Abstract
Background: The use of digital devices has increased tremendously during recent years in Saudi Arabia. Many concerns were raised about the safety of this technology. 
Objective: To develop an instrument for determining the pattern of use of digital devices, and to investigate the link between the use of digital devices and visual symptoms among students of general education schools.
Methods: This cross-sectional study was carried out from the beginning of April 2017 to the end of September 2017 among students of general education schools in the Western region of Saudi Arabia. The study sample included 475 randomly selected participants. A self-administered questionnaire was used for data collection. The questionnaire had two parts: the first part was about personal information of the study participants, while the second part was about the pattern of use of digital devices, associated visual complaints after use, and recommendations to decrease visual health hazards. IBM-SPSS version 22 was used to conduct the statistical analysis. Logistic regression analysis was used to examine associations with visual and muscular complaints; odds ratios with 95% confidence intervals were generated. Chi square goodness-of-fit test was used to compare categorical variable frequencies across different groups. A p-value of < 0.05 was considered statistically significant.
Results: A total of 475 students completed the questionnaire. Nearly half the respondents were males aged more than 19 years old (p<0.001). Most respondents attended secondary schools (p<0.001). Most users experienced neck or shoulder pain (n=305, 64.2%, p<0.001), followed by headaches (n=301, 63.4%, p<0.001), and visual disturbances (n = 275, 57.9%, p=0.001). The majority of students used cellular phones or tablets (n=389, 83.8%). Half the respondents spent more than 4 hours daily using digital devices (p<0.001) and had 2 or more devices. Most students agreed that decreasing the duration of usage (n=217, 45.7%) and scheduling hours (n=214, 45.1%) are the best solutions to decrease the health hazards of digital devices. Logistic regression analysis identified female gender (OR: 2.8, 95% CI: 1.6-4.8, p<0.001) and exposure to digital devices for more than 2 hours per day (OR: 2.9, 95% CI: 1.4-6.3, p=0.006) as significant predictors of symptoms. 
Conclusion: A significant proportion of school students were aware that prolonged use of digital devices is associated with visual and muscular complaints. Females and individuals spending more than 2 hours a day using these devices are more prone to visual and muscular complaints. Decreasing the hours of usage is necessary to avoid digital device-related health risks.
 
Keywords: Cellular Phone; Computer; Eyestrain; Syndrome; User-Computer Interface; Vision

 

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