The Association Between Emotional States and Binocular Vision Function in University Students: A Cross-Sectional Study Publisher Pubmed



Riazifar A ; Hashemi H ; Jamali A ; Asharlous A ; Narooienoori F ; Bahreini R ; Sadri M ; Yekta A ; Khabazkhoob M
Source: Strabismus Published:2025

Abstract

Purpose: To examine the association between emotional states and binocular vision functions in university students. Methods: This cross-sectional study involved university students aged between 19 and 35 years who did not have any ocular or systemic diseases. The assessment of emotional states was conducted using the Depression, Anxiety, and Stress Scale (DASS) questionnaire. The relationship between binocular vision functions and each emotional state was examined. Results: A total of 82 individuals were examined, with an average age of 22.38 ± 2.91 years, of which 57.3% were male. The mean scores for stress, anxiety, and depression across the entire sample were 15.78 ± 9.07, 8.61 ± 6.75, and 9.02 ± 7.50, respectively. 52.4% of participants were classified as having normal stress levels, 51.2% demonstrated normal anxiety levels, and 61% were within the normal range for depression; the remaining individuals exhibited varying degrees of emotional distress. Monocular accommodation facility was higher in females (β = 3.37, p <.001), and was associated with higher stress scores (β = 0.11, p =.022), larger near exophoria (β = 0.20, p =.003), and greater accommodation response (β = 1.79, p =.075), while it was lower in individuals with better stereoacuity (β = −0.01, p =.002). Furthermore, accommodation amplitude decreased with increasing age (β = −0.28, p =.001), more myopic spherical equivalent (β = −0.38, p =.005), better stereoacuity (β = −0.01, p =.021), closer near point of convergence (β = −0.21, p =.025), and higher depression scores (β = −0.07, p =.081), and increased with higher stress scores (β = 0.08, p =.016). No significant correlations were found between anxiety or depression and the binocular vision parameters that were assessed. Conclusion: Stress is significantly linked to accommodative functions among university students, underscoring the importance of incorporating stress considerations into clinical assessments of binocular vision function. © 2025 Elsevier B.V., All rights reserved.