Contribution of Total Screen/Online-Course Time to Asthenopia in Children During COVID-19 Pandemic via Influencing Psychological Stress

Lin Li; Jing Zhang; Moxin Chen; Xue Li; Qiao Chu; Run Jiang; Zhihao Liu; Lili Zhang; Jun Shi; Yi Wang; Weizhong Zhu; Jian Chen; Pengcheng Xun; Pengcheng Xun; Jibo Zhou

doi:10.3389/fpubh.2021.736617

Frontiers in Public Health (Dec 2021)

Contribution of Total Screen/Online-Course Time to Asthenopia in Children During COVID-19 Pandemic via Influencing Psychological Stress

Lin Li,
Jing Zhang,
Moxin Chen,
Xue Li,
Qiao Chu,
Run Jiang,
Zhihao Liu,
Lili Zhang,
Jun Shi,
Yi Wang,
Weizhong Zhu,
Jian Chen,
Pengcheng Xun,
Pengcheng Xun,
Jibo Zhou

Affiliations

Lin Li: Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Jing Zhang: Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Moxin Chen: Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Xue Li: Center for Single-Cell Omics, School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Qiao Chu: Center for Single-Cell Omics, School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Run Jiang: Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Zhihao Liu: Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Lili Zhang: China Hospital Development Institute, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Jun Shi: Dongtai Tangyang High School, Yancheng, China
Yi Wang: Department of Ophthalmology, Jiaxing First Hospital, Jiaxing, China
Weizhong Zhu: Department of Ophthalmology, Shouxian Hospital, Huainan, China
Jian Chen: Huangpu District Center for Disease Control and Prevention, Shanghai, China
Pengcheng Xun: Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
Pengcheng Xun: Department of Global Value Access and Outcomes, Atara Biotherapeutics, Thousand Oaks, CA, United States
Jibo Zhou: Department of Ophthalmology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

DOI: https://doi.org/10.3389/fpubh.2021.736617
Journal volume & issue: Vol. 9

Abstract

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Objectives: During the coronavirus disease 2019 (COVID-19) self-quarantine period, the transition to online-course has profoundly changed the learning modes of millions of school-aged children and put them at an increased risk of asthenopia. Therefore, we aimed to determine associations of the total screen/online-course time with asthenopia prevalence among that children during the COVID-19 pandemic, and whether the associations were mediated by psychological stress.Methods: Asthenopia was defined according to a validated computer vision syndrome questionnaire (CVS-Q). We used CVS-Q to collect the frequency and intensity of 16 asthenopia-related eye symptoms of 25,781 children. Demographic features, eye care habits, visual disorders, lifestyle, psychological and environmental factors, were also collected.Results: The overall asthenopia prevalence was 12.1%, varying from 5.4 to 18.2% across grade/gender-classified subgroups. A 100-h increment of total screen/online-course time were associated with an increased risk of asthenopia by 9% [odds ratio (OR) = 1.09] and 11% (OR = 1.11), respectively. Mediation analysis showed that the proportions of total effects mediated by psychological stress were 23.5 and 38.1%, respectively. Age, female gender, having myopia or astigmatism, bad habits when watching screens were also risk factors. Conversely, keeping 34–65 cm between eyes and screen, increased rest time between classes, and increased eye exercise were all associated with a decreased risk.Conclusion: Our study indicated that the influence of long total screen or online-course time on psychological stress increases asthenopia risk. The findings of this study have provided a new avenue for intervening screen-related asthenopia in addition to incorporating a reasonable schedule of online courses into educational policy.

Published in Frontiers in Public Health

ISSN: 2296-2565 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.frontiersin.org/journals/public-health

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