Keywords
computer vision syndrome -
trataka
- eye exercises - eye strain - yogic interventions
Introduction
Digital eye strain is known as computer vision syndrome (CVS). On average, it is seen that an individual going through his or her daily routine is required to blink 18 times in a minute. Though passing a long duration gazing at a digital eye screen may cause decreased blink rates which results in dry, burning, and itchy eyes.[1] Factors such as exposure to bright light, prolonged hours of working, a very short-distance light, more concentration on the near work without changing gaze, poorly illuminated room, no or less blinking rate, reading very short fonts against very bright screens, and constant screen staring could develop digital eye strain.[2] The primary features noted by such users include eye fatigue, eye tiredness, itchy eyes, redness, blurred vision, burning sensation, and double vision. The prevalence of symptoms associated with digital eye strain was 89.9%, the most prevailing and distressing symptom being headache (19.7%) and the second being eye strain (16.4%); students who were using digital devices for 2 or more hours per day had significantly more symptoms of digital eye strain.[3] Digital eye strain affects all age groups—87.7% of ages 18 to 39 years, 82.6% of ages 40 to 59 years, 76.3% of ages 60 years and above. Trataka aids in the elimination of all disorders of the eye, including eye strain, and is known to close the doorway of creating these symptoms. Trataka also helps in a wide range of physiological and mental functions.[4]
Trataka means to look or gaze steadily. It is a preliminary step for meditation. It is a kriya (technique) that includes prolonged staring at a single point such as a small object or black dot or candle flame. Trataka helps in the degree of relaxation, emotional stability, and pleasant feeling.[5] The purpose of this study was to analyze the effect of trataka kriya in the management of digital eye strain.
Materials and Methods
The study design was a pre–post experimental study for the duration of 1 year.
Sampling method was convenient sampling and sample size was 30.
To calculate sample size, technique of estimation of single proportion (digital eye strain) is used:
Where α = confidence level
The calculated sample size is 30.
Data Collection and Procedure
A total of 30 participants were recruited in the study by using a convenient sampling method. Inclusion criterion was 18 to 40 years of age. All participants used a laptop or smartphone daily for 2 hours and were experiencing eye strain, dry eyes, burning sensation in the eyes, headache, and eye fatigue.
Exclusion criteria were who were suffering from infective conditions of the eyes like conjunctivitis, scleritis, uveitis, and refractive errors.
Ethical Clearance
The study was approved by the institutional ethical committee of Nitte Institute of Physiotherapy, Mangaluru, Karnataka, India. The details of the study were explained to the participants and informed consent was taken before commencing the study.
Intervention
Participants were assessed at baseline and the end of 1 month by the assessor, who was blinded to the intervention. During 1 month participants practiced trataka 3 times a week under supervision. Initially the intervention was demonstrated in a small group—10 participants were seated around a stool maintaining distance of 2 m. Later, participants were asked to practice individually under supervision and there were no dropouts ([Figs. 1] and [2]).
Fig. 1
Trataka kriya, individual practice.
Fig. 2
Trataka kriya group demonstration.
The practices had three stages:
-
Gazing the whole flame without any effort (duration 30 seconds).
-
Intense gazing at the tip of the wick of the candle (duration 1 minute).
-
Expanding awareness (duration 1 minute)—frequency once a day for alternative days for 1 month.
Assessment
Computer Vision Syndrome Questionnaire
It is a tool to assess visual fatigue. This scale has got a good validity and reliability and can be used to assess the visual health of computer workers and for research purposes.[6] The questionnaire was given before the commencement and at the end of the study.
Schirmer Test
The Schirmer test is a useful assessment of aqueous tear production. This involves assessing the sum of wetting of a special filter paper (No. 41 Whatman; 5 mm width and 35 mm length), and it was performed without topical anesthesia. The test was performed as follows[7]
Measures taken to avoid adverse events during intervention: Participants were advised to rub their palms and place them over their eyes to feel the warmth around the eyes and also splash cold water on their eyes if they experienced visual problems like pain in the eyes and lacrimation, and were unable to concentrate.
Results
[Table 1] shows age distribution of participants. Out of 30 participants, 91% included female and 9% included male participants. Mean age of the female participants was 26.00 years, with a standard deviation (SD) of 6.245 years, and mean age of the male participants was 23.51 years, with a SD of 5.30 years. The p-value is more than 0.05, suggesting age is homogeneously distributed among male and female participants.
Table 1
Age distribution of participants
|
n = 30(%)
|
Mean
|
SD
|
t
|
p-Value
|
|
Female
|
91%
|
26.00
|
6.245
|
0.762
|
0.452
|
|
Male
|
9%
|
23.51
|
5.30
|
[Table 2] shows the pre- and posttest comparison of the computer vision syndrome questionnaire scores and Schirmer test scores among the participants. The obtained p-value was 0.001. Hence there was a difference in the mean before and after the intervention. This indicates that there was a significant change in the postintervention parameter.
Table 2
Pre- and posttest comparison of computer vision syndrome questionnaire (CSV-Q) and Schirmer test score
|
|
Mean
|
SD
|
t
|
p-Value
|
|
Abbreviation: SD, standard deviation.
aIndicates significance.
Analyzed through paired t-test.
|
|
CVS-Q
|
Pretest
|
14.37
|
2.593
|
4.507
|
a<0.004
|
|
Posttest
|
9.33
|
1.882
|
|
Schirmer test
|
Pretest
|
7.70
|
1.393
|
−2.989
|
a<0.001
|
|
Posttest
|
6.53
|
1.456
|
Discussion
The present study investigated the effectiveness of trataka kriya in computer vision syndrome. It was found that trataka kriya is effective in reducing eye strain in individuals with digital eye strain or computer vision syndrome and it was also shown that a significant improvement was achieved in producing tears which help to keep the eye moisturized. Probably the reason for this could be that during trataka kriya, when the identical object (candle), is continuously being observed, the brain becomes habituated and soon stops registration of that particular object. This habituation tends to occur at the same time with an incline in α waves which indicates reduced visual attention to the exterior world; the time they are formed, several brain areas stop functioning. Trataka helps to reduce and cure all eye disorders such as eye fatigue, myopia, and headache.[3]
Trataka kriya helps to relax the eyes and the mind, and also improves the vision. There was average improvement in clarity of vision, contrast sensitivity, and fineness of objects, a best relief was appreciated by patients of trataka kriya.[8]
Trataka helps in the vitalization of vision by circulating blood around the areas of the eye. Trataka kriya improves the metabolism of rods and cones through the mechanism of dark and light adaptation. It has also been seen that the use of gazing helps in decreasing mental fatigue and bringing about relaxation.[9] The findings of this study have been supported by Gopinathan et al (2017) who conducted a study to assess the effect of eye exercises and trataka kriya in the treatment patients with ametropia and presbyopia who were registered under two main groups (group A and group B); 32 patients performed eye exercises, 34 patients performed trataka kriya. The patients in both groups were subjected to perform the exercises once daily for 3 weeks. The patients were followed-up for 30 days to observe any ill effects of the therapy. There was a better result in clarity of vision and contrast sensitivity. The grade of development was almost similar in both the groups; a better relief was valued by patients in the trataka kriya group.[8] During trataka, several centers of the brain are connected to the optic nerves and they receive input via the optic nerves and send signals to rise the perception function. Through the perception, the brain centers that remain dormant for an ordinary individual are awakened. Trataka also aids in relieving eye disorders. Gazing helps decrease the central nervous system and autonomic nervous system activity by decreasing the proprioceptive feedback to the reticular activating system.[10]
Conclusion
The study concluded that there is an improvement in self-rated discomfort in the participants with digital eye strain. The clinical implication of the study is that trataka method can be used as an adjunct to pharmacological management.
Limitations
The sample size was very small and only the student population was recruited. Hence the study should be done in a larger population and participants other than students can also be recruited.
