{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T21:19:00Z","timestamp":1775251140818,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MCIN\/AEI\/10.13039\/501100011033"},{"name":"ERDF\/Junta de Andaluc\u00eda-Consejer\u00eda de Transformaci\u00f3n Econ\u00f3mica, Industria, Conocimiento y Universidades"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Mental health concerns have emerged at the university level, with the psychological well-being of students being increasingly affected. This cross-sectional study investigated the proportion of university students having anxiety, and its effects on their visual function and symptomatology. We included 41 students (26.1 \u00b1 4.8 years), and their visual function was assessed through several tests to produce a general visual performance index (VPI). The visual symptomatology was studied using the Conlon Visual Discomfort Survey and the Quality of Vision (QoV) questionnaire. The students were classified into two groups according to the Generalized Anxiety Disorder Screener (GAD-7) test (\u201cno anxiety\u201d and \u201canxiety\u201d groups). The visual function evaluation indicated significantly worse VPI in the anxiety group (p = 0.047). These students also showed significantly higher scores in the Conlon survey (p = 0.004) and two subscales of the QoV questionnaire: symptom severity (p = 0.041) and symptom bothersomeness (p = 0.013). Moreover, the multiple linear regression model showed a significant association between visual discomfort according to the Conlon questionnaire and the level of anxiety (r = 0.405; R2 = 0.164; B = 0.405; p = 0.012). It is important to study the influence of psychological factors on vision, not only for refractive error, but also for binocular and accommodative disorders.<\/jats:p>","DOI":"10.3390\/jcm12206595","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T10:36:56Z","timestamp":1697625416000},"page":"6595","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Relationship between Anxiety, Visual Function, and Symptomatology in University Students"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6353-9511","authenticated-orcid":false,"given":"Sonia","family":"Ortiz-Peregrina","sequence":"first","affiliation":[{"name":"Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0248-1699","authenticated-orcid":false,"given":"Carolina","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2767-4913","authenticated-orcid":false,"given":"Miriam","family":"Casares-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6812-1675","authenticated-orcid":false,"given":"Francesco","family":"Martino","sequence":"additional","affiliation":[{"name":"Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5913-7536","authenticated-orcid":false,"given":"Pilar","family":"Granados-Delgado","sequence":"additional","affiliation":[{"name":"Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3614-2142","authenticated-orcid":false,"given":"Rosario G.","family":"Anera","sequence":"additional","affiliation":[{"name":"Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/j.respol.2017.02.008","article-title":"Work organization and mental health problems in PhD students","volume":"46","author":"Levecque","year":"2017","journal-title":"Res. Policy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/S40037-020-00639-4","article-title":"In the eye of the storm: The mental health situation of PhD candidates","volume":"10","author":"Mattijssen","year":"2020","journal-title":"Perspect. Med. Educ."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1038\/d41586-019-03459-7","article-title":"PhDs: The tortuous truth","volume":"575","author":"Woolston","year":"2019","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"(2019). The mental health of PhD researchers demands urgent attention. Nature, 575, 257\u2013258.","DOI":"10.1038\/d41586-019-03489-1"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2955","DOI":"10.1017\/S0033291716001665","article-title":"Mental disorders among college students in the World Health Organization World Mental Health Surveys","volume":"46","author":"Auerbach","year":"2016","journal-title":"Psychol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1176\/appi.ps.201800332","article-title":"Increased rates of mental health service utilization by U.S. College students: 10-year population-level trends (2007\u20132017)","volume":"70","author":"Lipson","year":"2019","journal-title":"Psychiatr. Serv."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.oftal.2019.08.002","article-title":"Unexplained ocular and visual symptoms: The need for a psychosomatic approach in Ophthalmology","volume":"94","author":"Arntz","year":"2019","journal-title":"Arch. Soc. Esp. Oftalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s13167-018-0136-8","article-title":"Mental stress as consequence and cause of vision loss: The dawn of psychosomatic ophthalmology for preventive and personalized medicine","volume":"9","author":"Sabel","year":"2018","journal-title":"EPMA J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1046\/j.1475-1313.2002.00054.x","article-title":"Sympathetic control of accommodation: Evidence for inter-subject variation","volume":"22","author":"Gilmartin","year":"2002","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_10","first-page":"439","article-title":"Autonomic control of the eye","volume":"5","author":"McDougal","year":"2015","journal-title":"Compr. Physiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1002\/gps.5534","article-title":"Visual, hearing, and dual sensory impairment are associated with higher depression and anxiety in women","volume":"36","author":"Pardhan","year":"2021","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Filon, F.L., Drusian, A., Ronchese, F., and Negro, C. (2019). Video display operator complaints: A 10-year follow-up of visual fatigue and refractive disorders. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16142501"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1136\/oem.58.4.267","article-title":"Psychological factors and visual fatigue in working with video display terminals","volume":"58","author":"Mocci","year":"2001","journal-title":"Occup. Environ. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1097\/OPX.0b013e31812f5f51","article-title":"Measuring visual discomfort in college students","volume":"84","author":"Borsting","year":"2007","journal-title":"Optom. Vis. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1080\/135062899394885","article-title":"Measuring visual discomfort","volume":"6","author":"Conlon","year":"1999","journal-title":"Vis. Cogn."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1097\/00006324-200311000-00008","article-title":"Is all asthenopia the same?","volume":"80","author":"Sheedy","year":"2003","journal-title":"Optom. Vis. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1111\/j.1475-1313.2009.00687.x","article-title":"Accommodation response and visual discomfort","volume":"29","author":"Tosha","year":"2009","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_18","unstructured":"Scheiman, M., and Wick, B. (2008). Clinical Management of Binocular Vision, Wolters Kluwer Health\/Lippincott Williams & Wilins. [3rd ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/MLR.0b013e318160d093","article-title":"Validation and Standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the General Population","volume":"46","author":"Decker","year":"2008","journal-title":"Med. Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/cxo.12550","article-title":"Does Hofstetter\u2019s equation predict the real amplitude of accommodation in children?","volume":"101","author":"Hashemi","year":"2018","journal-title":"Clin. Exp. Optom."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/j.1475-1313.2009.00701.x","article-title":"Clinical evaluation of the Grand Seiko Auto Ref\/Keratometer WAM-5500","volume":"30","author":"Sheppard","year":"2010","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1111\/opo.12851","article-title":"Dynamics of the accommodative response after smoking cannabis","volume":"41","author":"Ortiz","year":"2021","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.visres.2012.04.017","article-title":"Accommodative response and cortical activity during sustained attention","volume":"63","author":"Poltavski","year":"2012","journal-title":"Vis. Res."},{"key":"ref_25","first-page":"919","article-title":"Changes in accommodation dynamics after alcohol consumption, for two different doses","volume":"259","author":"Ortiz","year":"2020","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1016\/j.jcrs.2011.03.042","article-title":"Visual quality after monovision correction by laser in situ keratomileusis in presbyopic patients","volume":"37","author":"Anera","year":"2011","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"5537","DOI":"10.1167\/iovs.10-5341","article-title":"The development of an instrument to measure quality of vision: The quality of vision (QoV) questionnaire","volume":"51","author":"McAlinden","year":"2010","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.clae.2018.03.006","article-title":"Light disturbance with multifocal contact lens and monovision for presbyopia","volume":"41","author":"Fernandes","year":"2018","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/opo.12009","article-title":"Statistical guidelines for the analysis of data obtained from one or both eyes","volume":"33","author":"Armstrong","year":"2013","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1038\/nj7677-549a","article-title":"Graduate survey: A love\u2013hurt relationship","volume":"550","author":"Woolston","year":"2017","journal-title":"Nature"},{"key":"ref_31","first-page":"1","article-title":"A repeated cross-sectional survey assessing university students\u2019 stress, depression, anxiety, and suicidality in the early stages of the COVID-19 pandemic in Poland","volume":"2","author":"Debowska","year":"2020","journal-title":"Psychol. Med."},{"key":"ref_32","unstructured":"Mattijssen, L., van Vliet, N., van Doorn, T., Kanbier, N., and Teelken, C. (2020). PNN PhD Survey Asking the Relevant Questions, Promovendi Netwerk Nederland."},{"key":"ref_33","first-page":"612","article-title":"The relative importance of the parasympathetic and sympathetic nervous systems for accommodation in monkeys","volume":"6","year":"1967","journal-title":"Investig. Ophthalmol."},{"key":"ref_34","first-page":"197","article-title":"Sustained near-vision augments sympathetic innvervation of the ciliary muscle","volume":"1","author":"Gilmartin","year":"1987","journal-title":"Clin. Vis. Sci."},{"key":"ref_35","unstructured":"Gilmartin, B. (1998). Myopia and Nearwork, Butterworth Heinemann."},{"key":"ref_36","unstructured":"Gilmartin, B. (2000). Accommodation and Vergence Mechanisms in the Visual System, Birkh\u00e4user."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1111\/j.1444-0938.2001.tb06606.x","article-title":"Is there an association between functional vision and learning to read?","volume":"84","author":"Kiely","year":"2001","journal-title":"Clin. Exp. Optom."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1097\/OPX.0b013e3181ae1b7c","article-title":"Visual discomfort and objective measures of static accommodation","volume":"86","author":"Chase","year":"2009","journal-title":"Optom. Vis. Sci."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/20\/6595\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:09:07Z","timestamp":1760130547000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/20\/6595"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,18]]},"references-count":38,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12206595"],"URL":"https:\/\/doi.org\/10.3390\/jcm12206595","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,18]]}}}