), moderate-to-severe:59(41-85), p = 0.029) differed significantly between mild and moderate-to-severe anterior location of Marx's line, and associated to the anterior location of Marx's line(r=-0.134, p = 0.03; r=-0.194, p = 0.000; r = 0.093, p = 0.041; r = 0.119, p = 0.009; r = 0.105, p = 0.022) However, no statistical significance was observed in the OSDI, SPEED, partial blink rate, non-invasive tear breakup time, lipid layer thickness, meibomian gland dropout and lid wiper epitheliopathy(p > 0.05). Meanwhile, in the demographic characteristics, statistically significant correlations were associated with skin property(r = 0.154, p = 0.001) and sleep duration(r=-0.124, p = 0.006), but not with age, sex, and the length of visual terminal use (p > 0.05). CONCLUSIONS Lower TMH and shorter TBUT positively correlated with anterior location of the Marx's line, and were risk factors. Meanwhile, participants with oily skin and shorter sleep duration were more likely to exhibit anterior location of Marx's line.
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Affiliation(s)
- Ming Sun
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Medical University, Tianjin, China
- Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin Medical University, Tianjin, China
| | - Jiangqin Tang
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Medical University, Tianjin, China
- Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin Medical University, Tianjin, China
| | - Yang Zhao
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Medical University, Tianjin, China
- Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin Medical University, Tianjin, China
| | - Shengshu Sun
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Medical University, Tianjin, China
- Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin Medical University, Tianjin, China
| | - Zhanglin Liu
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Medical University, Tianjin, China
- Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin Medical University, Tianjin, China
| | - Shaozhen Zhao
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Medical University, Tianjin, China
- Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin Medical University, Tianjin, China
| | - Yue Huang
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Medical University, Tianjin, China
- Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin Medical University, Tianjin, China
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Wang N, Yang S, Gao Q, Jin X. Immersive teaching using virtual reality technology to improve ophthalmic surgical skills for medical postgraduate students. Postgrad Med 2024; 136:487-495. [PMID: 38819302 DOI: 10.1080/00325481.2024.2363171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/28/2024] [Indexed: 06/01/2024]
Abstract
Medical education is primarily based on practical schooling and the accumulation of experience and skills, which is important for the growth and development of young ophthalmic surgeons. However, present learning and refresher methods are constrained by several factors. Nevertheless, virtual reality (VR) technology has considerably contributed to medical training worldwide, providing convenient and practical auxiliary value for the selection of students' sub-majors. Moreover, it offers previously inaccessible surgical step training, scenario simulations, and immersive evaluation exams. This paper outlines the current applications of VR immersive teaching methods for ophthalmic surgery interns.
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Affiliation(s)
- Ning Wang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Shuo Yang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Qi Gao
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Xiuming Jin
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
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Souchet AD, Lourdeaux D, Burkhardt JM, Hancock PA. Design guidelines for limiting and eliminating virtual reality-induced symptoms and effects at work: a comprehensive, factor-oriented review. Front Psychol 2023; 14:1161932. [PMID: 37359863 PMCID: PMC10288216 DOI: 10.3389/fpsyg.2023.1161932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Virtual reality (VR) can induce side effects known as virtual reality-induced symptoms and effects (VRISE). To address this concern, we identify a literature-based listing of these factors thought to influence VRISE with a focus on office work use. Using those, we recommend guidelines for VRISE amelioration intended for virtual environment creators and users. We identify five VRISE risks, focusing on short-term symptoms with their short-term effects. Three overall factor categories are considered: individual, hardware, and software. Over 90 factors may influence VRISE frequency and severity. We identify guidelines for each factor to help reduce VR side effects. To better reflect our confidence in those guidelines, we graded each with a level of evidence rating. Common factors occasionally influence different forms of VRISE. This can lead to confusion in the literature. General guidelines for using VR at work involve worker adaptation, such as limiting immersion times to between 20 and 30 min. These regimens involve taking regular breaks. Extra care is required for workers with special needs, neurodiversity, and gerontechnological concerns. In addition to following our guidelines, stakeholders should be aware that current head-mounted displays and virtual environments can continue to induce VRISE. While no single existing method fully alleviates VRISE, workers' health and safety must be monitored and safeguarded when VR is used at work.
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Affiliation(s)
- Alexis D. Souchet
- Heudiasyc UMR 7253, Alliance Sorbonne Université, Université de Technologie de Compiègne, CNRS, Compiègne, France
- Institute for Creative Technologies, University of Southern California, Los Angeles, CA, United States
| | - Domitile Lourdeaux
- Heudiasyc UMR 7253, Alliance Sorbonne Université, Université de Technologie de Compiègne, CNRS, Compiègne, France
| | | | - Peter A. Hancock
- Department of Psychology, University of Central Florida, Orlando, FL, United States
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Wolffsohn JS, Lingham G, Downie LE, Huntjens B, Inomata T, Jivraj S, Kobia-Acquah E, Muntz A, Mohamed-Noriega K, Plainis S, Read M, Sayegh RR, Singh S, Utheim TP, Craig JP. TFOS Lifestyle: Impact of the digital environment on the ocular surface. Ocul Surf 2023; 28:213-252. [PMID: 37062428 DOI: 10.1016/j.jtos.2023.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Eye strain when performing tasks reliant on a digital environment can cause discomfort, affecting productivity and quality of life. Digital eye strain (the preferred terminology) was defined as "the development or exacerbation of recurrent ocular symptoms and/or signs related specifically to digital device screen viewing". Digital eye strain prevalence of up to 97% has been reported, due to no previously agreed definition/diagnostic criteria and limitations of current questionnaires which fail to differentiate such symptoms from those arising from non-digital tasks. Objective signs such as blink rate or critical flicker frequency changes are not 'diagnostic' of digital eye strain nor validated as sensitive. The mechanisms attributed to ocular surface disease exacerbation are mainly reduced blink rate and completeness, partial/uncorrected refractive error and/or underlying binocular vision anomalies, together with the cognitive demand of the task and differences in position, size, brightness and glare compared to an equivalent non-digital task. In general, interventions are not well established; patients experiencing digital eye strain should be provided with a full refractive correction for the appropriate working distances. Improving blinking, optimizing the work environment and encouraging regular breaks may help. Based on current, best evidence, blue-light blocking interventions do not appear to be an effective management strategy. More and larger clinical trials are needed to assess artificial tear effectiveness for relieving digital eye strain, particularly comparing different constituents; a systematic review within the report identified use of secretagogues and warm compress/humidity goggles/ambient humidifiers as promising strategies, along with nutritional supplementation (such as omega-3 fatty acid supplementation and berry extracts).
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Affiliation(s)
- James S Wolffsohn
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.
| | - Gareth Lingham
- Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Byki Huntjens
- Division of Optometry and Visual Sciences, City, University of London, EC1V 0HB, UK
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Saleel Jivraj
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK
| | | | - Alex Muntz
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Karim Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL). Monterrey, 64460, Mexico
| | - Sotiris Plainis
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | - Michael Read
- Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Rony R Sayegh
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sumeer Singh
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Tor P Utheim
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Jennifer P Craig
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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Al-Mohtaseb Z, Schachter S, Shen Lee B, Garlich J, Trattler W. The Relationship Between Dry Eye Disease and Digital Screen Use. Clin Ophthalmol 2021; 15:3811-3820. [PMID: 34531649 PMCID: PMC8439964 DOI: 10.2147/opth.s321591] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/30/2021] [Indexed: 11/23/2022] Open
Abstract
Dry eye disease is characterized by tear film instability that can result in ocular surface damage. Patients with dry eye disease may experience ocular pain/discomfort and visual disturbances that may negatively impact quality of life. Increased use of digital screens for work, communication, and entertainment, especially during times of pandemic, may contribute to dry eye. Extensive cross-sectional studies have shown that digital screen use duration is associated with an increased risk of severe symptoms and clinical diagnosis of dry eye disease in adults. Smartphone use duration has also been found to be greater in school-age children with dry eye disease than in those without dry eye disease. A commonly accepted hypothesis for the relationship between digital screen use and dry eye disease is that digital screen use changes blinking dynamics, leading to ocular dryness. This review describes evidence that digital screen use is associated with dry eye disease, that digital device use alters blinking dynamics, and that dry eye affects mental health and work productivity in digital screen users. Helpful prevention and management strategies for dry eye disease exist for those who use digital screens.
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Affiliation(s)
- Zaina Al-Mohtaseb
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA
| | - Scott Schachter
- Presbyopia and Ocular Surface Disease, Allergan, an AbbVie Company, Irvine, CA, USA
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