Associations between ocular surface parameters, contrast sensitivity, and higher-order aberrations in computer vision syndrome.

PURPOSE: To evaluate changes in ocular surface parameters, contrast sensitivity (CS), and higher-order aberrations (HOAs) in patients with computer vision syndrome (CVS)/digital eye strain (DES), and to assess associations among these factors.

DESIGN

Prospective observational case-control study.

METHODS

Both eyes of 55 CVS cases (CVS-Q score ≥ 6) and 55 age-matched controls (18-40 years) with best-corrected visual acuity (BCVA) of 6/6 were enrolled. Participants with ocular comorbidities were excluded. Central and peripheral CS were assessed using the Pelli-Robson (PR) chart and Spaeth-Richman contrast sensitivity test (SPARCS). Dry eye disease (DED) workup was performed. HOAs were measured using a wavefront aberrometer (iDesign® Refractive Studio, Johnson and Johnson Surgical Vision, Inc.).

RESULTS

PR scores were identical across groups. SPARCS revealed significantly reduced total CS scores (central and peripheral) in the CVS group (W = 3641.000, P < 0.001), highlighting its sensitivity to subtle CS changes. The CVS group showed significantly higher HOA values (%), root mean square HOA error (P < 0.001), and spherical aberration (P = 0.033), along with more severe DED findings.

CONCLUSION

CVS/DES leads to impaired visual function due to reduced CS, increased HOAs, and dry eye. Assessment of both central and peripheral CS provides a more complete understanding of its impact on visual quality and daily functioning. Early ergonomic interventions and preventive strategies are vital for protecting ocular health in an increasingly digital world.