Investigations on the comparison between electronic and non-electronic near work on symptomatic health concerns and ocular changes / Saiful Azlan Rosli

Background: Over the years, technology has revolutionised our world and impacted our lifestyles. Extended technology exposure has been linked to both physical and mental health concerns. Extant literature on electronic health risks has primarily focused on office workers or schoolchildren. Although young people commonly use electronic devices, there is a dearth of information regarding daily usage patterns between the weekends and weekdays. Yet, very little attention has been paid to its effects on visual functions and changes in ocular structure in young adults. This thesis intends to compare the near work-related symptomatic health concerns, visual function, and micro-ocular structure changes between electronic and non-electronic near work among young adults. Methods: This study adhered to the Declaration of Helsinki. Three main research questions were examined using a survey and 2 experimental studies. The crosssectional quantitative method approach was employed. The survey studied weekend-weekday electronic related activities profile in young adults. Seven questions were used to inspect lifestyles regarding indoor-outdoor activities and near-work usage patterns. The symptomatology enquiry consisted of questions on general ocular, visual, ocular surface, and body sensation. The first experimental study inspected the effect of electronic near-work on visual function. The accommodation accuracy (accommodation lag) and accommodation stability (accommodation microfluctuations) were compared before and after the electronic and non-electronic near-work task using infrared open field binocular autorefractor Grand Seiko. The 2D Colour Analyser measured the luminance of near task and room illumination and illuminance spectrophotometer, respectively. The second experimental study focused on the microstructural changes after 20-minutes of the near task. Changes in the microstructure in choroidal thickness were assessed by 3D optical coherence tomography (OCT). The microstructural changes were observed between the baseline and after electronic and nonelectronic tasks. Results: Lifestyle and Symptomatology Survey: The analysis was performed on 220 respondents (age range=20.3±2.9 years old). Overall, young adults reported a preference for spending most of their hours each day on electronic near work than non-electronic near work. Young adults were found to have spent more time with electronics on the weekends than on the weekdays. The symptomatology patterns comprised 45% body, 43% ocular surface, 38% general ocular, and 32% visual sensation. Lower back pain (70%) was found to be the highest reported symptom, followed by shoulder (68%), and upper back/neck pain/tired eye (67% each). Vision Function Experiment: There was no significant change in the accommodation lag after 20 minutes near work on electronic and non-electronic. Similarly, there was no significant change in the accommodation microfluctuations after 20 minutes near work on electronic and non-electronic. Microstructure Experiment: There was a significant thinning of choroidal thickness after 20-min reading. Approximately 31.17 μm choroidal thinning after electronic and 28.00 μm choroidal thinning was observed after non-electronic reading. Although the microstructural change in choroidal thickness was noted to be slightly higher for the electronic than the non-electronic reading, but not statistically significant. Conclusion: This thesis provides more insight into the visual adaptation behaviour in dealing with vision stress between electronic and non-electronic near-work. The lifestyle of young adults inclined towards the indoor trend, pre-eminent electronic engagement with notable reported health symptoms. The baffling predisposition lingered over the weekends. The robust accommodation system responding to electronic and non-electronic near work was expected because young people are shielded with sufficient accommodation, so they automatically accommodate to keep things clear. This might imply an efficient readjustment mechanism of the accommodation system in young adults. However, this efficacy was not translated into micro-ocular structures reaction. Choroidal thinning was more evident in electronics than non-electronic near work. This unique discovery stipulates further investigation. Future studies on the longitudinal effects of excessive electronic exposure might warrant the added value of understanding electronic vision stress.