Assessment of Binocular Vision and Digital Device Use in Asthenopic and Non-Asthenopic Pre-Presbyopic Adults
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Abstract
Background: Digital device use has increased substantially among pre-presbyopic adults and is frequently associated with asthenopic symptoms such as eye strain, headache, blurred vision, diplopia, ocular fatigue, and burning sensation. However, the relationship between these symptoms and measurable binocular vision parameters remains unclear. Objective: To assess binocular vision parameters and digital device-use patterns among asthenopic and non-asthenopic pre-presbyopic adults and determine whether asthenopic symptoms are associated with objective binocular vision differences. Methods: An analytical cross-sectional comparative study was conducted among 70 adults aged 20–40 years who were regular digital device users. Participants were classified as asthenopic or non-asthenopic using the Convergence Insufficiency Symptom Survey. Digital device-use characteristics and asthenopic symptoms were recorded through a structured questionnaire. Binocular vision assessment included near point of convergence, positive and negative fusional vergence, accommodative amplitude, accommodative facility, and vergence facility. Data were analyzed using SPSS version 26.0, with independent-samples t-tests used for group comparisons. Results: Asthenopia was present in 44 participants (62.9%), while 26 participants (37.1%) were non-asthenopic. Eye strain and headache were the most common symptoms, each reported by 39 participants (55.7%). More than one-third of participants used digital devices for >8 hours daily, and 37 participants (52.9%) reported worsening symptoms after prolonged device use. No statistically significant differences were found between asthenopic and non-asthenopic groups for near point of convergence, positive or negative fusional vergence, accommodative amplitude, accommodative facility, or vergence facility. Conclusion: Asthenopia was highly prevalent among pre-presbyopic digital device users, but symptoms were not associated with significant differences in measured binocular vision parameters. Digital eye strain appears to be multifactorial, requiring assessment of binocular function alongside screen exposure, visual breaks, ergonomics, and ocular comfort.
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