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RAJIV GANDHI UNIVERSITY OF HEALTH
SCIENCES, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
1.Name of the candidate and
address
MS IEITRITI LYNDEM
M.sc(N) 1 year
DR.SYAMALA REDDY COLLEGE OF
NURSING
#111/1 SGR MAIN ROAD,
MUNNEKOLALA ,
MARATHAHALI ,
BANGALORE -560037.
2.Name of the Institution
Dr. Syamala Reddy College of Nursing
3.Course of study and subject
M. sc(N )1 year
Community Health Nursing
4.Date of admission to course
5. Title of the topic
09 .06.2008.
A study on knowledge and practice among
computer professionals regarding computer vision
syndrome in a selected IT company at Bangalore
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
“SEE BETTER LIVE BETTER”
Imagine life without good vision unclear, hazy images that keep you from
appreciating the beauty of the world around. Does the thought make you
Shudder? Well, help is closer then you think.
Among the advancement of the technology, computer have the first place everywhere,
computer is an inevitable electronic device in Hospitals and educational institutions for the
fastand accurate work
Computer decrease the work load of man in the increase of
productivity. Computers have become an integral part of every ones life. Predictions indicate
that 75percent of working population will be using computer by the year 2005
Vision is our premier connection with the world. We use our eyes to interact with our
environment in more than one million ways every second .The eyes is an extension of the
brainand is our direct link between our physical environment and our psychological mind.
Computers have made things so much fast and simple but has brought with them new problems
related to health and vision. Using computers for long hours put repetitive stress on body,
muscles and joints especially to eyes. Problems related to eyes affect all those who spend a
significant time working with computers. There are many IT professionals who spend most of
their time in front of computer screen are at risk of computer vision syndrome
26 years old Joe John an IT professional working in a multinational company has a
gritty sensation in his eyes at the end of the day almost every day. There are many such young
professionals who experience similar symptoms, ophthalmologist term it computer vision
syndrome, and say this problem is on the rise . Experts warn of computer vision syndrome.
6.1NEED FOR THE STUDY
Twenty years ago, the optometrist began to hear the first murmuring of vision
related complaints from computer using patients. Today we here the same array of
symptoms from great many more people, but we seem to be no closer to a good set of
reliable answer. Computer vision syndrome has gain increasing attention recently, probably
due to our growing dependence on computers.
Computers vision syndrome is a real problem and there are solutions to the
problems. Certainly there are no scientific evidence that computer screen damage the eyes,
but prolonged use, bad posture, demand of strain on eye muscles to read the print on computer
screen, poor work habit, all add up to a pile of symptoms. A computer related vision and an
eye problem known as computer vision syndrome are already reaching a crisis in work place.
According to a study conducted by National Institute of Occupational Safety And
Health, USA indicates that 88 percent of people working on computer more than three hours a
day suffer from symptoms of eye strain. Number of computer vision syndrome sufferer
seeking help is on the rise growing from 10 million in 1992 to 15 million in 1995.
A computer related health problems among IT professionals in DELHI study
include 200 IT professionals with varied job profiles viz, software developers 82 percentage,
call center 54 percentages and data entry processing 64percentage as study population. The
frequency of computer related problems in the studying group visional problems in 76
percentage, stress in 35 percentages, muscular skeletal problems in 77.5 percentage, visual
problems and stress was significant among subjects working in software development, while
musculoskeletal problem was prevalent in data entry/processing operators.
Tens of millions of peoples spend 48 hours in front of computer every day, and it’s
going to get worse. All that can have an impact on the eye sight. Chances are that you suffer
from a syndrome that you don’t even realize you have. Statistics shows that in general eye
and vision problems afflict some 70 to 75 percentages of people with desk bound jobs who
work in front of computers. This makes computer vision syndrome most frequently reported
health problems among these computer workers.
According to doctor Arun samprathi, 98 percentages of professionals in urban
India show symptoms of computer vision syndromes, 10 percentages raise in complaints
between 1999-2005 and sixteen new patients on an average are treated every month. A study
on prevalence of asthenopia among computer operators shows that 46.3 percentages suffered
from asthenopia. A survey of optometrists indicates that ten million primary eye care
examination are provided annually because of computer vision related problems.
Majority of health survey shows that the most frequent health related problems
complaint by computer professionals are visually related and the computer professionals have
lack of knowledge regarding computer vision syndrome and its prevention.
There are limited number of research studies done on knowledge and attitude of
computer professional regarding computer vision syndrome and its prevention. Consider India
in the throes of an IT revolution, the nation’s computer population stands between 15 to 20
million and they work long hours too, 60 hours a week compare to 43 hours globally
(Assocham survey 2007). Nearly 40 million Indians surf the net every day and nearly 90
percentages computer user stare at the small screen over four hours every day.
Nurses have the responsibility in this advance world of technology to identify the
symptoms of computer vision syndrome and to create awareness regarding the management
of such problems.
6.2 REVIEW OF LITERATURE:
Computer vision syndrome is a term that describe eye related problems and the
other symptoms caused by computer used. As our dependence on computer continues to grow,
an increasing number of people are seeking medical attention for eye strain and irritation, along
with back, neck, shoulder and wrist soreness. These problems are more noticeable with
computer tasks than other near work because letter on the screen are form by tiny dots called
pixels, rather than a solid image .This causes the eyes to work a bit harder to keep the images in
focus. There is no scientific evidence that computer screens are harmful to the eyes. Common
myth is that eye strain caused by reading and close work is damaging to the eyes .This is not
true; However, those who work at computers often experience many frustrating symptoms.
The related literature has been organized and presented under the following headings.
1. Definition of computer vision syndrome
2. Prevalence of computer vision syndrome
3. Effects of computer use.
4. Clinical manifestations of computer vision syndrome
5. Prevention of computer vision syndrome
6. Studies related to knowledge, attitude and practice of Indian ophthalmologist regarding
computer vision syndrome.
1. Definition of Computer Vision Syndrome
Computer vision syndrome is defined as an eye and vision problems that are
experienced during and related to computer use is a repetitive strain disorder that appears to
be growing rapidly.
National institute of occupational health and safety (1997) indicated that 88 percent
of people working at computer more than 3 hours a day suffer from symptom of eye strain
dryness in the eyes, eye strain, eye irritation, watering from the eyes, redness, blurred vision,
double vision are universal complaints among computer user who put in long hours in front of
computer screen. This group of symptoms is called computer vision syndrome. Number of
computer vision syndrome sufferers seeking help is on the rise growing from 10 million in
1992 to 15 million in 1995.computer vision syndrome is defined as a eye and vision problems
that are experienced during and related to computer use is a repetitive strain disorder that
appears to be growing rapidly
Sahana Chavan (2007) cited in her article on the Hindu news “do not close your eyes
to computer vision syndrome. A 26 year old Joe John an IT professional working in a
multinational company at Bangalore has a gritty sensation in his eyes at the end of the day
almost everyday. A few hours of working on the computer, I feel as if there is some particle
inside my eyes, and not able to concentrate it interfere my eyes, often eyes becomes extremely
dry and burning sensation. There are many such young professionals who experience similar
symptom. Ophthalmologist terms it as computer vision syndrome.
2. Prevalence of computer vision syndrome
Sharma et al., (2006) conducted a study on computer related health problems among I.T.
Professionals in Delhi. Study included 200 I.T Professionals with varied job profiles viz,
software developers 82 percent, call centers 54 percent and data entry processing 64 percent
as study population. The frequency of computer related problem in the studying group were;
visual problems 76 percent, musculo skeletal problem77.5percent and stress in 35percent.
Visual problems and stress was significant among subject working in software development
while musculo skeletal problem was prevalent in data entry/processing operators.
A survey of 30 computer professionals in Udaipur, Rajasthan in November 2006
found that 43 percent had glare and reflections falling on the screen. No wonder 90 percent
showed eye strain. Meantime the new millennium disorder is changing out trendy slogans.
Department of community medicine (2008) conducted a study on the prevalence
of asthenopia among 419 computer operators and its association with factors. Results show
that among 419 subjects 194 (46.3percent) suffered from asthenopia and its higher in female
compare to males. Occurrence of asthenopia associated with age of starting use of computer,
presence of refractive error, viewing distance, use of antiglare screen. Prevalence of
asthenopia was noted to be quite high among computer operators.
3. Effects of computer use
A study conducted by Gina (1998) revealed that having irritated eyes (eye strain, dry
eye) is one of the common complaints about computer used, and it has a variety of causes.
Actually a person blinks two third less than usual when working at computer. When a person
does not blink enough, eyes can become dried out and irritate (normal blinking rate is 16
times per minute). When working at computer a person tends to open his eyes wider
exacerbates the dryness.
Osha (1999) cited that humans evolve biologically as “hunters and gatherers”
Our vision developed primarily for seeing distance. Ninety eight percent of all humans are
born farsighted. Our eye muscle systems are in their most relaxed state when we use our vision
for distance objects and space. In similar fashion our bodies were designed for movement.
Maintaining a sitting posture for long periods of time is un-natural for us. As a result, working
at computer for a long period of time without breaks can cause unnatural strain and that can
result in a condition called computer fatigue syndrome.
Computer users have shown to have a reduced average blinking time while using
computers which according to Japanese Investigators causes a major risk of developing
transient or short term dry eyes. Over a period of time excessive computer use can have
cumulative negative effects on the user including the worsening of farsightedness,
nearsightedness, astigmatism, eye focusing disorders and poor eye coordination. In addition,
constant working from a set position can cause neck and shoulder stiffness, as well as stress,
headache, which can then cause pain in the jaw referred to Tempero Mandibular Joint (TMJ).
Sandhu (2001) conducted a study on complaints of vision related problems like eyestrain,
blurred vision, headache, brow ache, neck ache, which are multiplying rapidly among
computer users. Although there is no evidence of any permanent visual damage from
prolonged use of computer even temporary impairment can be troublesome. Problem can be
sometime dangerous, if computer use at work impairs one’s distance vision, driving home can
be difficult. Good news is that computer does not emit hazardous radiation (neither ultraviolet
nor ionizing radiation). Even daily use for years together should not cause permanent myopia
or speed up development of myopia more than reading books or doing similar works. Several
survey of people who work on computer indicate that 75% of them experience one or other
reversible eye problem.
According to B.C Rathna human being blink 22 times per minute, while on computer
we do not blink too often. The lower blink rate cause dryness and discomfort feeling that there
is something inside the eyes. As most people who work on computer are on air condition
environment, this adds to dryness. Blinking voluntarily for 20 second every 20 minute can
reduce the problem.
Indian express (2002) published an article on the effects of computer on eyes. The
effects of computer on eyes can broadly divide into two categories (a). Those related to long
period of near work on computers (b). Those related to electro magnetic emission from
computers. When you work on computer for long hours eye muscles will have to work hard
maintaining focus and parallel alignment of eyes. This will leads to fatigue of this muscle
which will cause eye strain. Another reason for eye strain is its interference with the tear film.
Usually we blink 10 to 15 times per minute. While working on computer, we blink less, and
then the tear film breaks and the surface of eye becomes dry affecting the lubricating effect
between the lid and the eye.
Praveen in his article on the Hindu News (2008) “experts warn of computer vision
syndrome” stated that we might be one among those who spend most of our time in front of
computer screen. He warns us that we should be aware for we might fall victim to computer
vision syndrome.
Jean (2008) in her article on KING 5 NEWS says how to protect eyes from computer
vision syndrome. Tens of millions of people spend 4 to8 hours in front of computer everyday,
and its only going to get worse. All that time can have an Impact on your eye sight; chances
are there for you suffer from a syndrome you don’t even realize you have, like millions who
suffer from computer vision syndrome. Sometimes they feel like there’s sand in their eyes,
said Dr Richard ophthalmologist.
4. Clinical manifestations of computer vision syndrome
Speedy (1992) reported a survey that ranks the symptoms of computer vision syndrome
in order of their frequency. Frequency of complaints includes;
1. Eye strain
2. Headache
3. Slowness in changing focusing distance
4. Blurred vision after close up work
5. Eye irritation
6. Contact lens discomfort
National Institute of Occupational Safety and Health (1997) conducted a study on
symptoms of computer vision syndrome and indicate that eighty eight percent of people work
at computer more than three hours a day suffer from symptoms of eye strain. Number of
computer vision syndrome sufferer seeking help is on the rise growing from ten million in
1992 to fifteen million in 1995.
American Optometric Association (1997) study reveals that dryness in the eyes, eye
strain eye irritation watering from the eyes, redness ,blurred vision, double vision, slow
refocusing, headache, are universal complaints among computer user who put in long hours in
front of computer screen
National Institute of Occupational Safety and Health (1997) indicated that 88 percent of
people working at computer more than 3hours a day suffer from symptom of eye strain,
dryness in the eyes, eye strain, eye irritation, watering from the eyes, redness, blurred vision,
double vision are universal complaints among computer user who put in long hours in front of
computer screen
5. PREVENTION OF COMPUTER VISION SYNDROME
Sandhu (2001) conducted a study on prevention of vision related problem. People
who wear bifocals or progressive lens are forced to tilt their head back to see the screen. Even
with a head tilt, the image is not as clear as it should because the prescription issued for reading
lens is adjusted for eye – to page distance of 16 inches at an angle of 30 degree. But computer
screen are usually 20-24 inches away at an angle of 15 degree. Periodic rest breaks are crucial
after every 20 minutes of working on computer look up and focus at a distant object for 2
minutes. During this 2 minutes do some stretching exercise for relieving tension on your neck
and back. Frequent blinking and using eye drops like refresh tears will help to reduce dryness,
irritation and eye strain.
Home Vision Therapy Program (2003) cited that eye strain is the number one complaint
of office workers today, but it can be treated. Good vision is more than just the ability to see
clearly. It is the ability to understand and respond to what is seen-from whatever source for
hours an end. Human eyes were designed for outdoor functions-for our hunter-gatherer
ancestors such as spotting games or dangers at a distance. The vision skill that served our
ancestors is different from those we need in modern society, especially in front of a computer
viewing text and on our vision system capabilities. Today, nearly all our visual demand on the
job and during recreation has shifted to close up, within arms length.
Near vision work requires that your eyes work as a team called binocular vision a) to
coverage-aiming together to combine the images from each eye into one. b) to accommodatecurving the lens to bring images into clear focus. c) to fixate – moving the eyes across the
computer screen finding and then jumping to the next line. Today, computer user must persist
in this complex visual task for many hours on end – a stress for which our eyes were not
designed. Vision therapy can retrain your eye muscles to meet the visual demand of twenty
first century.
Cornell University (2003) research at Cornell University in New York found that
computer worker who take break are more productive those who don’t. Cornell professor
Alan Hedge says that workers who receive screen alerts are 13percent more accurate in their
work than those who don’t.
Mary (2008) conducted a survey on computer vision syndrome and promotion of
specific measures in the management of computer vision syndrome among computer
professionals .It was found that there is positive influence of age of computer professionals,
the number of years of work on computer and the numbers of hours on computer per day on
number of symptoms of computer vision syndrome multiple co- relation shows a linear
relationship among age, symptoms of computer vision syndrome, hundred and fifteen
computer professionals are having one or more symptoms of computer vision syndrome. The
leading symptoms is eyestrain and more prevalent in those who are in medical transcription.
Most of the computer professionals have adopted specific measures for their symptoms and
they express relief of symptoms by the particular measures, only 9 computer professionals
sought medical aid, so practicing eye exercises regularly. This reveals the worth of specific
measures in the management of computer vision syndrome.
Blink, breath and break says M.P Praveen in his article on Hindu news 2008 blinking
20 times a minute, breathing 20 times a minute increase blood flow, and taking a break after
20 minutes of non stop works can prevent the prevalence of computer vision syndrome.
6. Studies related to knowledge, attitude and practice regarding computer vision
syndrome
Indian Journal of Ophthalmology (2005) conducted a study on knowledge, attitude and
practices towards computer vision syndrome prevalent in Indian ophthalmologist and to assess
whether computer use by practitioner had any bearing on knowledge and practice in computer
vision syndrome. A random knowledge, attitude and practice survey was carried out on 300
Indian ophthalmologists using 34 point spot questionnaire. The results are all doctors
responded were aware of computer vision syndrome. The chief presenting symptom was eye
strain (97.8percent), headache (82.1percent) tiredness and burning sensation (79.1percent),
watering (66.4percent) and redness (61.2percent). Indian ophthalmologist using computer
reported that focusing from distance to near and vice versa.(p=0.026,chi square test).blurred
vision at a distance (p=0.016 chi square C test) and Blepharospasm (p=0.026 chi square test)
form part of the syndrome. Main mode of treatment used was tear substitution. Half of the
ophthalmologist 50.7 percentwere not prescribing by spectacles, they did not have any
reference for special Glasses 68.7 percent computer users were most likely to prescribe
sedative /anxiolytics (p=0.04chi square test) spectacles (p=0,02,chi square) and conscious
frequent blinking (p=0.003 chi square test) than non computer users.
6.3 STATEMENT OF THE PROBLEM
A study on knowledge and practice among computer professionals regarding computer vision
syndrome in a selected IT company at Bangalore.
6.4 OBJECTIVES OF THE STUDY
1. To describe the level of knowledge of computer professionals regarding computer vision
syndrome.
2. To elicit the level of practices of computer professionals regarding computer vision
syndrome.
3. To determine the co-relation between knowledge and practice of computer professionals
regarding computer vision syndrome.
4. To find out the relationship between demographic variables and knowledge
and practice
of computer professionals regarding computer vision syndrome
6.5 HYPOTHESIS
H (1): There is a significant relationship between knowledge and practice of computer
professionals regarding computer vision syndrome
H (2): There is an association of knowledge and practice of computer professionals regarding
computer vision syndrome with socio demographic variables.
6.6 OPERATIONAL DEFINITIONS
Knowledge: Information gained through experience and education measured using structured
questionnaire on knowledge regarding computer vision syndrome
Practice: Following few strategies to prevent eye related health problems by computer
professional elicited using structured questionnaire on practice regarding computer vision
syndrome.
Computer professional: A person who is skilled in a computer job and working in the
computer for minimum of 6 hours in a day
Computer vision syndrome: It is the complex of eye and vision problems such as redness,
watering of the eyes, double vision, and blurred vision related to near work which are
experienced during or related to computer use.
I.T. Company: An information technology company where the primary business of which
involves the provision or development of hardware and software for a better today and
tomorrow.
6.7ASSUMPTIONS
1. Level of knowledge and practice differ from individual to individual
2. Knowledge level influences the practice
3. Socio demographic variables affect the level of knowledge and practice
4. Health message have an effects on level of knowledge and practice.
7. MATERIALS AND METHODS
7.1 Source of data:
Computer professionals working in I.T. company at Bangalore
Method of data collections Procedure
Research Method
: Descriptive method
Research design
: Descriptive co-relational design
Sampling technique
: Convenience sampling technique
Sample size
: 100 samples
Setting of the study
: study will be conducted in a selected I.T. company at
Bangalore.
7.2.1: SAMPLING CRITERIA
Inclusion criteria
1. Computer professionals working in I.T. Company with minimum of I year experience
2. Age group between 20-45 years
3. Willing to participate in the study
Exclusion Criteria
1. Computer professionals in leadership positions.
7.2.2: DATA COLLECTION TOOL
A structured self administered questionnaire will be prepared to assess the knowledge
and practice of computer professionals regarding computer vision syndrome.
Content validity will be ascertained in consultation with guide and experts form various
fields Reliability of the tool will be established by spilt half method
Prior to the study written permission will be obtained from the concerned authority of
IT company. Further verbal consent will be taken from the computer professional regarding
their willingness to participate
The questionnaire has two aspects like base line information and specific information.
Base line information includes age, sex, educational status, number of years of working on
computer, number of hours of working on computer per day, use of glass and hobbies. The
specific information was related to the knowledge on computer vision syndromes and practice
adopted by computer professionals to prevent computer vision syndrome.
7.2.3: DATA ANALYSIS METHOD
Data analysis will be done using 1.descriptive statistics like (i) frequency distribution
(ii) Percentage, (iii) mean, and (iv) standard deviation. 2. Inferential statistic like chi-square
and co-relation co-efficient will be used.
7.3: DOES THE STUDY REQUIRE ANY INVESTIGATION OR
INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR OTHER
HUMAN OR ANIMALS?
NO
7.4: HAS ETHICAL CLEARANCE BEEN OBTAINED
YES
Confidentially and anonymity of the subjects will be maintained. Consent will be obtained
from the computer professional before conducting the study.
LIST OF REFERENCES
BOOKS
1. Barbara Kozier et al., “Fundamentals of nursing concepts, process and practice’.
Philadelphia, Benjamin cunnings publishing company, 5th edition, 1995.
2. Burns Nancy et al., The practice of nursing research conduct, critique and utilization.
Philadelphia W.B Saunders publisher, 3rd edition, 1998.
3 ChatterjeeB.M Handbook of opthalmalogy, delhi, CBS publishers and distributers,4th
edition,1998.
4.Potter and Perry ; Fundamentals of Nursing Concepts, Process and Practice; Elsevier
publisher 9th edition 2000.
5. Tortora G.J.P ; Principles of anatomy and physiology; Harper Collins college publishers
;11th edition 2006.
JOURNALS
6 Alen Hedge; research at cornell university new York; the computer eye strain journal 2003 .
7 .Sharma A.K., ;computer related problems among IT professionals in Delhi , Indian Journal
Of opthalmalogy, volume 31.no1 Jan-march 2006.
8 A survey of 30 computer professionals in Udaipur Rajasthan,Indian journal of
opthalmalogy. Volume 5. no 4 april 2006.
9 Computer related vision reaching crisis;National institute of occupational setting and
health.1995.
10 Dr Arun sanpreet ;study on computer vision syndrome most frequently reported health
problems.Indian Journal of Othalmalogy vol 6 ,no 4 july 2006.
11. Effects of computer on eye ;Indian express Chandigarh 24 july 2001.
12 HTS home vision therapy programme 2003; eye strain is the number one
complaint of office workers today.
13. Jeffrey Ansher OD; Computer Vision Syndrome; The eye to eye;
Computer Eyestrain Journal April 2002.
14. Jeffrey Ansher OD; Dry eye Syndrome; The eye to eye; Computer
Eyestrain Journal April 2003.
15. Osha article computer use is growing exponentially Nature Eye Care 1999.
16 Paramsad;community based study of asthenopia in computer
operators;department of community medicine 2008
.
17 Research study on knowledge attitude and practice towards computer
vision syndrome prevalent in Indian ophthalmology jan-2005.
18 Sheedy R.;a survey that ranks the symptoms of computer vision
Syndrome in order of their frequency; journals of America optometric
Association 1992
19 Zheng Albany; computer vision syndrome;a widely spreading but largely unknown
epidemic among computer users;computers ihuman behavior vol 24 ;issue 5 sept-2008
UNPUBLISHED THESIS
20 S.R.Mary;a survey of computer vision syndrome and promotion of
specific measures in management of computer vision syndrome among
computer professionals’ sc(N) thesis , college of nursing; Coimbatore.
NEWS PAPER
21. Editor B.C rathna ;Do not close your computer vision syndrome ;The Hindu News
Wednesday 21 nov-2007.
22. Editor; ‘see better live better ’ Times of India; Bangalore sat-11 2008.
23.Editor Jean enerson; ‘protect your eyes from computer vision syndrome’’; King 5 news
thurs-oct 9 2008.
24. Editor. M.P.Praveen; Experts warn on computer vision syndrome; The Hindu News wed,
–feb-20 2008.
25. Editor Sahana chavan; Lower blink rate causes dryness; The Hindu News wed 21 nov
2007.