Annual Scientific Meeting
Introduction: Previous studies indicate that adenoma detection rate (ADR) decreases as the number of consecutive hours performing procedures increases. Differences in adaptation between a bright screen and a dimly lit room may contribute to eye strain and eye strain related symptoms occur in most video display users. Increasing ambient light may improve symptoms of eye strain, but ambient light effects have yet to be explored in the field of gastroenterology. We aim to determine if the use of ambient lighting, between 75-150 lux, during screening colonoscopy will maintain ADRs and decrease symptoms of eye strain.
Methods: A single center study comparing screening colonoscopies in a dimly lit room to use of ambient lighting by 9 gastroenterologists was performed. Retrospective data was collected over a 6-month period performed in procedure rooms with no lighting. Prospective data was then collected on colonoscopies with ambient lighting during the same 6 calendar months the following year. A survey on eye fatigue was completed by all gastroenterologists before and after the use of ambient lighting. Satisfaction surveys were completed by gastroenterologists, anesthesiologists, nurses and technicians.
Results: There were 498 low light and 611 ambient light cases. 172 adenomas (ADR=34.5%) were detected with low light and 220 adenomas were detected with ambient light (ADR= 36.0%), (p=0.611). For low light cases, ADR was 37.5% for 1st cases of the day and 31.9% for last cases of the day, (p=0.545), (Table 1). For ambient light cases, the ADR was 34.1% for 1st cases of the day and 36.9% for last cases of the day, (p=0.266). Overall difference in ADR between 1st and last cases using ambient lighting (+2.80%) versus no lighting (-5.60%), was statistically significant (p=0.010), (Table 2). 41% of respondents agreed or strongly agreed fewer symptoms of eyes strain occurred with ambient light and 54% of respondents felt that ambient light improved detection of changes in patient status.
Discussion: Our data suggests that performing screening colonoscopies with ambient light may improve the differential change in ADR that occurs from the beginning to the end of the day, as compared with lights off. This improvement in ADR may be related to improved symptoms of eye strain, and further investigation is warranted.