INTRODUCTION:

The human brain combines the fireworks of neurons of seeing, hearing, smelling, tasting and touching into a meaningful whole. But we don’t think about our senses until an organ stops working. The human eye is a organ of vision, good vision is critical and essential to conducting the activities of daily living easily.

It is important for language and affects developmental learning, communicating, working, health and quality of life. The eye is not only the most beautiful but also the most important sensory organ of the human body; four fifths of all the impression of the senses come from the eye. Moreover, the eyes make an essential contribution to the facial expression and serve for getting into contact with other people, therefore they are an indispensable means of communication.

Refractive errors are extremely common in the young academically active population. Many of the vision problems would be undetected by vision screening based on distance visual acuity, illustrating the need for comprehensive vision, examination for students who struggling academically. Thus the study related to the refractive errors in the young population, especially those involved in the professional studies should be prime concern.

Myopia is the commonest type of refractive error in eye where the light from infinity will focus in front of retina rather than focusing of the retina leads to blurring of image. Myopia is derived from Greek word "muopia" which means “trying to see like a blot” and also called as shortsightedness. The world Health Organization (WHO) has grouped myopia and uncorrected refractive error with cataract, muscular degeneration, infectious disease, vitamin A deficiency among the leading causes of blindness and vision impairment in the world.

Myopia can be corrected with glasses, contact lenses or refractive surgery. Depending on the degree of your myopia, you may need to wear your glasses or contact lenses all the time or only when you need very clear distance vision, like when driving, seeing a chalk board or watching a movie.

The global prevalence of myopia the primary data were gathered into 5-year age groups from 0 to≥100, in urban or rural populations in each country, standardized to definition of myopia of -0.50 diopter (D) or less and of high myopia of -5.00D or less, projected to the year 2010, then meta-analyzed within global Burden of disease (GBD) regions. Any urban or rural age group that lacked data in a GBD region took data from the most similar region. The prevalence data were combined with urbanization data and population data from United Nations Population Department (UNPD) to estimate the prevalence of myopia and high myopia in each country of the world. We included data from 145 studies covering 2.1 million participants. We estimated 1406 million people with myopia (22.9% of the world population; 95% confidence intervals [CI], 932 – 1932 million [15.2%-31.5%]) and 163 million people with high myopia(2.7% of the world population; 95% CI, 86 – 385 million [1.4%-6.3%])in 2000.We predict by 2050 there will be 4758 million people with myopia (49.8% of the world population; 3620-6056 million[95% CI, 43.4 %-55.7%]) and 938 million people with high myopia(9.8% of the world population; 479-2104 million [95% CI, 5.7%-19.4 % ])

Ophthalmic exercises have also received increasing attention as a means of reducing temporary eye irritation induced by eye strain from long period of focused vision. The Ophthalmic exercise has now developed into series of exercise and relaxation technique which aim to relieve the eye strain naturally without need of glasses and surgery.

NEED FOR THE STUDY:

The eyes are complex organs, with many parts that must work together to produce clear vision. The eye is a compact organ of sense of sight. This is an amazingly complex creation by the creator. On the other hand, the eye subject to various disorder such as infection disease, refractive error and disorders associated with intraocular pressure.

Each year thousands of students suffer from visual problems that can make life difficult. Students with poor visual skills may struggle to read, poor attention span and develop low self-esteem. The global prevalence of refractive errors have been estimated from 500 million to 2.3billion. The eye exercise was specific techniques can be used as a means for improving the eye sight in myopia of college students. This will help to relieve the eye strain and health of college students.

Rudnicka R Alicja (2012) was conducted across – sectional study in assess the Prevalence of the refractive error and related visual impairments in school children between 7-15 years in the city of Qazvin Northeastern Iran. 5903 primary and high schools students were randomly selected. 59% were females and 41% males. The examinations included visual acuity measurements, ocular motivity evaluation retinoscopy and auto refraction under cycloplegia, and examination of the anterior segment, media and fundus. The results revealed that the distribution of refractive errors was 65% of myopia, 12.46% of hypermetropia, 16.1% of astigmatism and 6.37% of amblyopia respectively. Myopia was more prevalent in women [60%] than in men [40%]. Hyperopia was 56.74% in women and 43.26% in men. The results concluded that refractive error was the main cause of visual impairment in children aged between 7 and 15 years in Qazvin-Iran.

Myopia develops in between the ages of eight and twelve years and almost always before the age of twenty. During this stage their may be a period of rapid change in the eyes and they grow and then it stabilizes as the reach adulthood. Myopia occur when the eyeball is elongated. If the eyeball too long in length, the light rays culminate at a point in front of the retina rather than on the retina.

Ophthalmic exercise is also aim to relax the muscles that is too tight so that aware eyeball will go back to its proper shape. Ophthalmic exercises are way better than glasses, contact lenses and eye surgery. Eye exercises are designed to strengthen your eye muscles, improve focusing, reducing the eye strain, eye movements and stimulate the vision center of your brain.

Ophthalmic exercise is also commonly used to relieve the eye strain after long periods of focused vision. While eye exercise have been proven effective in treating eye problem. Following are simple eye exercise which provide you relaxation and help to relieve the eye strain in the long run are palming, sunning, shifting, focus on near and far object, zooming, blinking these exercise for eye so effective that you can practice this even if you are not wearing glasses or even if you suffer eye problems.

Based on the above statistics and reviews related to early detection and correction of myopia and also the investigator experienced during her clinical postings, it was noticed that there is a need to impart knowledge regarding early detection and correction of myopia among students.

STATEMENT OF THE PROBLEM:

Effect of Structured Teaching Programme on ophthalmic exercises among students with myopia at selected college, Coimbatore.

OBJECTIVES:

1. To assess the level of knowledge on ophthalmic exercise among students with myopia.

2. To assess the level of eye strain among students with myopia.

3. To evaluate the effect of structured teaching programme on ophthalmic exercise among students with myopia.

4. To associate the level of knowledge on ophthalmic exercise and level of eye strain with selected demographic variables among students with myopia.

OPERATIONAL DEFINITIONS:

EFFECT:

It is the difference in the level of knowledge on ophthalmic exercise and level of eye strain before and after administration of ophthalmic exercise as measured by self structured questionnaire, Snellen chart and asthenopic symptoms scale.

STRUCTURED TEACHING PROGRAM:

It refers to an organized series of information regarding the anatomy and physiology of eye, definition of myopia, types of myopia, definition of ophthalmic exercise and its steps, advantages and disadvantages of ophthalmic exercise.

OPTHALMIC EXERCISE:

It consists of eight exercises designed for students with myopia. Each exercise is performed for 2 minutes, twice a day for one week.

MYOPIA:

It is a condition of the eye where light focuses in front of the retina. It is otherwise known as nearsightedness. It is assessed by Snellen chart and asthenopic symptoms scale.

Conceptual Framework:

In general system theory, the main concepts are input, throughput and output. Input and output are a process in which the system is able to communicate reaction with the environment.

Input:

It can be defined as any form of information, energy (or) material that enters into a general system through its boundary. In pretest input consists identification of students as per criteria, collection of demographical variables, level of knowledge and level of eye strain were assessed among students with myopia using a semi structured questionnaire and asthenopic symptoms scale.

Throughput:

It is a process that occurs at some point between the input and output process. In the study, throughput refers to the structured teaching programme include anatomy and physiology of eye, definition of myopia, types of myopia, definition of ophthalmic exercise, steps, advantages and disadvantages of ophthalmic exercise, tips to reduce eye strain. Ophthalmic exercise were demonstrated by using flash card and slide projector and students continued to practice the exercise for 15 minutes twice a day for one week.

Output:

It is any energy (or) matter that is transferred to the environment. In post test the researcher reassess the level of knowledge by self structured questionnaire and level of eye strain by asthenopic symptoms scale.

Feedback:

It refers to the process by which information is received at each stage of the system and feedback is given based on the evaluation.

REVIEW OF LITERATURE:

Rahul Pandey, Anamika Pandey (2017) conducted the research study on effect of eye exercise on myopia in children aged between 10-15 years- A Randomized clinical trial. The study was conducted in the MMIMSR, Mullana- Ambala and Ashirwad Eye hospital Yamuna nagar-ambala. The study sample is 50 subject of both gender mean age of 12.86±1.48 years with diagnosed case of myopia were recruited through criteria baser purposive sampling. Consent was taken, random allocation done in two groups experimental group and control group. Pre intervention optical power and CISS were taken by Nidek ARK 700A and CISS scale respectively experimental groups receives palming exercise, Eye warm up exercise, cross crawl exercise for 3 weeks 5 days per week and 20 minutes per day, control group advice to use spectacles and contact lens for regular basis for 3 weeks. After 3 weeks of intervention post optical power and CISS were taken and analysis. The result of the study was CISS score significantly reduced with in both the groups after treatment, but there is no significant change observed for optical power in control group. Eye exercise improvise the visual acutity and health in children with myopia.

Soumya, Manju Chhugani (2017) the study to assess the effectiveness of trataka exercise on vision and asthenopia, among student nurses with refractive error in a selected college of nursing in Delhi. The study sampling comprised of student nurses belonging to the age group of 15-25 years studying at Rufaida College of Nursing, New delhi. A total of 30 student nurses were selected, out of 30, 15 each were randomly assign to experimental and control group using lottery method. The result of the study was no significant difference in vision of student nurses who received Trataka exercise in experimental group at 0.05 level of significance, in control group there was no significant difference in both vision asthenopia at 0.05 level of significance

Balamurali Vasudevan (2016) conducted research study on Eye exercise of Acupoints their impact on myopia and visual symptoms in Chinese rural children. The study was conducted in eye hospital of Wenzhou medical university. A study samples was 836 students (437 males, 52.3%) aged 10.6±2.5 (range 6-17) years from the hand an of spring myopia study (HOMS) who completed the eye exercise and vision questionnaire, the convergence insufficiency symptoms survey (CISS) questionnaire and had cycloplegic refraction were included in the study. The result of the study was 121(14.5%) students (64 males, 52.9%) performed the eye exercise of acupoints in school. The students performed the eye exercise each week, the less likely was their chance of being myopic, after adjusting for the same confounders. The traditional eye exercises of acupoints appeared to have a modest protective effect on myopia among these Chinese rural students aged 6-17 years. However, no association between the eye exercise and near vision symptoms was found.

Nitin Gosewade (2016) conducted study on Effect of Pranayama and Eye Exercise on Visual Acuity of Medical students. This case control study was done 60 medical students, divided into study and control groups equally. Study group subjects performed Kapalabhatipranayama and eye exercises regularly for eight weeks while control group participants did not participate in any kind of exercise. Snellen chart was used to test the visual acuity. There was significant improvement in visual acuity in subjects practicing pranayama and eye exercises. Visual acuity values in left eye were 34.30±20.28 and 30.70±21.89 respectively. Values in left eye were 34.60±20.08 and 30.46±21.62 respectively. In control group the values were 32.60±20.37 and 32.30±20.44 for right eye respectively and 31.10±19.22and 30.90±19.15 for left eye. As the result visual acuity improvement.

Sawant Dhamanjay Anandraol (2016) conducted a clinical study to evaluate the role of eye exercise. A total of 64 patients were registered under two main groups with four sub groups of refractive error like myopia, hypermetropia, astigmatism and presbyopia, respectively. (GROUP A – 32 patients) and (GROUP B-32 patients) by random sampling method. A total of 64 patients were recruited for the study. An elaborative case taking performance was specially for the purpose of incorporative all aspects of the disease on Ayurvedic and modern parlance. In Snellen`s chart reading one line improvement in clarity of vision, contrast sensitivity and fineness of the objects. Out of 64 patients studied in this work, maximum patients (45.45%) were found in the age group of 16-30 years. Majority of patients were watching television (50%) and working on computers (59.09%) for 2-4 hours daily. By eye exercise, moderate improvement was observed in one patient (3.20%), mild improvement was observed in 20 patients (64.45%), and no improvement was observed in 12 patients (37.5%) of timira.

METHODS AND MATERIALS:

Research Design:

Quasi-experimental one group pretest and posttest design was adopted in this study. Samples were taken based on the criteria. Hence the design was found to be an appropriate to evaluate the effect of ophthalmic exercise among students with myopia

Research Setting:

The study was conducted in Nursing college. It is situated inside the campus of Hospital, Coimbatore. The total strength of the students was 383.

Population:

The target population of the present study was students with myopia. The accessible population of I, II and III Year B.Sc (Nursing) students with myopia. The population for the present study were 35samples.

Sampling Technique:

A total of 35 students with myopia were selected for the study using non probability–purposive sampling technique.

Variables of the Study:

Independent variable: Ophthalmic exercises

Dependent variable: Level of eye strain among students with myopia.

Criteria for Sampling Collection:

Inclusion criteria:

· I, II, III Year nursing Students with myopia

· Students of male and female

· Students with age group between 17 to 21 years

· Students who are cooperative.

Exclusion criteria:

· Students age more than 21 years.

· Students with other eye disorder.

· Tool for the Data Collection

The following tools were used for the data collection and it consists of 3 section

PART-A Structured Questionnaires for Demographic Variables:

Demographic data consists of age, sex, education and history related to Duration of Spectacles usage, Previous vision consultation.

PART-B Questions Related to Level of Knowledge:

It consists of a 20 questions which is related to myopia and ophthalmic exercise.

Each correct answer carries “one mark” and wrong answer carries “zero mark”. The total mark was 20.

Score interpretation: Obtained score / Total score x 100

< 50% - Inadequate Knowledge

51-75% - Moderately Adequate Knowledge

>75% - Adequate Knowledge

PART-C Asthenopic Symptoms Scale:

It consist of seven components to assess the level of eye strain. The total mark was 14.

Score interpretation:

0 No Symptoms,

1-4 Mild Symptoms,

5-9 Moderate Symptoms,

10-14 Severe Symptoms.

Ophthalmic exercise:

It consists of eight exercises designed for students with myopia. Each exercise is performed for 2 minutes, twice a day for one week.

DATA ANALYSIS AND INTERPRETATION:

Table No 1: Frequency and Percentage Distribution of Age Group among Students with Myopia: n=35

S. No.	Age	Frequency	Percentage (%)
1.	17-18 years	26	74.29
2.	19-20 years	7	20.00
3.	21andabove	2	5.71

The above table reveals that among35 samples, 74.29% of students were in age group of 17-19 years, 20% of students were in the age group of 19-21years, 5.71% of students were above 21 years.

Table No 2: Gender Distribution among Students with myopia: n=35

S. No	Gender	Frequency	Percentage (%)
1.	Male	10	28.57
2.	Female	25	71.43

The above table reveals that among 35 samples, 28.57%ofstudents were male and 71.43% of students were female.

Table 3 : Course of College Students with Myopia: n=35

S. No	Year of the student	Frequency	Percentage (%)
1.	First year	23	65.72
2.	Second year	4	11.43
3.	Third year	8	22.85

The above table reveals that 35 samples, majority 65.72% of students were in the first year, 11.43% of students were in the second year and 22.85% of students were in the third year.

Table No 4 : Duration of Spectacles Usage among Students with Myopia n=35

S. No.	Duration	Frequency	Percentage (%)
1	Within 1 year	3	8.58
2	1-5 years	20	57.14
3	5-10 years	10	28.57
4	Not in regular use	2	5.71

The above table reveals that among 35 samples, 8.58% of students were wearing spectacles within 1year, 57.14% students were wearing spectacles within 1-5years, 28.57% of students were wearing spectacles within 5-10years, 5.71 of students were not in regularly usage.

Table 5: Previous Vision Consultation among Students with Myopia n=35

S. No.	Consultation	Frequency	Percentage (%)
1	Within 4-12 months	17	48.57
2	1-2 year	15	42.85
3	Above 2 years	3	8.58

The above table reveals that among 35 samples, 48.57% students had previous vision consultation within 4-12 months, 42.85% students had previous vision consultation within 1-2 year, 8.58% students had previous vision consultation above 2 years.

Table 6: Regular Spectacles Users among students with Myopia n=35

S No	Regular use of spectacles	Frequency	Percentage (%)
1	Yes	26	74.29
2	No	9	25.71

The above table reveals that among 35 samples, 74.29% of tudents used spectacles regularly and 25.71% of students were not using spectacles regularly.

Table No. 7: Contact Lens Users among students with Myopia:

n =35

S. No	Contact lens users	Frequency	Percentage (%)
1.	Yes	9	25.71
2.	No	26	74.29

The above table reveals that among 35 samples, 25.71% of students were using contact lens, 74.29% of students were not using contact lens.

Table No. 8: Distribution of Associated Illness among Students with Myopia n=35

S. No.	Other associated illness	Frequency	Percentage (%)
1	No	33	94.29
2	Yes	2	5.71

The above table reveals that among 35 samples, 5.71% of students had other associated illness and 94.29% of students did not have any associated illness.

Table No 9: Pre test Level of Knowledge on Ophthalmic Exercise Among Students with Myopia n=35

S. No	Knowledge score	No of samples	Percentage
1.	Inadequate <50%	-	-
2.	Moderate 51-75%	23	65.71
3.	Adequate >50%	12	34.29

The above table reveals that among 35 samples, 65.71% of students had moderate knowledge and 34.29% of students had adequate knowledge.

Table No 10: Post test Level of Knowledge on Ophthalmic Exercise Among Students with Myopia

S. No	Knowledge score	No of samples	Percentage (%)
1.	Inadequate <50%	-	-
2.	Moderate 51-75%	2	5.71
3.	Adequate >50%	33	94.29

The above table reveals that among 35 samples, 5.71% of students had moderate knowledge, 94.29% of students had adequate knowledge.

Table No. 11: Level of Eye Strain Among Students with Myopia Before Intervention

S. No	Symptoms	Frequency	Percentage (%)
1.	No symptoms	-	-
2.	Mild symptoms(1-4)	22	62.86
3.	Moderate symptoms(5-9)	13	37.14
4.	Severe symptoms(10-14)	-	-

The above table reveals that among 35 samples, 62.86% of students had mild symptoms, 37.14% of students had moderate symptoms on the asthenopic symptoms scale.

Table No. 12: Level of Eye Strain Among Students with Myopia after Intervention

S. No	Symptoms	Frequency	Percentage (%)
1.	No Symptoms (0)	5	14.28
2.	Mild Symptoms (1-4)	30	85.72
3.	Moderate Symptoms (5-9)	-	-
4.	Severe Symptoms (10-14)	-	-

The above table reveals that among 35 samples, 14.28% of students with no symptoms, 85.72% of students with mild symptomsasthenopic symptoms scale.

Table No. 13: Analysis the Effect of Ophthalmic Exercise on Level of Knowledge Among Students with Myopia

S. No	Observation	Mean	Standard deviation	Mean difference	‘t’ value
1.	Pre-test	13.6	0.64	2.48	10.75**
2.	Post-test	16.08	1.56	2.48	10.75**

**Significant at 0.001 level

Paired “t” test was used to compare the pre test and post test level of knowledge among college student with myopia. It was identified that the mean level of knowledge among college student during pre test and post test was 13.6 and 16.08 respectively with a mean difference of 2.48. Likewise the standard deviation of pre test and post test was 0.64 and 1.56 respectively. The calculated “t” value 10.75 was greater than the table value of 1.96 at 0.001 level of significance. Hence the research hypothesis Ho: “There is a significance difference in the pre test and post test level of knowledge among student with myopia” is accepted

Table No. 14: Analysis the Effect of Ophthalmic Exercise on Level of Knowledge Among Students with Myopia

S. No	Observation	Mean	Standard deviation	Mean difference	‘t’ value
1.	Pre test	4.08	2.01	2.08	5.94***
2.	Post test	2	1.19	2.08	5.94***

***Significant at 0.01 level

Paired ‘t’ test was used to compare the pre test and post test level of eye strain among college student with myopia. It was identified that the mean level of eye strain among college student during pre test and post test was 4.08 and 2 respectively with a mean difference of 2.08. Likewise the standard deviation of pre test and post test was 2.01 and 1.19 respectively. The calculated ‘t’ value 5.94 was greater than the table value of 1.96 at 0.01 level of significance. Hence the research hypothesis Ho: “There is a significant difference in the pre test and post test level of eye strain among college students with myopia is accepted.

RESULTS AND DISCUSSION:

Table reveals that, 23 (65.71%) samples had moderately adequate knowledge (51-75%) and 12 (34.29%) samples had adequate knowledge (>75%) in pre-test. In post test, 33 (94.29%) samples had adequate knowledge (>75%) and 2(5.71%) samples had moderately adequate knowledge. The study states that structured teaching programme on ophthalmic exercises was an effective. Hence the level of knowledge on ophthalmic exercises among students with myopia had significant difference before and after intervention.

In pretest, 22 (62.86%) samples had mild symptoms and 13 (37.14%) samples had moderate symptoms. In post test, 5 (14.28%) samples had no symptoms and 30 (85.72%) samples had mild symptoms. Hence the ophthalmic exercises among students with myopia had significant difference before and after intervention.

The association between the level of Knowledge and demographic variables among college students with myopia were calculated using chi square.

It was found that chi square value had no association with the ophthalmic exercises among college students with myopia.

The association between the level of eye strain and demographic variables among college students with myopia were calculated using chi square. It was found that chi square value had no association with the ophthalmic exercises among college students with myopia.

MAJOR FINDINGS OF THE STUDY:

· In the present study, out of 35 samples, 26 (74.29%) samples were between 17-19 years of age, 7 (20%) were between 19-21 years, 2 (5.71%) were between 21 above years respectively.

· The samples gender reveals that, 10 (28.57%) samples were males and 25 (71.43%) were females.

· The students educational status reveals that 23 (65.72%) samples are studying in Iyear and 4 (11.43%) samples are studying in II year and eight (22.85%) samples are studying in III year B.SC nursing.

· The duration of continuous spectacles usage among students with myopia reveals that 3 (8.58%) samples with the duration of spectacles usage within one year, 20 (57.14%) samples with the duration of 1-5 years, 10 (28.57%) samples with the duration of 6-10 year and 2 (5.71%) samples were not in regular usage.

· Regards to last vision consultation 17 (48.57%) samples had a last ophthalmic consultation within 4-12 months, 15 (42.85%) samples had a lastophthalmic consultation within 1-2 years and 3 (8.58%) samples had a lastophthalmic consultation above 2 years.

· Out of 35 samples, 26 (74.29%) samples using spectacles regularly and 9(25.71%) samples not wearing spectacles regularly.

· In this study there were, 9(25.71%) samples only used contact lens and 26 (74.29%) samples not using contact lens.

· In the present study, it was identified that majority of the students with myopia revealed that, 26 (74.29%) were between the age group of 17-18years.

· Majority of the students with myopia revealed that, 25(71.43%) were females. Majority of students 23 (65.72%) belong to first year nursing students.

Majority of students 20(57.14%) used spectacles continuously revealed that, were between 1-5 years.

Most of the students 17(48.57%) checked the vision within 4-12 months.

Majority of the students 26(74.29%) used the spectacles regularly

In pre-test, majority of students had moderately adequate knowledge 23(65.71%). In the post-test the student had adequate knowledge 33(94.29%)

LIMITATIONS :

· Sample size of the study was small.

· The duration of the data collection period was short.

RECOMMENDATIONS :

· Replication of the study could be done with a larger samples to validate and generalize the findings.

· Students have to be practiced the ophthalmic exercise to reduce the level eye strain.

· A comparative study can be done with the different level of eye strain among school and college students.

SUMMARY:

Quasi experimental pretest-posttest design was adopted in this study. Ludwing von Bertalanffy general system theory was used as a conceptual framework for the study. This was conducted in nursing college. Reza Norouzirad, Hassan Hashemi (2015) in this cross sectional study, 1375 dezful school children were selected through multistage cluster sampling. Refractive errors were defined as myopia, hyperopia, astigmatism.1151 school children participated in the study, 1130 completed their examinations prevalence of myopia 14.9%, hyperopia12.9% and astigmatism 45.3%. multiple logistic regression analysis showed manage related increase in myopia prevalence and decrease in hyperopia prevalence. This study showed a considerably high prevalence of refractive errors among Iranian population of school children in dezful in the west of Iran.

CONCLUSION:

Regular ophthalmic exercise is healthy lifestyle choice with numerous benefits to eye health. It is beneficial to the eyes by reducing the level of eye strain among students with myopia.

The world health organisation has said short sightedness or myopia, already affect about 30 per cent of the world’s population. That figure is expected to rise to 50 per cent by 2050. Although, the prevalence of myopia varies by the country, age and by ethnic group it is a major cause of visual impairment in both the developed and the developing world. The prevalence of myopia has been reported to be as high as 70-90% in some Asian population with Taiwan reporting a myopia prevalence of 84 per cent among 16-18 years old high school students.

Ophthalmic exercises help to improve in clarity of vision, contrast sensitivity and fineness of objects. It is an encouraging finding that a non-pharmacological, low cost, relaxation techniques can improve the quality of vision by which indirectly check the progression of the disease condition. Hence the ophthalmic exercise is an effective among students with myopia.

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Received on 16.08.2018 Modified on 05.10.2018

Asian J. Nursing Education and Research. 2019; 9(1):43-50.

DOI: 10.5958/2349-2996.2019.00008.9