Determinants of Digital Eye Strain Among Office Workers:  Individual, Device-Related, and Environmental Factors

Nabilah Nur Hasanah; Iting Shofwati; Yustinus Denny Ardyanto Wahyudiono

doi:10.33096/woh.vi.2861

Nabilah Nur Hasanah Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Indonesia
Iting Shofwati Department of Public Health, Faculty of Health Sciences, UIN Syarif Hidayatullah Jakarta, Indonesia
Yustinus Denny Ardyanto Wahyudiono Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Indonesia

DOI: https://doi.org/10.33096/woh.vi.2861

Keywords: Anti-Glare, Digital Eye Strain, Light Intesity, Rest Pattern

Abstract

Frequent use of digital devices among office workers contributes to a high risk of Digital Eye Strain (DES), with a reported prevalence of 69.0%, which can adversely affect visual performance, sleep quality, and work productivity. This study aimed to analyze the association between individual, device-related, and environmental factors with DES among office workers using a cross-sectional design involving 66 respondents. Data were analyzed using Chi-square and Mann–Whitney tests. The prevalence of DES was 69.7%, with common symptoms including itchy eyes, eye discomfort, and light sensitivity. Key individual factors significantly associated with DES were unsafe digital device use behavior (OR = 11.25; 95% CI: 1.169–30.280), lack of 20-20-20 rest practice (OR = 10.00; 95% CI: 2.895–30.542), and refractive error (OR = 8.20; 95% CI: 2.287–23.399). Among device-related factors, improper computer screen position (OR = 4.263; 95% CI: 1.323–13.736) was identified as a significant predictor. Environmental factors such as inadequate lighting (OR = 5.455; 95% CI: 1.595–18.657) also showed a strong association with DES. In conclusion, DES among office workers is predominantly influenced by behavioral factors, particularly unsafe digital device use and inadequate eye rest practices, which demonstrated the strongest associations. Preventive strategies should prioritize behavioral interventions, ergonomic improvements, and optimization of workplace environmental conditions.

References

American Optometric Association. Computer vision syndrome. American Optometric Association. 2024. [accessed 8 Jun 2025] Available from: https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y

Ccami-Bernal F, Soriano-Moreno DR, Romero-Robles MA, Barriga-Chambi F, Tuco KG, Castro-Diaz SD, et al. Prevalence of computer vision syndrome: A systematic review and meta-analysis. Journal of Optometry. 2024;17(1):1–15.

Baxter R, Hastings N, Law a., Glass EJ. Universal Eye Health 2014-2019 WHO. World Health Organization. 2008;39(5):561–3.

Foreman J, Salim AT, Praveen A, Fonseka D, Ting DSW, Guang He M, et al. Association between digital smart device use and myopia: a systematic review and meta-analysis. The Lancet Digital Health. 2021;3(12):806–18.

Lema AK, Anbesu EW. Computer vision syndrome and its determinants: A systematic review and meta-analysis. SAGE Open Medicine. 2022;10:1–10.

Data Reportal. Digital Around the World. Data Reportal. 2024. [accessed 10 Jun 2025] Available from: https://datareportal.com/global-digital-overview

Badan Pusat Statistik. Statistik Telekomunikasi Indonesia 2023. Jakarta: Badan Pusat Statistik; 2024.

Kementerian Komunikasi dan Informatika Republik Indonesia. Survey Penggunaan TIK Serta Implikasinya terhadap Aspek Sosial Budaya Masyarakat. Jakarta: Kementerian Komunikasi dan Informatika Republik Indonesia; 2018.

Battisti E, Alfiero S, Leonidou E. Remote working and digital transformation during the COVID-19 pandemic: Economic–financial impacts and psychological drivers for employees. Journal of Business Research. 2022;150:38–50.

Diab-Bahman R, Al-Enzi A. The impact of COVID-19 pandemic on conventional work settings. International Journal of Sociology and Social Policy. 2020;40(9–10):909–27.

McPhail R, Chan XW, May R, Wilkinson A. Post-COVID remote working and its impact on people, productivity, and the planet: an exploratory scoping review. International Journal of Human Resource Management. 2023;35(1):154–82.

León-Figueroa DA, Barboza JJ, Siddiq A, Sah R, Valladares-Garrido MJ, Adhikari S, et al. Prevalence of computer vision syndrome during the COVID-19 pandemic: a systematic review and meta-analysis. BMC Public Health. 2024;24(1):640.

Cantó-Sancho N, Porru S, Casati S, Ronda E, Seguí-Crespo M, Carta A. Prevalence and risk factors of computer vision syndrome—assessed in office workers by a validated questionnaire. PeerJ. 2023;11:1–9.

Pavel IA, Bogdanici CM, Donica VC, Anton N, Savu B, Chiriac CP, et al. Computer Vision Syndrome: An Ophthalmic Pathology of the Modern Era. Medicina. 2023;59(2):412.

Tesfaye AH, Alemayehu M, Abere G, Mekonnen TH. Prevalence and Associated Factors of Computer Vision Syndrome Among Academic Staff in the University of Gondar, Northwest Ethiopia: An Institution-Based Cross-Sectional Study. Environmental Health Insights. 2022;16.

Zenbaba D, Sahiledengle B, Bonsa M, Tekalegn Y, Azanaw J, Kumar Chattu V. Prevalence of Computer Vision Syndrome and Associated Factors among Instructors in Ethiopian Universities: A Web-Based Cross-Sectional Study. The Scientific World Journal. 2021;2021(1).

Nopriadi, Pratiwi Y, Leonita E, Tresnanengsih E. Faktor yang Berhubungan dengan Kejadian Computer Vision Syndrome pada Karyawan Bank. Media Kesehatan Masyarakat Indonesia. 2019;15(2):111–9

Sengo DB, da Deolinda Bernardo Pica A, Dos Santos II d’Alva B, Mate LM, Mazuze AN, Caballero P, et al. Computer vision syndrome and associated factors in university students and teachers in Nampula, Mozambique. BMC Ophthalmol. 2023;23(1):1–11.

Shadik RM, Widanarko B. Gambaran Kejadian Computer Vision Syndrome dan Faktor Risikonya pada Mahasiswa FKM UI di Masa Pandemi Covid-19. National Journal of Occupational Health and Safety. 2023;4(1):6.

Gasheya KA, Belay AA, Abegaze T, Zele YT, Daba C. Computer vision syndrome and ergonomic risk factors among workers of the Commercial Bank of Ethiopia in Addis Ababa, Ethiopia: an institutional-based cross-sectional study. Front Public Health. 2024;12:1–11.

Seguí MDM, Cabrero-García J, Crespo A, Verdú J, Ronda E. A reliable and valid questionnaire was developed to measure computer vision syndrome at the workplace. Journal Clinic Epidemiology. 2015;68(6):662–73.

Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Nomor 48 Tahun 2016 tentang Standar Keselamatan Dan Kesehatan Kerja Perkantoran. Kementerian Kesehatan Republik Indonesia. [accessed 10 Jun 2025] Available from: https://peraturan.bpk.go.id/Details/113097/permenkes-no-48-tahun-2016

Blehm C, Vishnu S, Khattak A, Mitra S, Yee RW. Computer Vision Syndrome: A Review. Survey of Ophthalmology. 2005;50(3):253–62.

Loh KY, Reddy SC. Understanding and Preventing Computer Vision Syndrome. Malaysian Family Physician. 2008;3(3):130.

Tortora GJ, Derrickson B. Principles of Anatomy and Physiology. United States: John Wiley & Sons; 2009.

Huyhua-Gutierrez SC, Zeladita-Huaman JA, Díaz-Manchay RJ, Dominguez-Palacios AB, Zegarra-Chapoñan R, Rivas-Souza MA, et al. Digital Eye Strain among Peruvian Nursing Students: Prevalence and Associated Factors. International Journal of Environmental Research and Public Health. 2023;20(6):1–9.

Indah FPS, Listiana I, Aprilia I, Satriani S. FAKTOR PENCETUS COMPUTER VISION SYNDROME PADA PEKERJA PENGGUNA KOMPUTER. MAP (Midwifery and Public Health) Journal. 2022;2(1):36–44.

Wu Z, Begley CG, Port N, Bradley A, Braun R, King-Smith E. The Effects of Increasing Ocular Surface Stimulation on Blinking and Tear Secretion. Investigative Ophthalmology & Visual Science. 2015;56(8):4211–20.

Alemayehu AM, Alemayehu MM. Pathophysiologic Mechanisms of Computer Vision Syndrome and its Prevention: Review. World Journal of Ophthalmology & Vision Research. 2019;2(5):1–7.

Davies LN, Biswas S, Bullimore M, Cruickshank F, Estevez JJ, Khanal S, et al. BCLA CLEAR presbyopia: Mechanism and optics. Contact Lens and Anterior Eye. 2024;47(4):1–24.

Hall JE. Guyton and Hall Textbook of Medical Physiology. 12th ed. Philadelphia: Elsevier; 2011.

Hennelly ML, Barbur JL, Edgar DF, Woodward EG. The effect of age on the light scattering characteristics of the eye. Ophthalmic and Physiological Optics. 1998;18(2):197–203.

Chellappa SL. Aging, light sensitivity and circadian health. Aging. 2021;13(24):25606.

Guillon M, Maïssa C. Tear film evaporation-Effect of age and gender. Contact Lens and Anterior Eye. 2010;33(4):171–5.

Assefa NL, Weldemichael DZ, Alemu HW, Anbesse DH. Prevalence and associated factors of computer vision syndrome among bank workers in Gondar City, northwest Ethiopia, 2015. Clinical Optometry. 2017;9:67–76.

Uba-Obiano CU, Onyiaorah AA, Nwosu SNN, Okpala NE. Self-reported Computer Vision Syndrome Among Bank Workers in Onitsha, Nigeria. Journal of the West African College of Surgeons. 2022;12(3):78.

LL M, LZ F, PA S, SLP W. The Influence of Estrogen on Dry Eye Prevalence in Women. Journal of Clinical Ophthalmology and Eye Disorders.. 2021;5(1):1–4.

Matossian C, McDonald M, Donaldson KE, Nichols KK, Maciver S, Gupta PK. Dry eye disease: Consideration for women’s health. Journal of Women's Health. 2019;28(4):502–14

Derbew H, Nega A, Tefera W, Zafu T, Tsehaye K, Haile K, et al. Assessment of Computer Vision Syndrome and Personal Risk Factors among Employees of Commercial Bank of Ethiopia in Addis Ababa, Ethiopia. Journal of Environmental and Public Health. 2021;2021(1):6636907

Ekemiri K, McKnight D, Ekemiri C, Ezinne N, Ashang H, Victor V, et al. Computer vision syndrome and associated factors among urban and rural bankers in Trinidad and Tobago. PeerJ. 2024;12(12):2–12.

Bali J, Neeraj N, Bali RT. Computer vision syndrome: A review. Journal of Clinical Ophthalmology and Research. 2014;2(1):68.

Rosenfield M. Computer vision syndrome: A review of ocular causes and potential treatments. Ophthalmic and Physiological Optics. 2011;31(5):502–15.

Munshi S, Varghese A, Dhar-Munshi S. Computer vision syndrome—A common cause of unexplained visual symptoms in the modern era. International Journal of Clinical Practice. 2017;71(7):e12962.

Talens-Estarelles C, Cerviño A, García-Lázaro S, Fogelton A, Sheppard A, Wolffsohn JS. The effects of breaks on digital eye strain, dry eye and binocular vision: Testing the 20-20-20 rule. Contact Lens and Anterior Eye. 2023;46(2):1–9.

Lemma MG, Michael Beyene KG, Tiruneh MA. Computer Vision Syndrome and Associated Factors Among Secretaries Working in Ministry Offices in Addis Ababa, Ethiopia. Clinical Optometry. 2020;12:213–22.

Pratiwi Y, Lestari M. Hubungan Pengetahuan dan Sikap Mengenai Perilaku Pencegahan Computer Vision Syndrome Pada Karyawan Pengguna Komputer di Setco Group Pekanbaru. Al Makki Health Informatics Journal. 2023;1(2):65–80.

Pakpahan M, Siregar D, Susilawaty A, Tasnim, Ramdahny MR, Manurung EI, et al. Promosi Kesehatan dan Perilaku Kesehatan. Jakarta: Yayasan Kita Menulis; 2021.

Zayed HAM, Saied SM, Younis EA, Atlam SA. Digital eye strain: prevalence and associated factors among information technology professionals, Egypt. Environmental Science and Pollution Research. 2021;28(20):25187–95.

Heus P, Verbeek JH, Tikka C. Optical correction of refractive error for preventing and treating eye symptoms in computer users. Cochrane Database of Systematic Reviews. 2018;2018(4):1–64.

Das A, Shah S, Adhikari TB, Paudel BS, Sah SK, Das RK, et al. Computer vision syndrome, musculoskeletal, and stress-related problems among visual display terminal users in Nepal. PLoS One. 2022;17(7):1–13.

Nadhiva RF, Mulyono. The Relation between Symptoms of Computer Vision Syndrome and Visual Display Terminal Utilization. The Indonesian Journal of Occupational Safety and Health. 2020;9(3):328–37.

Occupational Safety and Health Administration. eTools : Computer Workstations | Occupational Safety and Health Administration. Occupational Safety and Health Administration. [accessed 10 Jun 2025] Available from: https://www.osha.gov/etools/computer-workstations/components/monitors

Anshel J. Visual Ergonomics Handbook. Boca Raton: CRC Press; 2005.

Ranasinghe P, Wathurapatha WS, Perera YS, Lamabadusuriya DA, Kulatunga S, Jayawardana N, et al. Computer vision syndrome among computer office workers in a developing country: An evaluation of prevalence and risk factors. BMC Research Notes. 2016;9(1):1–9.

Rochmayani DS, Cahyaningsih O. Risk Factors for the Incidence of Computer Vision Syndrome (CVS) in Lecturers During the Online Learning Period. Journal of Health Education. 2021;6(2):65–72.

Borchman D, Foulks GN, Yappert MC, Mathews J, Leake K, Bell J. Factors affecting evaporation rates of tear film components measured in vitro. Eye Contact Lens. 2009;35(1):32–7.

Rolando M, Refojo MF. Tear evaporimeter for measuring water evaporation rate from the tear film under controlled conditions in humans. Experimental Eye Research. 1983;36(1):25–33.

Baudouin C, Aragona P, Messmer EM, Tomlinson A, Calonge M, Boboridis KG, et al. Role of Hyperosmolarity in the Pathogenesis and Management of Dry Eye Disease: Proceedings of the OCEAN Group Meeting. The Ocular Surface. 2013;11(4):246–58.