Association between Ocular Dominance and Interocular Asymmetry in Computer Vision Syndrome: A Multimodal OCT and Scheimpflug Imaging Study

INTRODUCTION: Computer Vision Syndrome (CVS) is a widespread condition driven by prolonged digital device use, yet the structural impact of the inherent functional asymmetry (ocular dominance) within the visual system remains unclear. This study investigates the association between ocular dominance and interocular asymmetries in corneal, anterior segment, and macular neurovascular parameters in individuals with CVS, and assesses the correlation of these asymmetries with daily computer usage.
METHODS: This prospective, cross-sectional study included 80 adults diagnosed with CVS and reporting ≥4 hours of daily computer use. Ocular dominance was determined using standardized tests. All participants underwent Scheimpflug imaging (Pentacam HR) for anterior segment analysis and spectral-domain optical coherence tomography (OCT/OCTA; RTVue-XR Avanti) for macular ganglion cell complex (GCC) thickness and microvascular density measurements. Paired comparisons were made between dominant (DE) and non-dominant eyes (NDE). Correlations with computer use duration were analyzed.
RESULTS: The DE demonstrated significantly thinner central corneal epithelium, deeper anterior chamber depth (exploratory), greater temporal GCC thickness, and reduced deep capillary plexus (DCP) vascular density compared to the NDE. Daily computer use duration showed significant positive correlations with interocular asymmetry for temporal GCC thickness (r=0.38, p=0.001) and foveal avascular zone area (r=0.42, p=0.001).
DISCUSSION AND CONCLUSION: A pattern of structural and vascular interocular asymmetry associated with ocular dominance was identified in CVS patients, characterized by corneal epithelial thinning and temporal macular neurovascular decoupling in the dominant eye. The dose-response relationship with computer use duration suggests an association with cumulative digital visual workload.

Keywords: Computer Vision Syndrome, Ocular Dominance, Corneal Epithelium, Ganglion Cell Complex, Optical Coherence Tomography Angiography, Asymmetry