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Ergonomic office design and aging: a quasi-experimental field study of employee reactions to an ergonomics intervention program.

A naturally occurring quasi-experimental longitudinal field study of 87 municipal employees using pretest and posttest measures investigated the effects of an office workstation ergonomics intervention program on employees' perceptions of their workstation characteristics, levels of persistent pain, eyestrain, and workstation satisfaction. The study examined whether reactions differed between younger and older employees. Results revealed that workstation improvements were associated with enhanced perceptions of the workstation's ergonomic qualities, less upper back pain, and greater workstation satisfaction. Among those experiencing an improvement, the perceptions of workstation ergonomic qualities increased more for younger than older employees, supporting the "impressionable years" framework in the psychological literature on aging. Implications for human resources managers are discussed.

Adult↗

Optometric correlates of Meares-Irlen syndrome: a matched group study.

People who report visual perceptual distortions, typically when reading, that are alleviated by using coloured filters are described as suffering from 'Meares-Irlen Syndrome'. A recent double-masked placebo-controlled trial showed that this condition cannot be solely explained as a placebo effect and that the beneficial filter is idiosyncratic and sometimes needs to be highly specific. Several mechanisms have been suggested for Meares-Irlen Syndrome including ocular motor (binocular and accommodative) anomalies, a sensitivity to patterned stimuli (pattern glare), and a deficit of the transient visual sub-system. We investigated these hypotheses by comparing 16 children, who reported the symptoms described above and who showed a sustained benefit from coloured filters, with 25 control children who came from the same school and were matched for age, reading performance and intelligence. The 'Meares-Irlen Syndrome' group had slightly, but significantly, reduced vergence and accommodative amplitudes and stereo-acuity; they also demonstrated significantly more pattern glare. The two groups did not differ significantly in their visual acuities, refractive error, dissociated or associated heterophoria, AC/A ratio, or ability to perceive 20 Hz flicker. It appears that certain ocular motor factors are correlates of Meares-Irlen Syndrome, rather than the primary underlying cause of the symptoms. The results support the hypothesis that pattern glare may be involved in the mechanism of Meares-Irlen Syndrome.

Accommodation, Ocular↗

A preliminary investigation into the aetiology of Meares-Irlen syndrome.

A recent double-masked placebo-controlled trial has confirmed that some children experience a reduction in symptoms of eyestrain and headache when they read through individually prescribed coloured filters and has shown that this benefit cannot be solely attributed to a placebo effect. People who are helped by coloured filters in this way have been described as having "Meares-Irlen syndrome'. We investigated the mechanism of this benefit by studying the optometric and visual perceptual characteristics of the children in the double-masked study. This population had normal refractive errors and heterophorias (none of the subjects had strabismus). They demonstrated slightly, but significantly, reduced amplitudes of accommodation and vergence and poor stereo-acuity. However, these factors seemed to be correlates of Meares-Irlen syndrome rather than the underlying cause. Pattern glare, a sensitivity to striped patterns (e.g. lines of text), was prevalent in our sample and was significantly associated with the subjects' symptoms. The spatial contrast sensitivity function was normal.

Adolescent↗

The effect of coloured filters on the rate of reading in an adult student population.

Meares-Irlen Syndrome is characterised by visual stress (visual discomfort) and visual perceptual distortions that can be alleviated by individually prescribed coloured filters. The benefit from coloured filters can be demonstrated with the Wilkins Rate of Reading Test (WRRT). Previous research using individually prescribed coloured overlays (sheets of plastic placed on a page) found that between one-fifth and one-third of unselected school-children show a significant (> 5%) improvement in their rate of reading with their chosen overlay. This 5% cut-off has good sensitivity and specificity for predicting those children who will continue to voluntarily use their overlay for a sustained period. Previous research has concentrated on children, and we sought to investigate the immediate effect of overlays on rate of reading in an adult population. Subjects were 113 unselected university students who answered a symptom questionnaire and were tested with the Wilkins Intuitive Overlays and WRRT. Some symptoms were common: 73% reported sore or tired eyes when reading and 40% reported four to 12 headaches a year. One hundred of the subjects chose an overlay as improving their immediate perception of text. These subjects were significantly more likely to report perceptual distortions and visual discomfort on viewing text than subjects who did not choose an overlay. The 100 subjects read 3.8% faster with the overlay than without any overlay (p < 0.00001), whereas the 13 subjects who did not choose an overlay read 1.7% slower with a placebo overlay than without (p = 0.37). Of the subjects who chose an overlay, 38% read more than 5% faster with the overlay and 2% read more than 25% faster. These results are comparable with those obtained for children. We conclude that Meares-Irlen Syndrome is likely to be as common in adults as it is in children.

Adolescent↗

Coloured overlays and their effects on reading speed: a review.

Coloured overlays can reduce symptoms of visual stress and improve reading speed. These benefits are reliable and are not attributable simply to placebo effects. Five percent of children in mainstream education read at least 25% more quickly with an overlay, provided they have chosen the colour. The suboptimal design of children's text and the high level of classroom lighting may be partly responsible.

Adolescent↗

Efficacy of treatment for convergence insufficiency using vision therapy.

PURPOSE: The purpose of this study was to determine if vision therapy (VT), as practised within the constraints of UK optometric practice, employing graded routine eye exercises, is as an effective method for treatment of convergence insufficiency (CI) as previously published data suggest. The study also evaluates the associated symptoms before and after therapy. METHODS: As many optometrists diagnose CI solely on the basis of near point of convergence (NPC) and treat only when symptoms are present (Letourneau et al., 1979; Rouse et al., 1997), in this study CI was defined as NPC of 10 cm or greater (either with or without the presence of asthenopic symptoms for near work) accompanied by exophoria greater at near than at distance. The effect of treatment by optometric vision therapy (OVT) on the NPC and number of symptoms was investigated for 92 patients by retrospectively reviewing the clinical records. Success was defined as the restoration of NPC to normal values and significant reduction in the presenting symptoms. RESULTS: The effect of treatment on the NPC was shown to be highly significant (t = 14.61, p < 0.001). Although treatment times were slightly longer, the success rates were higher than reported by other authors. Post-treatment values for NPC were: <10 cm (98.9%), <8.5 cm (95.7%) and <6.5 cm (80.4%). Longer treatment times were noted for patients who complained that the text appeared to move (chi2, p = 0.007). CONCLUSION: Vision therapy is an effective method for treatment of CI.

Adolescent↗

Stereoacuity versus fixation disparity as indicators for vergence accuracy under prismatic stress.

BACKGROUND: Fixation disparity has been widely used as an indicator for vergence accuracy under prismatic stress. However, the targets used for measuring fixation disparity contain artificial features in that the fusional contours are thinned out. We considered that stereoacuity might be a preferable indicator of vergence accuracy, as stereo targets represent natural viewing conditions. METHODS: We measured fixation disparity with a computer adaptation of Ogle's test and stereoacuity with the automatic Freiburg Stereoacuity Test. Eight subjects were examined under increasing base-in and base-out prisms. RESULTS: The response of fixation disparity to prismatic stress revealed the curve types described by Ogle and Crone. All eight subjects reached a stereoscopic threshold below 10 arcsec. In seven subjects the stereoscopic threshold increased before double vision occurred. CONCLUSION: Our data suggest that stereoacuity is suitable to assess the range of binocular vision under prismatic stress. As stereoacuity bears the advantage over fixation disparity in that it can be measured without introducing artificial viewing conditions, we suggest exploring whether stereoacuity under prismatic stress would be more meaningful in the work-up of asthenopic patients than is fixation disparity.

Adult↗

[Asthenopic complaints and ocular convergence at the computer workstation: new test procedures for practice and research].

BACKGROUND: The present paper summarizes a series of ergonomic studies on the relation between asthenopic complaints and binocular vision at the computer workstation. In particular, the paper reports on measurements of the accuracy of ocular convergence during fixation of central fusion stimuli (i. e. fixation disparity) as a function of viewing distance. METHODS: Different versions of subjective tests for fixation disparity (using dichoptic nonius lines) are presented, including a computer-controlled procedure (the eye-test PC). RESULTS: These new tests suggest that non-presbyopic subjects with normal binocular vision may suffer from asthenopic complaints if they have - in near vision - an exo fixation disparity larger than average. CONCLUSION: In these cases, the stress exercised on the convergence system can be reduced by using a longer viewing distance at the workplace.

Accommodation, Ocular↗

[Asthenopic symptoms in cervical vertebrae syndrome].

The vertebral cervical syndrome is a clinical entity defined as a dysfunction of the cranio-cervical junction of traumatic or non traumatic cause. The authors report on asthenopic disorders occurring in such a syndrome. The fusion amplitude and the accommodation power were reduced in all patients and were a cause of delayed job recurrence. The treatment of fusion was long, painful and, in some cases, not successful. A depressive status associated with a prolonged job interruption were bad prognosis factors. A differential diagnosis has to be made with the so-called insurance neurotic reaction.

Accommodation, Ocular↗

[The F-L test for determining alternating central scotoma].

BACKGROUND: Based on their experiences several authors consider an alternating central scotoma as the main reason for reading difficulties due to dyslexia. METHODS: Searching for a simple and reliable method for determination of an alternating central scotoma we used a pair of synoptophore fusion images, in the center of which we added the letter F respectively L as central control signs. A spontaneously perceived and persisting E means a perfect and stable orthophoria. A persisting F or L with fusion of the images means a one sided central scotoma. Alternation of F and L with fusion of the images means an alternating central scotoma. RESULTS: By examining normal readers, untreated asthenopic and untreated dyslexic patients, we found mostly rapid alternation of F and L in the latter two groups, whereas most of the normal readers saw F, L and E alternating at longer intervals. CONCLUSIONS: Thus undisturbed reading seems not to demand perfect orthophoria. On the other hand a rapidly alternating central scotoma may be considered as an important factor causing reading difficulties.

Adolescent↗

[The 30 prism test].

The 30-prism-test is a relatively quick and simple method for many-sided testing binocular behaviour in near distance in patients with reading difficulties and asthenopic symptoms, respecting well known and assumed causes of the disturbances. Therefore indications for treatment are given.

Asthenopia↗

[The accommodation-convergence bar (A=C bar)].

The accommodation-convergence bar was developed as a simple measuring and exercise instrument. For the ophthalmologist, it is a convenient means of measuring accommodation and convergence in the office, while patients can use it for home convergence and fixation exercises which they can monitor themselves. The A = C bar has also been used experimentally to eliminate the functional central scotoma in dyslexic children.

Accommodation, Ocular↗

[Decreased reading speed and rapid fatigue as signs of disordered visual function].

Monocular and binocular reading curves of 20 patients (4 with cataract, 5 with glaucoma, 11 with maculopathy) were recorded by infrared oculography. Reading speed was found to be directly proportional to the visual acuity of the eye tested. However, the same visual acuity in both eyes does not always mean that the subject reads at the same speed with both eyes. For example, paracentral visual field defects impair reading ability and eyes which appear to have good vision may easily become tired. Twelve of 16 examined eyes with maculopathy showed a significant decrease in reading speed during a reading test lasting no more than 2 minutes. In tests of the same duration cataract patients did not tire; their reading speed increased. Binocular vision helps improve reading speed in cases of maculopathy, and even more so in cases of glaucoma with visual field defects. Attention is drawn to Mackensen's suggestion that measurement of reading speed is a valuable function test, and to the fact that in certain cases fatigue of an eye during reading is a new and measurable criterion of the degree of visual impairment.

Adult↗

The effects of visual discomfort and pattern structure on visual search.

Unpleasant somatic and perceptual side effects can be induced when viewing striped repetitive patterns, such as a square wave or a page of text. This sensitivity is greater in participants with higher scores on a scale of visual discomfort. In three experiments the effect that this sensitivity has on performance efficiency in a reading-like visual search task was investigated. In experiments 1 and 2, the 'global' structure of the patterns was manipulated to produce a square-wave, a checkerboard, and a plaid pattern. It was found that the group that suffered severe visual discomfort took significantly longer than other groups to perform the task, with interference greatest with presentation of the square-wave-like pattern. This supports the prediction of greatest distraction of visual attention from the local target elements with presentation of the pattern structure inducing greatest visual discomfort. In experiment 3, the internal pattern components were manipulated and task difficulty reduced. A no-interference and two interference patterns, one with a global characteristic only and the second made up of distracting line elements, containing global and local components were used. The global pattern structure produced interference effects on the visual-search task. All groups performed with the same speed and accuracy on the task involving the no-interference pattern, a finding attributed to reduced task difficulty. McConkie and Zola's model of visual attention was used to explain these results.

Asthenopia↗

A field study of supplementary rest breaks for data-entry operators.

This study examined the effects of supplementary rest breaks on musculoskeletal discomfort, eyestrain, mood, and performance in data-entry workers. Two rest break schedules were compared in a within-subjects design. Workers alternated between a 'conventional' and a 'supplementary' schedule in 4-week intervals. The conventional schedule contained a 15-min break during the first half of the work shift and a 15-min break during the second half of the shift. The supplementary schedule contained the same two 15-min breaks, and a 5-min break during each hour which otherwise did not contain a break, for a total of 20 extra minutes of break time. Results are based on data from 42 workers. They indicated that discomfort in several areas of the body, and eyestrain, were significantly lower under the supplementary than under the conventional schedule. While symptoms increased from pre- to post-work periods under both schedules, the magnitude of the increases was significantly less under the supplementary schedule. In addition, increases in discomfort of the right forearm, wrist and hand over the course of the work week under the conventional schedule were eliminated under the supplementary schedule. These beneficial effects were obtained without reductions in data-entry performance.

Adult↗

A critical appraisal of current knowledge and future directions of ergophthalmology: consensus document of the ICOH Committee on 'Work and Vision'.

In the past, occupational health gave scant attention to the visual apparatus. Studies on issues relating to 'work and vision' have predominantly addressed industrial accidents and the toxic effects of exposure to chemical and physical agents, with secondary prevention being more common than primary prevention. In recent years, the huge transformations implemented in workplaces, mainly due to computer-based technologies, demand a progressively higher efficiency of the eye and the related nervous system components that co-ordinate eye movements and accommodation. At the moment these aspects are managed by medical, psychosocial and a variety of technical disciplines, without any shared criteria, terminology and method. Objectives of the Committee are: to investigate holistically the many possible hazards associated to the occupational visual performance; to come to a consensus on terminology, risk assessment and health surveillance procedures. The present status of research and practice in ergophthalmology does not allow for clear-cut decision about health risk and nor is there a clear direction on the prevention of work-related ocular and visual disturbances and disorders. Specifically, at least three determinants must be objectively considered, namely: (a) visual effort; (b) environmental agents; (c) individual characteristics. Although criteria exist for the evaluation of some of these determinants, a greater refinement is necessary 'for a good working life' of the visual apparatus. The ICOH Scientific Committee on 'Work and Vision' is seeking to systematically develop this matter, yielding a more rational and complete approach to the relationship between work and vision.

Advisory Committees↗