Occupational exposure to video display terminals: a systematic review of ocular and visual health effects and...

To synthesize ocular and visual effects caused by occupational exposure to video display terminals (VDTs). Additionally, we aimed to identify the occupational and nonoccupational risk and protective factors related to these effects, and to propose a conceptual mapping to manage affected workers.

The review protocol was registered in PROSPERO and the systematic review was conducted following PRISMA guidelines. A search of MEDLINE, Scopus, and Web of Science was performed to identify studies published between January 2006 and December 2023. Only primary studies were included. Study quality was assessed using a critical appraisal tool based on STROBE statements for cross-sectional studies and the Scottish Intercollegiate Guideline Network checklist for randomized controlled trials and cohort and case-control studies. Low-quality studies were excluded.

Eighty-five articles were included, 50 of high quality. The main ocular and visual effects were computer vision syndrome, dry eye disease, and other isolated signs and symptoms. The main risk factors were the daily hours of VDT exposure, female gender, use of ophthalmic or contact lenses, increasing age, altered lighting conditions, and job seniority. Breaks, adequate workstation design, and ergonomic improvements were the main protective factors. Psychosocial factors and lifestyle behaviors also may influence ocular and visual health at work.

Wide methodological variations were found, making it difficult to compare studies. Nevertheless, an evidence-informed conceptual mapping has been proposed that could be used as a starting point to guide preventive measures in VDT work settings. Further research with appropriate epidemiological designs is needed to establish causal relationships or determine temporal sequences between exposures and outcomes.