Clinical Profile of Non-Strabismic Binocular Vision Anomalies in College Students in Haryana region aged 18–30 Years

Abstract

Purpose:
This study aimed to determine the incidence and clinical profile of non-strabismic binocular vision anomalies (NSBVAs) among college students aged 18–30 years and to examine their association with self-reported symptoms.

Methods:
A cross-sectional study was carried out among 476 screened students from two colleges, of whom 150 were eligible and selected using simple random sampling. Eligibility criteria included best-corrected or unaided visual acuity of 6/9 or better in each eye and absence of manifest strabismus, ocular disease, or prior ocular surgery. Students with systemic or neurological disorders, medications affecting vergence or accommodation, or uncorrected refractive errors greater than ±0.50 D were excluded. Clinical assessment included visual acuity, cover testing, near point of convergence (NPC), near point of accommodation (NPA), fusional vergence amplitudes (FVA), negative relative accommodation and positive relative accommodation (NRA and PRA), and accommodative facility (AF), performed under standardized protocols. Data were analysed using descriptive and inferential statistics, with p < 0.05 considered significant.

Results:
The final cohort comprised 87 females (58.0%) and 63 males (42.0%), with nearly equal representation of urban (49.3%) and rural (50.7%) students. NSBVAs were common, with convergence insufficiency (CI) being the most frequent anomaly (31.3%), followed by CI with accommodative insufficiency (18.0%), CI with accommodative excess (17.3%), and CI with accommodative infacility (15.3%). Accommodative excess alone occurred in 5.3% of cases, while other anomalies were rare (<5%). Although 42% of affected students were asymptomatic, the most reported complaints were headache (16.7%), blurred vision (10.0%), ocular pain (8.7%), and eye strain or watering (6%).

Conclusion:
Convergence insufficiency and its variants were the predominant NSBVAs, affecting nearly two-thirds of students. Despite many being asymptomatic, symptomatic cases reported significant discomfort. Routine binocular vision assessment in young adults is essential for early detection and management to enhance visual comfort and academic performance.