title: Visual consequences of electronic reader use: a pilot study.
abstract: BACKGROUND
  With the increasing prevalence of electronic readers (e-readers) for vocational and professional uses, it is important to discover if there are visual consequences in the use of these products. There are no studies in the literature quantifying the incidence or severity of eyestrain, nor are there clinical characteristics that may predispose to these symptoms with e-reader use.
  
  
  OBJECTIVE
  The primary objective of this pilot study was to assess the degree of eyestrain associated with e-reader use compared to traditional paper format. The secondary outcomes of this study were to assess the rate of eyestrain associated with e-reader use and identify any clinical characteristics that may be associated with the development of eyestrain.
  
  
  METHODS
  Forty-four students were randomly assigned to study (e-reader iPAD) and control (print) groups. Participant posture, luminosity of the room, and reading distance from reading device were measured during a 1-h session for both groups. At the end of the session, questionnaires were administered to determine symptoms.
  
  
  RESULTS
  Significantly higher rates of eyestrain (p = 0.008) and irritation (p = 0.011) were found among the iPAD study group as compared to the print 'control' group. The study group was also 4.9 times more likely to report severe eyestrain (95 % CI [1.4, 16.9]). No clinical characteristics predisposing to eyestrain could be identified.
  
  
  CONCLUSIONS
  These findings conclude that reading on e-readers may induce increased levels of irritation and eyestrain. Predisposing factors, etiology, and potential remedial interventions remain to be determined.
authors: Irvine School of Medicine, University of California, Irvine, CA, 92697, USA.
authors: Marlon M
authors: MM
authors: Maducdoc
authors: Department of Ophthalmology, Louisiana State University-Ochsner Eye Center, New Orleans, LA, 70112, USA.
authors: Asghar
authors: A
authors: Haider
authors: School of Medicine Irvine, Discovery Eye Foundation, University of California, Irvine, CA, 92697, USA.
authors: Angèle
authors: A
authors: Nalbandian
authors: Irvine School of Medicine, University of California, Irvine, CA, 92697, USA.
authors: Julie H
authors: JH
authors: Youm
authors: School of Medicine, Gavin Herbert Eye Institute, University of California, Irvine, 850 Health Sciences Road, Irvine, CA, 92697, USA.
authors: Payam V
authors: PV
authors: Morgan
authors: School of Medicine, Gavin Herbert Eye Institute, University of California, Irvine, 850 Health Sciences Road, Irvine, CA, 92697, USA. rcrow@uci.edu.
authors: Robert W
authors: RW
authors: Crow
mesh_terms: D000328:Adult; D001248:Asthenopia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D034201:Computers, Handheld; D003626:Data Display; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010865:Pilot Projects; D011932:Reading; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014792:Visual Acuity; D055815:Young Adult
keywords: Asthenopia; Computer vision syndrome; Electronic readers and tablets; Eyestrain; Ocular complaints