Yogic Eye Exercises for Computer Vision Syndrome in Female Design Students

Design. Single-arm, pre-post interventional study in which each participant served as her own control, conducted in the Graphic Design and Digital Media programme of Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. No control group was recruited and no masking was applied.

Participants. All 36 female students enrolled in the programme were invited and all agreed, so the convenience sample was a complete enumeration of the eligible cohort. The programme admits female students only. All participants were in the 18-22 year age band.

Intervention. Participants were trained in a single supervised group session before baseline and given written and illustrated instructions. Each session comprised relaxation exercises (slow blinking; gazing at a fine detail of a distant target; acupressure massage of periocular points) followed by strengthening exercises (eye-rolling movements; nose-tip gazing, in which the participant focuses on the extended thumb, moves it slowly toward the nose tip, holds for five seconds and moves it away). The combined sequence took approximately 13 minutes and was performed three days per week for four consecutive weeks, giving 12 sessions in total. After the training session participants practised independently and reported completion of each session the same day in a monitored group thread, so adherence was verified session by session rather than recalled at the end.

Assessment. Symptoms were assessed with an adapted electronic questionnaire administered at baseline and at the end of week 4. The instrument was developed by reviewing validated instruments in the literature, refining items with subject-matter experts and pilot testing in six female students. It recorded demographic details, medical history relevant to ocular surface dryness, habitual computer use, and nine symptom items each rated on a 4-point Likert scale (1 = never, 2 = rarely, 3 = sometimes, 4 = always). The identical instrument and platform were used at both time points.

Analysis. The primary outcome, the total symptom score, and the two domain scores were compared with the paired-samples t-test, with the Wilcoxon signed-rank test reported alongside where normality was not supported; item-level differences were tested with the Wilcoxon signed-rank test. Because nine item-level comparisons were made, p-values were adjusted by the Holm-Bonferroni procedure. No data were imputed and no subgroup or interaction analyses were performed. No formal a priori sample size calculation was performed; the study enrolled the entire eligible cohort.

Registration. This record was created retrospectively. The study was investigator-initiated and approved by the Princess Nourah bint Abdulrahman University Institutional Review Board on 20 December 2020, before the first participant was enrolled on 15 March 2021. The design, intervention and outcome measures recorded here are those specified in the approved protocol and are unchanged.

Inclusion criteria

• Female undergraduate enrolled in the Graphic Design and Digital Media programme at Princess Nourah bint Abdulrahman University
• Use of a computer for at least one month before the study
• Able to read and understand English
• Provided written informed consent

Exclusion criteria

• Diagnosis of Sjögren syndrome
• Diagnosis of keratoconjunctivitis sicca
• Use of medications known to reduce tear production, for example antihistamines
• Use of isotretinoin