Sports vision training reduces digital eye strain in screen-exposed university students: a randomized controlled trial of visuomotor and visual-attentional adaptation.

Background: Computer vision syndrome (CVS), or digital eye strain, is common among university students exposed to prolonged screen-based near work, yet most preventive approaches rely on passive strategies such as visual breaks, ergonomic advice, or optical filtering. This randomized controlled trial examined whether a 12-week sports vision training (SVT)-enhanced physical education program could reduce CVS symptoms in college students with high daily screen exposure. Methods: Two hundred undergraduate students were randomized to an SVT group or a control group, with 100 participants in each group and equal sex distribution. The SVT program integrated BACKNSHOU exercises, a structured sequence of eye, neck, shoulder, and back movements used for visual and postural preparation, Fitlight reaction tasks, SENAPTEC strobe-glasses training involving intermittent visual occlusion during visuomotor activities, multi-target tracking, and sport-based cognitive-motor activities. The control group continued standard physical education and received general 20-20-20 eye-use advice. CVS symptoms were assessed before and after intervention using CVS-SMART, covering visual-fatigue, ocular-surface, and neuromuscular/extraocular domains. Results: At baseline, 149 of 200 participants were classified as CVS-positive, corresponding to a prevalence of 74.5%, with no significant difference across sex-by-group strata. After 12 weeks, CVS-positive prevalence decreased from 76.0 to 44.0% in male SVT participants and from 72.0 to 38.0% in female SVT participants, whereas the control group showed only small, non-significant reductions. Self-reported symptom-specific analyses showed reductions in eye fatigue/soreness, difficulty focusing, red eyes, headache, and neck/shoulder/back pain in the SVT group. Generalized linear mixed models indicated lower post-intervention odds of symptom reporting across all five modeled symptoms, with group effects favoring SVT for all symptoms and reaching statistical significance for eye fatigue/soreness and red eyes. Conclusion: These findings suggest that dynamic, movement-based visual training may complement conventional CVS prevention strategies, although future studies incorporating objective ocular, oculomotor, and neurophysiological measures are needed to clarify mechanisms. This study extends sports vision training from athletic performance contexts to CVS symptom reduction in a non-athlete, screen-exposed student population.