Correlation between Eye Movements and Asthenopia: A Prospective Observational Study

Abstract

Purpose: To analyze the correlation between eye movements and asthenopia so as to explore the possibility of using eye-tracking techniques for objective assessment of asthenopia. Methods: This prospective observational study used the computer visual syndrome questionnaire to assess the severity of asthenopia in 93 enrolled college students (age 20–30) who complained about asthenopia. Binocular accommodation and eye movements during the reading task were also examined. The correlations between questionnaire score and accommodation examination results and eye movement parameters were analyzed. Differences in eye movement parameters between the first and last reading paragraphs were compared. The trends in eye movement changes over time were observed. Results: About 81.7% of the subjects suffered from computer visual syndrome. Computer visual syndrome questionnaire total score was positively correlated with positive relative accommodation (p < 0.05). In the first reading paragraph, double vision was positively correlated with unknown saccades (all p < 0.05). Difficulty focusing at close range was positively correlated with total fixation duration, total visit duration, and reading speed (all p < 0.05). Feeling that sight was worsening was positively correlated with regressive saccades (p < 0.05). However, visual impairment symptoms were not significantly correlated with any accommodative function. In a total 20 min reading, significantly reduced eye movement parameters were: total fixation duration, fixation count, total visit duration, visit count, fixation duration mean, and reading speed (all p < 0.01). The eye movement parameters that were significantly increased were: visit duration mean and unknown saccades (all p < 0.001). Conclusion: Eye tracking could be used as an effective assessment for asthenopia. Among the various eye movement parameters, a decrease in fixation duration and counts may be one of the potential indicators related to asthenopia.

Accommodative response and visual fatigue following a non‐congruent visual task in non‐asthenopic and asthenopic individuals

“…Those studies that previously compared CVS-Q data with full optometric findings reported unconvincing results. [51][52][53] These studies indicated that the CVS-Q items are multifactorial and seem to be more related to dry eye syndrome than binocular/accommodative anomalies or internal symptoms of asthenopia (see Figure 2). It should be noted that the CVS-Q was developed to assess visual symptoms related to computer use, but seems to be too specific to assess asthenopia, which was evaluated as accommodative fatigue.…”

“…To the best of our knowledge, no study has compared objective laboratory metrics of accommodation between individuals classified as either non‐asthenopic or asthenopic. Those studies that previously compared CVS‐Q data with full optometric findings reported unconvincing results 51‐53 . These studies indicated that the CVS‐Q items are multifactorial and seem to be more related to dry eye syndrome than binocular/accommodative anomalies or internal symptoms of asthenopia (see Figure 2).…”