Dear ASU Health and Wellness Services,
We are undergraduate students at the ASU. As undergraduates in this time when technology is thriving and is a large part of our lives, we have experienced how it affects students around our age. We would like to propose some solutions about what can be done to combat the effects of technology when it comes to the health of students’ eyes.
The problem we have noticed is how technology is affecting the ocular health of college students. Our proposal for the issue the declination of health in students’ eyes is having an area set up in the Health Center or the Union where students can get their eyes checked if they are not able to go to an optometrist on their own or have not found the time to do so. This event would be hosted for a week at the beginning of both the fall and spring semesters. The total price we would be proposing is a one-time payment of $1250 as well as $15,260 twice a year during the event.
For the equipment, the Snellen eye chart and a few basic machines to test students’ eyesight and health would be sufficient. This is because the event is not treating nor determining prescriptions for the students. Rather, it will be checking for ocular health concerns and educating the students on preventative measures and treatments. The purpose of this project is to bring awareness to the ocular health of students at the Arizona State University during this ever-changing and advancing technological time.
We appreciate your consideration of our request.
Executive Summary
The purpose of this proposal is to determine the statistics on the ocular health of college students and assist them with the help needed for their symptoms of ocular discomfort. The biggest issue causing these ocular issues is the amount of screen time they are exposed to each day. Over the last decade, technology has greatly advanced. This has led to universities having most of their content accessible online, causing the increased screen time that students are experiencing.
It is not typical for students to be concerned about their ocular health during the school year as they are kept busy with classes and work. Ocular symptoms will advance the longer they are ignored, and not everyone makes time to go to an optometrist with their busy schedule. Yet, having an event dedicated to ocular health on campus would increase accessibility. To accomplish this event, we are proposing the following:
Having a field week twice a year with an optometrist
Blue light glasses available
Advertising preventative exercises around campus
Price Summary
Asset
Quantity
Cost
Total Cost
Optometrist
1
$3,500
$3,500
Non-contact Tonometry (NCT)
3
$400
$1,200
Blue light glasses
250
$25
$6,250
Food for Volunteers
80
$10
$800
Marketing
1
$10
$10
Small equipment
1
$50
$50
Total Cost
$11,810
The cost of an optometrist is about $1,200 over the average pay for a single week for an optometrist because we need an incentive for them to take a week off their practice to come to the campus and do our field week. The non-contact tonometry equipment costs about $360 each but the cost of tax and shipping would bring the cost up to around $400 for each machine. For the blue light glasses estimate, there is about 2,500 students that live on campus, so we estimated around 10% of people would come and want the glasses. Feeding the volunteers would be about $10 per meal with 16 people a day for 5 days. Marketing isn’t a big cost because the flyers would just be printed on regular printer paper. The other form of marketing that this would need would be on email through the ASU newsletter which wouldn’t cost any money. The small equipment that we need would be a flashlight for the optometrist to observe inside the patient’s eyes, spoons to cover up eyes while the other eye is being tested, and a box of latex gloves for the volunteers and the optometrist to wear. That would bring our costs to $11,810 for the week.
Lit Review
Before delving into the specific effects of technology on vision, it is important to rule out other factors perceived to be the cause of eye strain. For instance, screen time may not be the main factor leading to ocular discomfort. Rather, the cause could be the continuous near-vision tasks involved with technology. It was determined that there are significant differences in symptoms between reading aloud from a screen versus from a hardcopy. Subjects experience more advanced symptoms while reading off a monitor compared to reading from a paper. The most common symptom reported was blurred vision. This blurred vision led to difficulty refocusing, causing eyestrain. (Chu 2011).
Mark Rosenfield (2016) provided an explanation as to why dry eye and eyestrain symptoms are much more severe while viewing computer screens, discussing the factors of screen time that contribute to the symptoms described by Chu (2011): gaze angle, text size, glare, and blink rate. When viewing screens, people tend to have their eyes at a primary (forward) or depressed angle. At the primary angle, more of the eye is exposed causing tears to evaporate at an increased rate. Furthermore, the text on screens is relatively small. This forces the subject to focus intensely on the screen, causing a change in their blink pattern. To see the text clearly, people will blink less often or incompletely. The decreased and incomplete blinking contribute to the increased evaporation of tears. These components are why subjects from Chu’s study experienced more eyestrain when they read from a screen versus from a hardcopy.
Now that it has been determined that screen time is the leading cause of symptoms related to ocular health, it is important to compare the different types of technology and screens. While subjects viewed a range of screen sizes and modes, Lee (2021) observed brain waves in different regions of the brain. The results paralleled Rosenfield’s observations: a positive correlation between screen size, advanced visual modes, and eye strain. This is because the large screens and advanced visual modes are inconsistent with the body’s natural sensory receptors.
Experts have introduced a modern condition associated with the effects of technology on ocular health: computer vision syndrome, or CVS. This condition involves dry eyes and eyestrain caused by prolonged computer use. Not only do screens cause computer vision syndrome, but long-term use also leads to more serious conditions including glaucoma, cataracts, and dry eye disease. To discover these conditions, specifically glaucoma, a non-contact tonometer (NCT) would be used. This machine measures the pressure inside the eye, detecting damage to the optic nerve. Discovering early stages of glaucoma, cataracts, dry eye disease, and the modern condition of computer vision syndrome is of paramount importance when it comes to the future ocular health of students.
In the light of the same, Agarwal et al. (2021) studied the rise in ocular problems with the use of technology subject to the Covid 19 environment. There was a rise in screen time for children where they developed problems like CVS or complex eye related concerns. Several eye-related issues have emerged with the rise of a pandemic due to virtual education, video conferences, and shopping, gaming, and online entertainment. Parents reflected a lack of awareness of ocular health-related problems in children who got exposed to the prevailing situation of the pandemic. Technological dependency not only causes dryness in the eyes but also progresses towards myopia which expedites with eye rubbing due to prolonged use (Agarwal et al., 2021). Thus, through this study, a certain degree of exposure is directed towards the need to use technological devices judiciously.
However, Wang et al. (2020) counter the study of Agarwal et al. (2021) with the evidence that myopia prevailed in eastern parts of Asia at higher rates even before the introduction of technology. Several studies support the fact produced by Wang et al. (2021) which suggests that intensive schooling and education led to myopia in students. A positive relationship between myopia and education and intensive schooling has been developed. There is a minimal risk association between the use of technology, screen time, and visual impairment. Loughman & Flitcroft (2016) studied the impact of atropine within the Caucasian population of the student body. Atropine is an effective measure to control myopic progression with the usage of bifocal glasses. However, the added cost subjugated with the remedy is mydriasis and paresis. A low dose of atropine at 0.01% can provide a therapeutic effect to myopia. There will be no effect on the visual acuity and the reading speed of the students although a long-term impact with increased glare is observed.
Berner & Al-Mahdi (2012) examined the impact that the excessive use of television and the internet had on the visual impairment of school children aged 6-18 in Qatar. Children with visual impairment can suffer from delayed developmental growth and problems in education. With the increasing dependency on technology owing to the information age, television and the internet have become an inevitable part of our lives. The study categorized students into two groups namely: frequent and infrequent viewers and the results affirmed the close association between the use of the internet and television with low vision. The results suggested that low vision was more prevalent amongst the frequent users. Thus, the results confirm the explanation provided by Rosenfield and highlight frequent users wearing glasses were higher than that of the infrequent viewers. Modernization of technology has caused eye strains within the child age group which can adversely affect eyesight and health. The author also calls for the need for health education programs for controlling and preventing low vision by raising public awareness.
Pathak et al. (2021) in their study, regarding the close relationship between the excessive use of gadgets and eye strain, found out that the most frequent gadget users are aged 11-20 with usage reaching t 6-8 hours a day. These users are frequently accompanied by headaches, myopic astigmatisms, astigmatisms, hyperopic astigmatisms. Excessive use of screens during childhood can have an adverse effect on their lifestyle and uncontrolled usage can lead to conditions like increased risk of myopia and asthenopia. Other complaints also included patients squeezing eyes, head tilt, watering, and blurring of vision. This study confirms the concept laid by Agarwal et al. (2021), Rosenfield (2016), and Lee (2021).
The visible blue spectrum of light emitted from the devices can disturb the eyesight and impact the health of the eyes. It can lead to problems like asthenopia or digital eyestrain which includes symptoms like dryness of the eyes, heaviness of the eyes, and headaches (Qasim et al., 2021). There can be permanent damage to the retinal cells in the eye with prolonged exposure to the light rays. The research conducted by the author mostly included the age group of 18-25 years. This age group reportedly uses devices lying on the bed with dark or no room lighting. The usage of smartphones at an angle with a distance less than 18 cm increases the risk of myopia. The participants refer to the use of digital reading devices while lying on the bed. There are similar studies that confirm the development of myopia and eyestrain among the students who have the practice of using their devices in the above-mentioned posture or by craning their neck posture. The remittance of these blue lights from electronic devices can also disturb the sleep pattern of individuals and can have a more severe impact except eye-related issues. Qasim et al. (2021) that there were both refractive errors and ocular symptoms observed in his study about the usage of technological devices.
The well-being of student health is impacted by the excessive usage of technology, particularly mobile media. High usage in his study has a cutoff of more than two hours of screen time (Domoff et al., 2019). The prolonged usage of these devices interrupts the sleep health of the students and adolescents. Sleep quality of the children fluctuates with the bedtime use of social media and mobile phones. Another factor that is prevalent among the teenage group is social networking that results in nighttime awakening among the youths. Studies have found out that there is a negative association between physical activity or obesity and the device ownership of students (D Domoff et al., 2019). Excessive mobile device use can have a potential impact on physical health and can give birth to several problems like discomfort and musculoskeletal pain, eye strain, and headache. Long hours of usage have increased the risk of lower back pain and shoulder pain among the teenage group. There was a higher component of ocular problems in children with intermittent usage of more than 2 hours.
Isawumi & Akinsola (2016) conducted a study on the ocular health of students and causes of enrolment into special schools in Nigeria. There was an abnormal ocular finding observed among the students followed by blindness. The lower socio-economic group reported ocular pathologies cases among the population group used in the study. To aid the students while assisting with disabilities, technology, computers, and information were introduced which provided positive results towards the communication, and educational field. The majority of the MBBS student spend time on the computer and are prone to CVS and the most common ocular complaint was headache and dry eyes (Sitaula, & Khatri, 2018). The survey also concluded that the students had poor knowledge and awareness about CVS syndrome and the majority of them used their devices at eye level. FU, Chen, and Zheng (2020) studied the mediating roles of the smartphone, health issues, and academic performance using the Stimulus Organism Response framework. There is a partially mediating relationship between the overuse of smartphones and the academic performance of the student with health issues like poor eyesight, insomnia, and nomophobia. This can be reduced with the awareness of health information literacy among the student group (FU, Chen, and Zheng 2020).
Thus, the increased use of digital devices and technological advancements have given birth to ocular problems within the student age group. Besides ocular problems, there are refractive errors that run parallel along with the ocular problem in the age group. The overall well-being of the individual is impacted by the prolonged usage of technology.
Proposal
Ocular health is becoming a more prevalent problem with people nowadays. For most of the activities that we do throughout the day, we are looking at screens. When students have free time, they look at their phones and computers. When students do homework, they are also looking at a screen. When added up, the amount of time students spend looking at a screen is unhealthy. Eye tests need to be performed on these students in order to prevent the worsening of symptoms.
Our plan is to have an optometrist come to campus along with volunteers to do eye tests for a week. They will be testing students’ eyes and informing them on what their next steps should be if they have a ocular problem. The optometrist will not be giving the patients eye prescriptions; rather, they will be testing different variables related to ocular conditions in the students’ eyes and looking to see if any issues are present.
Concluding Statement
With increasing symptoms of ocular discomfort, it is important to act before advancements of the symptoms occur; therefore, eye check services should be available to the student body. These services will provide information on the symptoms of ocular discomfort, tools for an eye check, and information on ways to prevent or treat the symptoms by having the following available:
Having a field week twice a year with an optometrist
Blue light glasses available
Advertising preventative exercises around campus
To accomplish these goals, a testing event should take place on campus. It is imperative to act as soon as the symptoms of ocular discomfort appear to prevent advancements of more serious conditions. The testing event hosted will make a difference in student ocular health by informing the student body on preventative measures and guidance on what treatments should be done.
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