Computer Vision Syndrome (CVS), Also Known As Digital Eye Strain, Is A Growing Public Health Concern Due To The Widespread Use Of Digital Devices. Prolonged Screen Exposure Leads To Symptoms Such As Eye Strain, Headaches, Blurred Vision, Dry Eyes, And Musculoskeletal Discomfort.1 University Students, Who Rely Heavily On Computers And Smartphones For Academic And Recreational Purposes, Are Particularly Susceptible. The Shift To Online Learning, Especially During The COVID-19 Pandemic, Has Further Intensified CVS Prevalence, Making Awareness And Preventive Strategies Essential For Maintaining Visual Health And Overall Well-Being.2,3

Present Study Aimed To Determine The Risk Factors, Prevalence And Clinical Manifestations Of The Computer Vision Syndrome Among College Going Students.

The present study is a cross-sectional observational investigation designed to assess the prevalence, risk factors, and clinical manifestations of Computer Vision Syndrome (CVS) among college-going students. The research will be conducted in the Department of Ophthalmology at the National Institute of Medical Science and Research, Jaipur. The target population comprises medical and engineering students at NIMS University, Jaipur, who report screen time usage exceeding three hours daily. Inclusion criteria include college students with more than three hours of daily screen exposure, while exclusion criteria encompass individuals with a history of ocular surgery, retinal or corneal pathology, or ocular trauma.

A total of 270 participants will be systematically selected from the medical and engineering faculties through a random sampling method. Ethical clearance will be obtained from the Institutional Ethics Committee before the commencement of the study. Informed consent will be sought from all participants, ensuring confidentiality, anonymity, and the voluntary nature of participation, with the right to withdraw at any point.

Data collection will be facilitated using a structured, self-administered questionnaire provided in both paper and online formats. The questionnaire will capture demographic data (age, gender, course, year of study), screen usage patterns (daily hours, types of devices, purpose), ergonomic and environmental factors (eye-to-screen distance, seating posture, screen brightness, ambient lighting), and a comprehensive symptom checklist indicative of CVS (headache, dry eyes, burning sensation, redness, blurred vision, eye pain, neck pain, and shoulder pain). Each symptom will be rated using a Likert scale to determine its frequency and severity.

Data management will involve entry into Microsoft Excel, followed by analysis using SPSS version 23. Descriptive statistics (mean, standard deviation, frequency, percentage) will summarize participant characteristics and symptom prevalence. Chi-square tests and logistic regression analyses will explore associations between screen exposure, ergonomic variables, and CVS symptoms. A p-value of <0.05 will denote statistical significance.

The study timeline spans from May 1, 2023, to October 31, 2024. Ethical approval and questionnaire development were scheduled from May to June 2023, followed by a pilot study and validation from July to December 2023. Data collection is set for January to June 2024, and data analysis, interpretation, and report writing will occur between July and October 2024.

Demographic parameters

Table 1. Demographical Parameters of the Subjects Enrolled In the Study

The Study Involved 268 College Students With A Mean Age Of 22.51 ± 2.206 Years, Of Which 50.4% Were Male And 49.6% Female. This Diverse Representation Supports The Generalizability Of The Findings Across Gender And Typical College-Going Age. The Majority of the Students (50.0%) We’re Pursuing Medical Degrees, While The Remaining (50.0%) We’re Engineering Students.

Clinical parameters

Table 2. Clinical Parameters Of The Subjects Enrolled In The Study

Headache Was More Prevalent Among Engineering Students, With Only 35.1% Reporting No Symptoms Compared To 55.2% Of Medical Students. Mild To Severe Headache Was More Frequently Reported In Engineering Students, With 32.8% Experiencing Mild Symptoms, 23.1% Moderate, And 9.0% Severe, Compared To 36.6%, 5.2%, And 3.0% Respectively In The Medical Group.

Burning Eye Sensation Was Also More Common Among Engineering Students, With Only 45.5% Reporting No Symptoms Compared To 65.7% Of Medical Students. Mild Symptoms Were Experienced By 41.8% Of Engineering Students And 29.1% Of Medical Students, While Severe Symptoms Were Rare In Both Groups (0.7%).

Eye Redness Was Significantly More Prevalent Among Engineering Students, With 45.5% Reporting No Symptoms Compared To 84.3% In Medical Students. Severe Redness Was Reported By 9.0% Of Engineering Students, Whereas It Was Rare (0.7%) In Medical Students.

Blurred Vision Showed A Similar Trend, With 50.7% Of Engineering Students Reporting No Symptoms Compared To 82.1% Of Medical Students. Severe Symptoms Were More Prevalent In Engineering Students (4.5%) Than In Medical Students (0.7%).

Dry Eyes Were Reported Less Frequently Among Medical Students, With 70.1% Experiencing No Symptoms Compared To 39.6% Of Engineering Students. Severe Dry Eyes Were More Common In Engineering Students (10.4%) Compared To Medical Students (2.2%).

Neck And Shoulder Pain Was Also More Prevalent Among Engineering Students, With Only 35.1% Reporting No Symptoms Compared To 50.7% In Medical Students. Mild To Severe Symptoms Were More Frequent Among Engineering Students, With 36.6% Reporting Mild, 19.4% Moderate, And 9.0% Severe Pain, Compared To 33.6%, 13.4%, And 2.2%, Respectively, Among Medical Students.

Screen Time Analysis Revealed That A Higher Proportion Of Medical Students (89.6%) Had Less Than 2 Hours Of Screen Time Compared To Engineering Students (82.8%). However, Prolonged Screen Time (5 Or More Hours) Was More Common Among Medical Students (45.5%) Than Engineering Students (29.9%).

Regarding Breaks During Device Use, 86.6% Of Medical Students Reported Taking Breaks Compared To 64.9% Of Engineering Students. Regular Breaks (Every 30 Minutes Or Hourly) Were More Common Among Medical Students, While Shorter Breaks (Less Than 5 Minutes) Were More Frequent Among Engineering Students (18.7% Vs. 7.5%).

Posture While Using Devices Was Generally Poor In Both Groups. Among Engineering Students, 44.0% Reported Bending Their Back, And 42.5% Reported Lying Down, Compared To 47.0% And 37.3% In Medical Students, Respectively.

Awareness And Use Of Monitor Filters Were Higher Among Medical Students (32.1%) Than Engineering Students (22.4%). Similarly, Awareness Of The 20-20-20 Rule Was Higher In Medical Students (44.0%) Compared To Engineering Students (35.1%).

Environmental Factors Such As Poor Room Illumination Were More Common Among Engineering Students, With 20.9% Reporting Dull And 6.0% Reporting Dark Lighting, Compared To 31.3% And 9.0%, Respectively, In Medical Students.

Finally, A History Of Ocular Diseases Was Reported By 16.4% Of Engineering Students And 21.6% Of Medical Students.

These Findings Indicate A Higher Prevalence Of CVS Symptoms Among Engineering Students, Highlighting The Need For Targeted Interventions, Including Awareness Programs And Ergonomic Adjustments, To Reduce The Burden Of CVS Among College-Going Students.

This Study Offers A Comprehensive Evaluation Of The Prevalence, Pattern, And Severity Of Computer Vision Syndrome (CVS) Symptoms Among College Students, Focusing On Engineering And Medical Disciplines. With A Mean Age Of 22.51 ± 2.206 Years And A Balanced Gender Distribution (50.4% Male, 49.6% Female), The Findings Are Generalizable To The Broader Young Adult Academic Population. In Line With Existing Literature, The Study Reaffirms That Students Engaged In Screen-Intensive Disciplines Experience A Greater Burden Of CVS Symptoms Due To Prolonged Exposure, Insufficient Ergonomic Awareness, And Lack Of Consistent Screen Hygiene Practices

Figure 3B. Slice Chart Showing The Visual Assessment Of The Subjects Enrolled In Both The Groups.

Headache Prevalence

Headache Emerged As A Prominent Symptom In This Study, Particularly Among Engineering Students, Where Only 35.1% Reported Being Symptom-Free Compared To 55.2% Of Medical Students. This Aligns Closely With Findings From Tawil Et Al.4, Who Reported A High Headache Prevalence (66.5%) Among Business Students Exposed To Long Hours Of Screen Use. These Comparable Findings Across Disciplines Indicate That The Intensity And Duration Of Screen Interaction Directly Influence The Development Of Headache-Related Symptoms. Supporting Literature By Rosenfield Et Al. (2016)5 And Sheppard & Wolffsohn (2018)6 Highlights The Physiological Basis Of Such Complaints, Pointing To Accommodative Stress, Reduced Blink Rate, And Blue Light-Induced Photostress As Significant Contributors. However, Some Contrasting Evidence, Such As From Coles-Brennan Et Al. (2019)7 And Blehm Et Al. (2005)8, Indicates A Notable Prevalence Of Headaches Even Among Medical Students, Attributed To Prolonged Academic Reading And Screen-Based Learning. These Mixed Trends Underscore The Importance Of Contextual Screen Use Behavior And Break Patterns In Modulating Headache Frequency.

Ocular Symptoms Were Frequently Reported, With Engineering Students Showing Significantly Higher Prevalence Of Burning Sensation (54.5%), Dry Eyes (60.4%), And Redness (54.5%) Compared To Their Medical Counterparts. This Mirrors Findings From Tawil Et Al.4, Who Observed That Over Half Of Business Students Reported Burning Sensations (58.3%) And Dry Eyes (51.5%)—Indicative Of Digital Eye Strain Across High-Screen-Use Academic Groups. The Commonality Of These Symptoms Across Studies Suggests An Underlying Physiological Mechanism, Notably A Reduced Blink Rate, Increased Evaporation Of Tear Film, And Inadequate Gaze Distance Management During Prolonged Visual Tasks. The Current Findings Are Corroborated By Reddy Et Al. (2013)9 And Mohan Et Al. (2020)10, Who Found Engineering Students To Be Particularly Prone To These Symptoms Due To Continuous Coding, Design, And Software Interface Usage. Conversely, Studies By Agarwal Et Al. (2014)11 And Kumar Et Al. (2018)1 Have Shown Similar Symptoms In Medical Students Due To Their Engagement With E-Texts, Histopathology Images, And Clinical Software—Suggesting That The Symptom Burden Is Not Solely Discipline-Specific But Rather A Function Of Digital Task Nature And Visual Ergonomics.

Neck And Shoulder Pain

Musculoskeletal Discomfort—Specifically Neck And Shoulder Pain—Was More Common Among Engineering Students, With 64.9% Reporting Varying Degrees Of Discomfort. A Similar Trend Was Documented By Tawil Et Al4, Where Business Students Also Experienced A High Prevalence (82.2%) Of Musculoskeletal Symptoms. This Strongly Suggests That Static Postures And Poor Ergonomic Conditions Prevalent In Screen-Heavy Academic Environments Lead To Cumulative Strain On The Cervical Spine And Shoulder Girdle. The Association Between Posture And CVS-Related Body Pain Has Been Previously Emphasized By Anshel Et Al. (2007)13 And Shrestha Et Al. (2021)14. Nonetheless, Singh Et Al. (2019)15 And Ganne Et Al. (2021)16 Noted That Medical Students Are Also At Risk Due To Long Hours Spent In Lectures Or Clinical Rotations, Often In Suboptimal Postures. This Suggests That Ergonomic Strain Is An Interdisciplinary Challenge, Warranting Systematic Interventions Across Educational Programs.

The Pattern Of Screen Exposure And Frequency Of Taking Breaks Was Another Critical Dimension Influencing CVS Symptom Severity. In Our Study, 35.1% Of Engineering Students Reported Not Taking Breaks Compared To Only 13.4% Of Medical Students, And A Larger Proportion Of Engineering Students Reported Screen Use Exceeding 5 Hours Daily. These Findings Are Congruent With Those Of Tawil Et Al4, Who Found Business Students Were Less Likely To Take Screen Breaks, Correlating With Higher Symptom Scores. These Behavioral Trends Have Been Substantiated By Sanchez-Brau Et Al. (2020)17 And Talwar Et Al. (2019)18, Who Observed A Higher Digital Load In Technical Fields, With Insufficient Time Allocated For Recovery. Conversely, Portello Et Al. (2012)19 And Hale & Guan Et Al. (2015)20 Emphasized That Even Medical Students May Remain Vulnerable To CVS Despite Scheduled Breaks, As The Cumulative Digital Learning Environment Places Continuous Stress On The Visual And Musculoskeletal Systems.

Postural Ergonomics And Environmental Factors Such As Lighting And Screen Brightness Were Found To Influence CVS Prevalence Significantly. Most Engineering Students Reported Sitting With Bent Backs Or Lying Down While Using Devices, And Similar Behaviors Were Noted Among Business Students In The Study By Tawil Et Al4, Highlighting A Common Lapse In Ergonomic Discipline Among Screen-Intensive Users. Preventive Practices Such As Adherence To The 20-20-20 Rule, Use Of Screen Filters, And Maintaining Appropriate Lighting Were More Commonly Reported By Medical Students In This Study. Only 35.1% Of Engineering Students Were Aware Of The 20-20-20 Rule, Compared To 44.0% Of Medical Students. Similarly, The Use Of Monitor Filters Was Reported By Just 22.4% Of Engineers, Reflecting Lower Preventive Engagement. This Mirrors Findings By Tawil Et Al4, Where Business Students Had Limited Awareness And Practice Of Preventive Measures, Contributing To Their Higher CVS Burden.

In Conclusion, This Study Reaffirms That Engineering Students—Like The Business Students Studied By Tawil Et Al4—Face A Significantly Higher Burden Of CVS Symptoms, Which May Be Attributed To Prolonged Screen Time, Poor Ergonomic Practices, Irregular Breaks, And Lack Of Awareness Of Preventive Strategies. These Results Highlight The Cross-Disciplinary Impact Of Digital Learning Environments On Student Health. To Mitigate This Growing Concern, Targeted Preventive Education, Integration Of Ergonomic Modules In Curricula, And Institutional Policies Supporting Regular Visual Breaks And Posture Correction Are Imperative Across All Academic Streams.

In Conclusion, The Findings Of This Study Reveal A Significantly Higher Prevalence Of Computer Vision Syndrome (CVS) Symptoms Among Engineering Students When Compared To Their Medical Counterparts. This Disparity Is Likely Linked To Several Factors, Including Prolonged Screen Time, Poor Ergonomic Practices, And Inadequate Preventive Measures. Engineering Students, Who Often Engage In Tasks Requiring Extensive Use Of Digital Devices For Academic Purposes, Appear To Be At A Heightened Risk Of Developing CVS. Their Academic Workload, Which Frequently Involves Extended Hours Of Computer Use Without Proper Posture Or Eye Care, Exacerbates The Occurrence And Severity Of Symptoms Such As Headaches, Eye Strain, Burning Sensations, Dry Eyes, And Blurred Vision.

The Results Highlight The Critical Role Of Screen Time As A Key Risk Factor For CVS. Engineering Students, Who Are More Likely To Spend Long Hours In Front Of Screens, May Not Always Adhere To The Best Practices For Eye Care Or Take Regular Breaks, Leading To An Accumulation Of Eye Strain And Discomfort. Furthermore, Improper Ergonomics, Including Poor Seating Positions And Inadequate Workspace Setups, Contribute Significantly To Musculoskeletal Discomfort And Visual Fatigue. These Factors Collectively Create An Environment Conducive To The Development Of CVS Symptoms.

Given The High Prevalence Of CVS Among Engineering Students, It Is Essential To Address This Issue Through Targeted Interventions. Implementing Ergonomic Training Programs To Educate Students On Proper Posture, Workstation Setup, And The Importance Of Regular Breaks Can Significantly Reduce The Risk Of CVS. Awareness Campaigns That Focus On The Importance Of Screen Time Management, Eye Care Practices, And The 20-20-20 Rule (Taking A 20-Second Break Every 20 Minutes Of Screen Use) Are Crucial In Promoting Better Habits And Preventing The Onset Of CVS. Additionally, Encouraging Students To Engage In Physical Activities And Exercises That Alleviate Neck And Shoulder Tension Can Further Mitigate The Physical Strain Associated With Prolonged Screen Use.

In Light Of These Findings, It Is Imperative For Educational Institutions To Incorporate These Preventive Measures Into Student Wellness Programs. By Fostering A Culture Of Awareness And Proactive Health Management, Universities Can Reduce The Burden Of CVS, Enhance Students' Overall Well-Being, And Improve Their Academic Performance By Minimizing The Physical Discomfort That Can Arise From Extended Screen Time. Implementing Such Strategies Will Not Only Benefit Students But Also Contribute To A Healthier And More Productive Academic Environment, Particularly For Those Engaged In Screen-Intensive Courses And Activities.

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