CORRELATION OF CRANIOVERTEBRAL ANGLE WITH DIGITAL EYE STRAIN IN E-SPORTS PLAYERS AMONG UNIVERSITY STUDENTS OF MANSEHRA AND ABBOTTABAD

Background; E-sports has emerged as a rapidly expanding global phenomenon, engaging millions of players, particularly young adults and university students. The extended screen time required in competitive gaming exposes players to digital eye strain (DES), a condition characterized by ocular and musculoskeletal symptoms. Forward head posture, measured by the craniovertebral angle (CVA), is a common postural deviation linked to prolonged device use. Despite growing recognition of these health risks, no prior research has examined the correlation between CVA and DES among university-level e-sport players in Pakistan. Objective: To investigate the correlation between craniovertebral angle and digital eye strain in e-sport players among university students of Mansehra and Abbottabad. Methods: This observational cross-sectional study included 358 university e-sport players aged 18–30 years from two government universities in Mansehra and Abbottabad. Participants played e-games for more than three hours daily and were recruited through non-probability convenience sampling. Digital eye strain was assessed using the validated Computer Vision Syndrome–Smart Questionnaire (CVS-Smart), while craniovertebral angle was measured using a standard goniometer. Ethical approval was obtained (HHIRS/REC/2024/1223), and informed consent was secured. Data analysis was performed using SPSS version 22.0. Descriptive statistics summarized demographics and symptom patterns, and Pearson’s correlation test was used to examine associations between CVA and DES, with p<0.05 considered statistically significant. Results: The mean age of participants was 20.95 ± 2.28 years, with 195 (54.5%) males and 163 (45.5%) females. Regarding gaming duration, 211 (58.9%) played 3–4 hours daily, 98 (27.4%) for 4–6 hours, and 47 (13.1%) for 6–8 hours. Visual symptoms were reported by 253 (70.7%) participants, with 133 (37.2%) experiencing one complaint and 105 (29.3%) reporting two or more. Ocular complaints were present in 253 (70.7%) respondents, while 239 (66.9%) had extraocular symptoms, most commonly two or more (39.7%). Craniovertebral angle assessment showed that 197 (55.0%) had mild deviation, and 137 (38.3%) had moderate deviation. Correlation analysis demonstrated a weak but statistically significant positive association between CVA and DES (r = 0.113, p = 0.032), indicating that posture deviations contributed to increased symptom severity. Conclusion: The findings revealed that the majority of e-sport players experienced visual and musculoskeletal complaints associated with prolonged gaming. Mild to moderate postural deviations were prevalent and correlated with higher severity of DES, highlighting the importance of ergonomic interventions and awareness programs to mitigate health risks among young gamers.