Available via license: CC BY-NC
Content may be subject to copyright.
37
This is an Open Access arcle licensed under the Creave Commons Aribuon-NonCommercial 4.0 Internaonal License (hp://
creavecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribuon, and reproducon in any medium,
provided the original author and source are properly cited
Effect of Eye Exercises on Computer Vision Syndrome among Medical
Students of Universitas Sumatera Utara, Indonesia
Angella Zhuang, 1 Bobby Ramses Erguna Sitepu, 2
1Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
2Department of Opthalmology, Universitas Sumatera Utara, Medan, Indonesia
Introduction
Computer Vision Syndrome (CVS) is a complex
eye discomfort condition in the form of visual
impairment symptoms caused by prolonged
exposure to digital displays.1 Globally, it is
estimated around 60 million people and
one million new cases occur annually.2 The
pathophysiology was divided into three
mechanisms: ocular mechanism, related to
dryness and redness of eyes are reduction in
blink rate; visual mechanism cause blurring
of vision, double vision and slowness of focus
change; extraocular mechanism, associated
with non-ergonomic posture in front of
computer screen cause musculoskeletal
symptoms such as headaches and shoulder
pain. 3 The COVID-19 pandemic poses a risk of
increasing cases of Computer Vision Syndrome
due to changes in environment for study
because of the implementation of the online
learning methods policy.4 Garg et al reported
more than 70% of medical students at Rama
University, India spent more than 4 hours
using computers. About 40% of students learn
about CVS but only 10% take CVS precautions.
5 Another study by Muma et al. of 348 students
in Kenya, showed the prevalence of CVS was
60,4% with a low level of knowledge about
CVS was 46,8% and those who didn’t take
preventive measures was 40%. It showed that
student’s prevention efforts against CVS are
still relatively low.
Eye exercises can be considered as a non-
pharmacological therapy to prevent and
reduce symptoms of Computer Vision
Syndrome. Eye exercises therapy is a series of
movement performed repeatedly by the eyes
to train our eye muscles and its surroundings
to be elastic and strong, relax the eyes as to
reduce discomfort in the eyes.6
Study by Intan Putri et al. regarding the
effectiveness of eye exercises on CVS in nursing
students of Riau University, it was concluded
decrease of CVS scores in the experimental
group after eye exercises intervention.7 In
connection with problems above, the purpose
Original Article Internaonal Journal of Integrated Health Sciences (IIJHS)
ISSN Print: 2302-1381; ISSN Online: 2338-4506
Received: December 21, 2022
Accepted: May, 2023
Published: March 30, 2023
Correspondence:
Angella Zhuang
Faculty of Medicine, Universitas
Sumatera Utara, Medan,
Indonesia.
E-mail: gelll2710@gmail.com
DOI: 10.15850/ijihs.v11n1.3136
IJIHS. 2023;11(1):37-41
Article History Abstract
Objective: To determine the effect of eye exercises on Computer Vision
Syndrome among batch 2019 medical students of the Faculty of Medicine,
Universitas Sumatera Utara, and Indonesia.
Methods: This study used analytical true experimental with a Pretest-
Posttest Control Group Design. Sample consisted of 86 respondents who
were divided into two groups: control and experimental (intervention)
groups. Each group consisted of 43 respondents who were sampled
randomly using the simple random sampling technique. Data were
collected through the Computer Vision Syndrome Questionnaire (CVS-Q)
and analyzed using a statistical software application with a p-value of <
Results: A decrease in the score of Computer Vision Syndrome in the
experimental (intervention) group after the eye exercise was observed
with a p-value of 0.001 (<0.05).
Conclusion: Eye exercise has an effect on the Computer Vision Syndrome.
Keywords: Computer vision syndrome, eye exercise
38 Internaonal Journal of Integrated Health Sciences (IIJHS), Vol 11, Number 1, March 2023
of this study is to determine the effect of
eye exercise on reducing and preventing
Computer Vision Syndrome complaints in
medical student of Universitas Sumatera
Utara during online learning during
COVID-19 pandemic with different types
of eye exercise, and subjects. Researcher
selected several types of eye exercises that
can be implemented effectively both in time
and place. Eye exercises in this study were
carried out twice a week, for one month,
with a duration of approximately 10 minutes
and can be done anywhere without using an
object.
Methods
This research is a quantitative study
with a true experimental design and a pre-
and post-test design. In this design, two
group were randomly selected, Samples
was divided into two groups (control and
intervention). The intervention group was
given eye exercises, while the control group
was not given an intervention. Each group
eye exercises and one day after the last
day of doing eye exercises. This study was
performed from September to October 2022.
The sampling technique used is the simple
random sampling technique with a total
sample of 86 medical students of Universitas
Sumatera Utara who met the inclusion and
exclusion criteria. The inclusion criteria were
medical students who use computers at least
4 hours a day and willing to be the subject of
the research, whereas the exclusion criteria
were medical students that do not agree to
be participate in the study. Computer Vision
out CVS-Q (Computer Vision Syndrome-
Questionnaire) from Segui et al. pre-and-post
eye exercises. Ethical approval for this study
has been granted by the Health Research
Ethical Committee, Faculty of Medicine,
Universitas Sumatera Utara, with 797/KEPK/
USU/2022.
Eye exercises in this study were carried
out twice a week, for one month, with a
duration of approximately 10 minutes. Each
eye exercises sessions involves the following
eight, eye movements, 20-20-20 rules, near
and far focus.
The following are steps for doing eye
exercises: (1) Sit on a chair with straight body
and head straight forward as comfortable as
possible; (2) Blink 1-2 times every 10 seconds;
Effect of Eye Exercises on Computer Vision Syndrome among Medical Students of Universitas
Sumatera Utara, Indonesia
Table 1 Individual Characteristic
Variable n=86
Ages (years)
20
21
22
Sex
Female
Male
27 (31.4)
53 (61.6)
6 (7)
66 (76.7)
20 (23.3)
(3) Rub your palms together to warm them up,
put them on your eyes and breathe deeply for 1
around 8 feet away, and move the eyes in the
of 8 for 30 seconds, then switch direction; (5)
Move the eyeball right and left, repeat 3 times;
(6) Move the eyeball up and down, repeat 3
times; (7) Move the eyeball in a clockwise
circle and counterclockwise, repeat 3 times;
(8) Direct your eyes to look at something 20
feet away for 20 seconds, every 20 minutes;
away from the eyes, then focus your gaze on
slowly point them back closer to eyes.
Sample measurement was determined
using the Wilcoxon test. Secondary data for
individual characteristic was obtained from
age and gender.
Results
Characteristic was obtained from 86
respondents who were divided based on
gender, age. Data regarding individual
characteristic can be seen in the following
table.
Based on Table 1, the respondents in this
study were mostly women and was dominated
by respondent from age 21 years old because
they are working on a thesis which increase
their usage of computers.
Table 2 and Fig. 1 shows there are three
symptoms that respondents complained
the most before and after intervention were
headache, tearing, and itching.
Based on Table 3, experimental group p
value = 0,001 (p<0, 05) so it can be concluded
in CVS score in experimental group while
control group showed a p value = 0,802 which
in CVS score. Two respondents in experimental
group showed an increase in CVS score after
Internaonal Journal of Integrated Health Sciences (IIJHS), Vol 11, Number 1, March 2023 39
intervention, whereas in control group there
were 17 respondents who experienced an
increase in CVS score.
Discussion
Computer and VDT(Visual Display Terminal)
have become an essential part of modern
lifestyle, hence the term “Computer Vision
Syndrome” appears associated with
prolonged use of VDT. Therefore, by doing eye
exercises could help to prevent and reduce the
occurrence of Computer Vision Syndrome.
Distribution frequency of symptoms pre-
andp-post intervention, headache, tearin, and
Angella Zhuang, Bobby Ramses Erguna Sitepu
Table 2 Computer Vision Syndrome Symptoms Before and After Intervention
SymptomsBefore intervention After intervention
n=86 n=86
Burning
Itching
Feeling of a foreign body
Tearing
Excessive blinking
Eye redness
Eye pain
Heavy eyelids
Dryness
Blurred vision
Double vision
Increase sensitivity to light
Colored halos around objects
Feeling that sight is worsening
Headache
25 (29)
74 (86.1)
67 (77.9)
75 (87.2)
34 (39.6)
57 (66.3)
60 (69.8)
47 (54.6)
54 (62.8)
60 (69.8)
27 (31.4)
32 (37.2)
47 (54.7)
21 (24.5)
43 (50)
77 (89.5)
20 (23.2)
61 (70.9)
43 (50)
64 (74.4)
29 (33.7)
43 (50)
48 (55.9)
40 (46.6)
52 (60.5)
48 (55.9)
21 (24.4)
19 (22.1)
36 (41.9)
14 (16.3)
32 (37.2)
67 (77.9)
Fig 1. Symptoms of CVS
Table 3 Wilcoxon Test Analysis between
Control and Experimental Group
Ranks
Group
Control Experimental
(n=43) (n=43)
Negative ranksa
Positive ranksb
17
25
1
0.802
2
37
4
0.001
Tiesc
p Value
Note: * a. (score (pre) < (score (post); b. (score (pre)>
(score (post); c. (score (pre)= (score (post)
40 Internaonal Journal of Integrated Health Sciences (IIJHS), Vol 11, Number 1, March 2023
itching are the most complaints symptoms by
participants. However, there was a decrease in
the number and percentage of symptoms post-
intervention compared to pre-intervention.
The result of this study supported with study
by Ranasinghe and Altalhi which also show that
the most complained symptoms is headache.8,9,
10 Excessive tear production of watery eyes is
not directly related to the duration of VDT use,
tear production 11.
The result of Wilcoxon test in experimental
group obtained a p value =0,001 (p<0, 05).
Thus, it can be concluded that there was an
effect of eye exercises on reducing the CVS
score in the intervention group. This research
decrease in CVS score on intervention
groups after eye exercises7,12
relationship in this study due to the obedience
of the respondents in following each eye
exercise properly and routinely twice a week
in a month.
Eye exercises are proven able to improve
vision and the performance of muscular and
motor activities of the eyes. Palming helps
to relax the ocular muscles and all sensory
nerves related with vision. Eye movements
controlling back and movement of eye’s lens, to
achieve sight at multiple distances13. Blinking
tears from the lacrimal glands and lipids from
meibomian glands on the surface of eye14. In
conclusion, there is an effect of eye exercise
to Computer Vision Syndrome. This research
can be used as a reference for the effect of
eye exercise to Computer Vision Syndrome.
However, this study has limitations, such as
the lack of number of respondents and short
period of eye exercises, which leads to less
data variation. If this research is continued,
it would be better to add the number of
respondents, extend the period eye exercises
or using other types of eye exercises, in order
to get more representative research results.
1. 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. J Environ Public Health.
2021(2):1–8
2. Sheppard AL, Wolffsohn JS. Digital eye strain:
prevalence, measurement and amelioration.
BMJ Open Ophthalmol. 2018; 3:146.
3. Coronel-Ocampos J, Gómez J, Gómez A,
Quiroga-Castañeda PP, Valladares-Garrido MJ.
Computer visual syndrome in medical students
from a Private University in Paraguay: a survey
study. Front Public Health. 2022; 10:935405.
4. Rahmania A. Hubungan penggunaan gawai
dengan sindrom penglihatan komputer
(computer vision syndrome/CVS) Pada
Mahasiswa FK Universitas Sriwijaya Selama
Masa Pembelajaran Jarak Jauh. Sriwij
University Repository. 2020;14.
5. Garg S, Mallik D, Kumar A, Chunder R,
Bhagoliwal A. Awareness and prevalence on
computer vision syndrome among medical
students: A cross-sectional study. Asian J Med
Sci. 2021;12(9):44–8.
6. Kusuma U, Surakarta H, Solikah SN, Hasnah
K, Insan P. Terapi senam mata sebagai upaya
preventif miopi pada anak di masa pandemi
COVID-19. J Kesehat Kusuma Husada. 2022;
13(1):109–18.
7. Arisandi IP, Utami GT, Novayelinda R.
Efektivitas senam mata terhadap computer
vision syndrome (CVS). J Online Mhs. 2018;
5(2):520–5.
8. Ranasinghe P, Wathurapatha WS, Perera YS,
Lamabadusuriya DA, Kulatunga S, Jayawardana
N, et al. Computer vision syndrome among
country: An evaluation of prevalence and risk
factors. BMC Res Notes. 20169;9(1):150.
9. Altalhi AA, Khayyat W, Khojah O, Alsalmi M,
Almarzouki H. Computer vision syndrome
among health sciences students in saudi
arabia: prevalence and risk factors. Cureus.
2020; 12(2): e7060.
10. Sánchez-Brau M, Domenech-Amigot B, Brocal-
Fernández F, Quesada-Rico JA, Seguí-Crespo M.
Prevalence of computer vision syndrome and
its relationship with ergonomic and individual
factors in presbyopic VDT workers using
progressive addition lenses. Int J Environ Res
Public Health. 2020;17(3):1003.
11. Nau S, Sagita S, Setiawan IM, Artawan I.
Senam mata menurunkan computer vision
syndrome (CVS) pada mahasiswa universitas
nusa cendana. Cendana Medical Journal (CMJ).
2022:10(1):58–66.
12. Pradeep Kurunhikattil. Role of eye exercises
References
Effect of Eye Exercises on Computer Vision Syndrome among Medical Students of Universitas
Sumatera Utara, Indonesia
Internaonal Journal of Integrated Health Sciences (IIJHS), Vol 11, Number 1, March 2023 41
in improving performance of professionals
working with computers. Joinsysmed.
2016;4(3):145–8.
13. Bron AJ, de Paiva CS, Chauhan SK, Bonini
S, Gabison EE, Jain S, et al. TFOS DEWS
II pathophysiology report. Ocul Surf.
2017;15(3):438–510.
14. Seguí Mdel M, Cabrero-García J, Crespo A, Verdú
J, Ronda E. A reliable and valid questionnaire
was developed to measure computer vision
syndrome at the workplace. J Clin Epidemiol.
2015;68(6):662–73.
Angella Zhuang, Bobby Ramses Erguna Sitepu
