OBJECTIVE: To compare the clinical efficacy between Wei's triple nine needling combined with esculin and digitalis glycosides eye drops and esculin and digitalis glycosides eye drops alone for presbyopia complicated with visual fatigue of liver depression and spleen deficiency. METHODS: Forty-six cases (92 eyes) with presbyopia complicated with visual fatigue of liver depression and spleen deficiency were randomly divided into an observation group (23 cases) and a control group (23 cases, 2 cases dropped off). The cases in the observation group were treated with Wei's triple nine needling and esculin and digitalis glycosides eye drops. The acupoints included Shangming (Extra), Chengqi (ST 1), Cuanzhu (BL 2) to Jingming (BL 1), Sizhukong (TE 23) to Taiyang (EX-HN 5), etc; the needling was given once every other day, three times a week, and the eye drops were given one drop each time, three times a day. The cases in the control group were only treated with the eye drops. Both groups were treated for 7 days as one course of treatment, and 2 courses of treatment were given. The visual fatigue core symptoms score, adjustment amplitude, adjustment lag and best average corrected visual acuity were observed in the two groups before treatment, 1 week and 2 weeks into treatment, respectively. RESULTS: Compared before treatment, the visual fatigue core symptoms scores in the two groups were decreased after 1-week and 2-week treatment (P<0.05); in the observation group, the adjustment amplitude was increased after 2-week treatment (P<0.05), while in the control group, the adjustment amplitude was increased after 1-week and 2-week treatment (P<0.05); in the observation group, the adjustment lag was decreased after 1-week and 2-week treatment (P<0.05). After 2-week treatment, the visual fatigue core symptoms score in the observation group was lower than that in the control group, and the adjustment amplitude was higher than that in the control group (P<0.05). There were no significant differences in adjustment lag and best average corrected visual acuity between the two groups after 1-week and 2-week treatment (P>0.05). CONCLUSION Wei's triple nine needling combined with esculin and digitalis glycosides eye drops could improve the visual fatigue and eye regulation ability in patients with presbyopia complicated with visual fatigue of liver depression and spleen deficiency, and the effect is better than esculin and digitalis glycosides eye drops alone.
Acupuncture Points ; Acupuncture Therapy ; Asthenopia ; Depression ; Digitalis Glycosides ; Esculin ; Humans ; Liver ; Ophthalmic Solutions ; Presbyopia ; Spleen ; Treatment Outcome

PURPOSE: To investigate ocular fatigue after the use of a head-mounted display (HMD)-type virtual reality device.METHODS: Healthy adult volunteers were examined for ocular fatigue before and after watching videos for 10 min with an HMD-type virtual reality device. Subjective ocular fatigue was measured using a questionnaire. Objective fatigue was measured using the critical flicker fusion frequency (CFF), high frequency component of accommodative microfluctuation, and accommodation amplitude. The accommodation amplitude was measured using the push-up method and the dynamic measurement mode of the autorefractometer. Changes in the spherical equivalent were also measured.RESULTS: The questionnaire-based subjective ocular fatigue increased (p = 0.020) after use of the HMD device. In the dominant eye, the high frequency component of accommodative microfluctuation increased (p < 0.05). The accommodation amplitude using the push-up method was decreased in the nondominant eye (p = 0.007), and temporary myopia was observed (p < 0.05). However, there was no increase in ocular fatigue in the CFF or the accommodation amplitude using the dynamic measurement mode, which showed no significant difference before and after using the HMD device (p > 0.05).CONCLUSIONS: A subjective test and some objective tests suggested that use of the HMD-type virtual reality display increased ocular fatigue. However, no increase in ocular fatigue was measured using CFF nor in the accommodation amplitude using the dynamic measurement mode which was a limitation of the study. More studies with the aim to alleviate ocular fatigue after using HMD-type virtual reality devices are therefore needed.
Adult ; Asthenopia ; Fatigue ; Flicker Fusion ; Humans ; Methods ; Myopia ; Volunteers

OBJECTIVE: To compare the therapeutic effects on the relevant symtoms in the patients with dry eye syndrome treated with the acupoint thread-embedding therapy versus topical artificial tears eye drops. METHODS: A total of 88 patients with dry eye syndrome of deficiency lacrima production were randomized into an acupoint thread-embedding therapy group (thread-embedding group) and a control group with topical artificial tears eye drops (medication group), 44 cases in each one. In the thread-embedding group, 3 cases were dropped out. In the thread-embedding group, Ganshu (BL 18), Pishu (BL 20) and Shenshu (BL 23) etc. were selected and the acupoint thread-embedding therapy was operated once every 30 days, totally for two treatments. In the medication group, the topical artificial tears eye drops was used, 4 to 6 times a day, one drop each time, for 8 weeks totally. Separately, before treatment, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears were determined and the scores of the relevant symptoms of ocular surface such as eye dryness, foreign body sensation in the eyes and eye fatigue were evaluated. RESULTS: In the thread-embedding group, after 4-week and 8-week of treatment as well as in 8-week and 12-week follow-up, the scores of eye dryness, foreign body sensation, burning sensation of eye, phengophobia and eye fatigue were reduced significantly as compared with those before treatment (all <0.05). In the medication group, the relevant symptoms of ocular surface were reduced after 4-week and 8-week treatment as compared with those before treatment (all <0.05). In the follow-up, the scores of the relevant symptoms of ocular surface in the thread-embedding group were significantly lower than the medication group (all <0.05). Separately, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears in the thread-embedding group were significantly increased as compared with those before treatment (all <0.05). The change was not obvious as compared with that before treatment in the medication group (>0.05). The levels of lactoferrin in tears at each time point after treatment in the thread-embedding group were higher than the medication group (<0.05). CONCLUSION The acupoint thread-embedding therapy effectively improves in the relevant symptoms of ocular surface, such as eye dryness, foreign body sensation, burning sensation of eye, phengophobia and eye fatigue, and increases the level of lactoferrin in tears in the patients with dry eye syndrome of deficiency aqueous production. In the follow-up, the therapeutic effects of the acupoint thread-embedding therapy are significantly better than artificial tears eye drops.
Acupuncture Points ; Asthenopia ; Dry Eye Syndromes ; therapy ; Humans

BACKGROUND: On-call work is a form of work that requires the person to work at any time during the on-call period. Thus, on-call work is often regarded as one of the most severe stress factors. This study investigates the associations between on-call work and health problems, injuries. METHODS: This study was based on the 3rd Korean Working Conditions Survey. Total of 29,246 employed workers who had been working for at least 1 year were included. Logistic regression analysis was performed to investigate the association between on-call work and health problems, injuries. RESULTS: The odds ratios for on-call workers in terms of physical health problems, psychological health problems, and injuries were 1.33 (95% confidence interval [CI] 1.22-1.44), 1.31 (95% CI 1.08-1.60), and 2.76 (95% CI 2.26-3.37), respectively. Analysis of the detailed symptoms revealed odds ratios in on-call workers of 2.06 for hearing problems (95% CI 1.63-2.62); 1.71 for skin problems (95% CI 1.38-2.12); 1.22 for back pain (95% CI 1.08-1.38); 1.23 for muscular pains in upper limbs (95% CI 1.12-1.34); 1.27 for muscular pains in lower limbs (95% CI 1.15-1.40); 1.46 for headache, eye fatigue (95% CI 1.32-1.60); 1.37 for abdominal pain (95% CI 1.02-1.85); 1.43 for depression or anxiety disorders (95% CI 1.07-1.93); 1.36 for fatigue (95% CI 1.24-1.49); and 1.41 for insomnia and general sleep difficulties (95% CI 1.13-1.76). CONCLUSIONS: The present study found that on-call work results in an increased risk of health problems and injuries. This study is the result of analyses of broad range of the job spectrum in Korean employed workers; thus, future studies are necessary to determine the effects of on-call work in various job groups.
Abdominal Pain ; Anxiety Disorders ; Asthenopia ; Back Pain ; Depression ; Fatigue ; Headache ; Hearing ; Humans ; Logistic Models ; Lower Extremity ; Odds Ratio ; Skin ; Sleep Initiation and Maintenance Disorders ; Upper Extremity

BACKGROUND: To investigate the influence of nocturnal ambient light on visual function and ocular fatigue. METHODS: Sixty healthy subjects (30 men and 30 women) aged 19 through 29 years with no history of ocular disease were recruited. All subjects spent 3 consecutive nights in the sleep laboratory. During the first and second nights, the subjects were not exposed to light during sleep, but during the third night, they were exposed to ambient light, measuring 5 or 10 lux at the eye level, which was randomly allocated with 30 subjects each. The visual function and ocular fatigue were assessed at 7 a.m. on the 3rd and 4th mornings, using best-corrected visual acuity, refractive error, conjunctival hyperemia, tear break-up time, maximal blinking interval, ocular surface temperature, and subjective symptoms reported on a questionnaire. RESULTS: Three men and three women subjects failed to complete the study (4 in the 5 lux; 2 from the 10 lux). For the entire 54 subjects, tear break-up time and maximal blinking interval decreased (P = 0.015; 0.010, respectively), and nasal and temporal conjunctival hyperemia increased significantly after sleep under any ambient light (P < 0.001; 0.021, respectively). Eye tiredness and soreness also increased (P = 0.004; 0.024, respectively). After sleep under 5 lux light, only nasal conjunctival hyperemia increased significantly (P = 0.008). After sleep under 10 lux light, nasal and temporal conjunctival hyperemia, eye tiredness, soreness, difficulty in focusing, and ocular discomfort increased significantly (P < 0.05). CONCLUSION: Nocturnal ambient light exposure increases ocular fatigue. Avoiding ambient light during sleep could be recommended to prevent ocular fatigue.
Asthenopia ; Blinking ; Dry Eye Syndromes ; Fatigue* ; Female ; Healthy Volunteers ; Humans ; Hyperemia ; Lighting ; Male ; Refractive Errors ; Tears ; Visual Acuity

PURPOSE: The purpose of this study was to identify sleep patterns, alertness, and fatigue of shift nurses according to circadian types. METHODS: The researchers' enrolled 17 nurses doing shift work in a tertiary hospital. To evaluate circadian types, a morningness-eveningness questionnaire (MEQ) was administered. Sleep patterns were examined using an actigraph for 14 days. To assess alertness and fatigue, Visual Analogue Scale (VAS) was used. The data were analyzed using ANOVA and Kruskal-Wallis test with a SPSS 21.0 program. RESULTS: The researchers found that 17.6% of participants reported morning type, 47.1% neither type, and 35.3% evening type. Mean total sleep time (TST) was 6.8 h, mean sleep efficacy was 82%, level of alertness was 6.54, and level of fatigue was 5.49, regardless of the type of shift work. Evening type nurses had higher variation in TST and alertness, according to the shift patterns than other circadian type nurses. Evening type nurses also had higher fatigue levels than other circadian type nurses. CONCLUSION: Sleep, alertness, and fatigue were related with circadian types. These results suggest that circadian rhythm management in shift work nurses, particularly in evening type nurses is urgently needed to improve sleep patterns, alertness, and to decrease the level of fatigue.
Asthenopia ; Circadian Rhythm ; Fatigue* ; Tertiary Care Centers

PURPOSE: In the present study, the visual discomfort induced by smart mobile devices was assessed in normal and healthy adults. METHODS: Fifty-nine volunteers (age, 38.16 ± 10.23 years; male : female = 19 : 40) were exposed to tablet computer screen stimuli (iPad Air, Apple Inc.) for 1 hour. Participants watched a movie or played a computer game on the tablet computer. Visual fatigue and discomfort were assessed using an asthenopia questionnaire, tear film break-up time, and total ocular wavefront aberration before and after viewing smart mobile devices. RESULTS: Based on the questionnaire, viewing smart mobile devices for 1 hour significantly increased mean total asthenopia score from 19.59 ± 8.58 to 22.68 ± 9.39 (p < 0.001). Specifically, the scores for five items (tired eyes, sore/aching eyes, irritated eyes, watery eyes, and hot/burning eye) were significantly increased by viewing smart mobile devices. Tear film break-up time significantly decreased from 5.09 ± 1.52 seconds to 4.63 ± 1.34 seconds (p = 0.003). However, total ocular wavefront aberration was unchanged. CONCLUSIONS: Visual fatigue and discomfort were significantly induced by viewing smart mobile devices, even though the devices were equipped with state-of-the-art display technology.
Adult ; Asthenopia* ; Computers, Handheld* ; Dry Eye Syndromes ; Female ; Humans ; Male ; Tears ; Video Games ; Volunteers

PURPOSE: To analyze blinking patterns when watching an ultra-high definition (UHD) television and to compare the results between normal eyes and dry eyes. METHODS: A total of 59 participants aged from 13 to 69 years were instructed to watch a colorful and dynamic video on a UHD television for 10 minutes. Before and after watching the UHD television, we measured the best corrected visual acuities, autorefraction, tear-break-up-time, degree of corneal erosion and conjunctival hyperemia via slit lamp biomicroscopy. In addition, questionnaires for the evaluation of eye fatigue and symptoms of a dry eye were completed. The definition of dry eye syndrome was that the tear-break-up-time of one of the eyes was less than 5 seconds, conjunctival injection, or marked corneal erosion. The number of blinks and the duration of blinking were both measured and analyzed at the early and late phases of video-watching. RESULTS: After watching the UHD television in the normal eye group, the tear-break-up-time was significantly decreased (p < 0.001) and the degree of corneal erosion was significantly increased (p = 0.023). However, the subjective symptoms of participants were not aggravated (p = 0.080). There were no significant differences in blinking patterns in the dry eye group. On the other hand, in the normal eye group, the mean blinking time was significantly increased (p = 0.030). CONCLUSIONS: Watching an UHD television changes the tear-break-up-time, degree of corneal erosion, and blinking pattern in normal eyes, which may increase the risk of dry eye syndrome.
Asthenopia ; Blinking* ; Dry Eye Syndromes ; Hand ; Hyperemia ; Slit Lamp ; Television* ; Visual Acuity

In March 2014, a 39-year-old Korean male presented with a 6-month history of various nonspecific symptoms including dizziness, fatigue, asthenia, irritability, elevated blood pressure, palpitation, eyestrain, and tinnitus. His occupational history revealed that he had been working as an indoor firing range manager for 13 months; therefore, he was subjected to a blood lead level (BLL) test. The test results showed a BLL of 64 µg/dL; hence, he was diagnosed with lead poisoning and immediately withdrawn from work. As evident from the workplace environmental monitoring, the level of lead exposure in the air exceeded its limit (0.015–0.387 mg/m³). He received chelation treatment with calcium-disodium ethylenediaminetetraacetic acid (1 g/day) for 5 days without any adverse effects. In the follow-up results after 2 months, the BLL had decreased to 9.7 µg/dL and the symptoms resolved. This report represents the first occupational case of lead poisoning in firing ranges in Korea, and this necessitates institutional management to prevent the recurrence of poisoning through this route. Workplace environmental monitoring should be implemented for indoor firing ranges, and the workers should undergo regularly scheduled special health examinations. In clinical practice, it is essential to question the patient about his occupational history.
Adult ; Asthenia ; Asthenopia ; Blood Pressure ; Dizziness ; Edetic Acid ; Environmental Monitoring ; Fatigue ; Firearms ; Fires* ; Follow-Up Studies ; Humans ; Korea ; Lead Poisoning* ; Male ; Military Personnel ; Poisoning ; Recurrence ; Tinnitus

PURPOSE: To evaluate the clinical manifestation and prognosis of convergence insufficiency after craniofacial trauma. METHODS: Twelve patients injured by craniofacial trauma were analyzed for the cause of trauma, ocular and accompanied non-ocular symptoms, presence of loss of consciousness, presence of craniofacial fracture and intracranial hemorrhage, treatment modality for ocular symptoms, change in strabismic angle and near point of convergence (NPC) after treatment and prognosis using clinical records from April 2008 to December 2014. RESULTS: Traffic accidents (8 patients) were the leading cause of trauma. Near diplopia (11 patients) was the leading type of ocular symptom and other following symptoms included headache, asthenopia and reading difficulty. Ten patients experienced loss of consciousness and craniofacial fracture and intracranial hemorrhage were observed in 7 patients. Intracranial hemorrhage and craniofacial fracture occurred in 3 patients and only 1 patient had neither intracranial hemorrhage nor craniofacial fracture. All 12 patients performed orthoptic exercises, but no improvement of near strabismic angle, NPC and ocular symptoms was observed. However, 4 patients who received surgery demonstrated improvement in near strabismic angle, NPC and ocular symptoms. CONCLUSIONS: Convergence insufficiency after craniofacial trauma occurred by relatively strong traumatic force and had a poor outcome in non-surgical methods such as orthoptic exercise. Surgery was an effective treatment method rather than orthoptic exercise.
Accidents, Traffic ; Asthenopia ; Diplopia ; Exercise ; Headache ; Humans ; Intracranial Hemorrhages ; Ocular Motility Disorders* ; Orthoptics ; Prognosis* ; Unconsciousness