Digital Strain and its Impact on Visual and Auditory Health in an Online Learning Environment: A Cross-sectional Study

Background: During the COVID-19 pandemic, concerns extended beyond respiratory health to include visual and auditory well-being in school-aged children. This study aimed to assess the prevalence and risk factors of digital device-related visual and auditory strain in children. Methods: A cross-sectional descriptive study using simple random sample technique as well as multistage cluster sampling was carried out at selected schools at Puducherry, India, from January 2022 to May 2022. Using a self-administered questionnaire, demographic information as well as digital-related visual and auditory strain were evaluated. Results: Of the 268 participants, 5.6% reported having moderate digital eye strain and 27.6% had mild digital eye strain. Students reported burning sensations (35.07%), dryness (20.14%), and itching (37.68%) as common visual discomforts. In the meantime, 7.5% of respondents reported significant auditory strain, and 10.4% reported mild strain. Ear irritation (17.91%), ear infections (7.46%), ringing in the ears (16.79%), and ear blockage (13.43%) are among the symptoms. Risk factors for eye strain included participant age (P=0.020), wearing spectacles (P<0.001), the number of hours spent using a device outside of class (P=0.009), and the distance between the device and the user (P=0.018). Age (P<0.05), sex (P<0.001), students' grade (P<0.001), hours spent (P<0.05), and headphone use (P<0.001) were all significantly correlated with auditory strain. Conclusions: The hybrid learning environment posed diverse challenges for students, highlighting the significant impact of both visual and auditory health. The findings advocate for proactive measures for students’ overall health.