{'fraction_non_alphanumeric': 0.0409859558612783, 'fraction_numerical': 0.03582688449412439, 'mean_word_length': 4.879528222409435, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 2, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
A Cross Sectional Study to assess prevalence of Computer Vision Syndrome and vision related problems in Computer Users

The aim was to assess prevalence of computer vision syndrome and find association of various factors with occurrence of symptoms. Methods- In this cross-sectional study participant were surveyed using self administered questionnaire and underwent complete ophthalmological and dry eye assessment. Results- A total of 150 participants aged 18-40 years were examined. Majority of the patients were in the age group of 26-30 years, who accounted for 57 cases i.e. 38% of total cases. Male and Female sex distribution was unequal in this study. Males 81 (54%) and females 69 (46%). The prevalence of symptoms of CVS was found to be 75.33% (113/150); most disturbing symptom was headache 101/150 (67.33%), tired eyes 76(50.66%) ,pain behind eyes 74(49.33%) Majority of patients 97 (64.66%) used computer for 4-6 hours. Abnormal TBUT 56 (37.4%), Schirmer’s Test II 42 (28%), Tear height meniscus 59 (39.4%), fluroscein staining findings 15 (10%), lissamine green staining findings 20 (13.33%) and conjunctival impression cytology findings were reported as mild dysplasia in 25 (16.66%), moderate dysplasia 7(4.66%), severe dysplasia 3 (2%), acute inflammatory lesions 5 (3.33%) & inclusion of Chlamydia trachomatis body was seen in 1. Knowledge about CVS was present in 65(43.33%). Conclusion- Most participants had CVS and its severity was correlated with prolonged working hours on


INTRODUCTION
Computers are being used increasingly by large number of people today. There has been a great advancement in the information technology in the past few decades. The use of computer has made life easier and has increased the work productivity tremendously [1] . In this present era, with excessive computer usage there has been an outbreak in computer related health problems. This has led to an increase in the number of patients complaining about ocular and non ocular symptoms related to computer use which are being grouped together as COMPUTER VISION SYNDROME (CVS). Computer has become an integral part of office equipments and in routine life. However, working at a computer terminal is not free from health hazards and computer users are experiencing a variety a vision related complaints which is collectively referred to as Computer Vision Syndrome(CVS) (Tamez-Gonzalez et al, 2003) [2]. American Optometric Association (AOA) has defined Computer Vision Syndrome as a complex of eye and vision associated problems mainly related to activities which stresses the near vision and which are experienced in relation or during the use of computer (Americian optometric Association 2010, Loh and Reddy, 2008). [1] [3] Blehm et al, 2005 [4] categorized the symptoms in four major categories: i. Asthenopic-eye strain, tired eyes, sore eyes ii.
Ocular Surface Related-watering, irritation, dry eye iii. Visual-blurred vision, slowness of focus change, double vision and iv.
Extraocular-neck pain, backache, shoulder pain Numerous factors accounting for Computer Vision Syndrome are duration of usage, poor lighting, screen brightness, environmental factors, vision problems & improper work station set up also account for eye & visual problems associated with computer. The aim of this study is to identify the prevalence of CVS AND major visual and systemic manifestations among the computer users also enlighten the public health professionals on the need of spreading awareness regarding health hazards associated with computer use.

MATERIALS AND METHODS
Study was cross sectional study conducted in MGM Medical college, Indore between 2015 July-2015 june. The study was approved by the local ethics committee and written informed consent was obtained from all subjects prior to participation. All participants were surveyed using self administered questionnaire and complete ophthalmic examination was done. A total of 150 computer users below 40 years age were included.

Inclusion Criteria
1. Subject working on computer for atleast 3 hours per day daily since 6 months and not using lubricating drops 2. Subject giving consent for the study Exclusion Criteria 1. Subject who did not give consent for the study 2. Subjects older than 40 years are excluded because of age induced vision problems of presbyopia 3. Contact lens users 4. Known case of dry eye disease and ocular motility disorder. 5. Subject using drugs (systemic/topical) causing dry eye

COMPLETE OPHTHALMIC ASSESSMENT
The patients were examined for their VA on snellen's chart on the first OPD visit. Detailed history (ocular and systemic symptoms) were noted and they were requested to fill the questionnaire provided to them. The detailed examination of patients were done under the following heading: 1. HISTORY a) Subjects were registered with their name, age, sex and address b) Relevant history from the patients was taken regarding -Headache, blurring of vision, watering, redness -Shoulder pain, neck pain, backache -Rule out conditions associated with dry eye 2. EXAMINATION a) A comprehensive general examination of all subjects was done to rule out any systemic illness. Any history regarding diabetes, hypertension, Rheumatoid Arthritis, Alcohol abuse, smoking, tobacco intake was be noted.            [5] reported prevalence of 76%, Zairina et al (2011) [6] -68.1% , Seshadhri et al (2014) [7] 69.3% In our study knowledge about Computer vision syndrome was present in 65 participants (43.33%).
Other studies like Stella C et al (2007) [10] , Zairinia Et al (2011) [6] and Lograj et al (2014) [12] also reported significant association of long working hours with computer and adverse effect. Following strategies have been reported by researchers to reduce the symptom of CVS-Taking regular breaks in between use of computer was the most preventive measure taken for relief of symptoms in form of rule 20/20/20 as suggested by Anshel (2005) [14] i,e after 20 minutes of computer use , one should look at distant object 20 feet away for 20 seconds, maintaining good sitting posture, use of eyedrops, use of antiglare screen has been reported to reduce the symptoms of CVS.  [15] reported positive schirmer's findings in 38.5%, Sanjeev kumar et al (2013) [16] reported conjunctival impression cytology-stage 4 in 90% and Rahul Bhargava et al (2014) [17] reported TBUT-48.5% , Schirmer's test-38.4% and Conjunctival impression cytology abnormal in 38.4%

CONCLUSION
In conclusion, in our study males were predominantly affected because of their nature of work. The age group of 26-30 years formed the core group of people to get symptoms of CVS.
Though, in our study the sample size was small the final outcome showed majority of computer users were suffering from Computer Vision Syndrome. Proper knowledge, work station setup and regular follow up with ophthalmologist and physician can reduce the computer related morbidity and improve the work performance among computer users.