{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:11:37Z","timestamp":1760058697313,"version":"build-2065373602"},"reference-count":71,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: To understand if binocular vision disorders are associated with Digital Eye Strain Syndrome (DESS), a study protocol is needed to ensure consistency across observational studies. This study aims to test the feasibility of a protocol to assess DESS, screen time, binocular vision, and dry eye. Methods: DESIROUS is an observational cross-sectional study among Polytechnic students at the Lisbon School of Health Technology, Portugal. The protocol includes three questionnaires (Computer Vision Syndrome Questionnaire [CVS-Q], Convergence Insufficiency Symptom Survey [CISS], and Dry Eye Questionnaire version 5 [DEQ-5]), an assessment of visual acuity and binocular vision (cover test for near and distance, stereopsis, near point convergence (NPC), near point accommodation (NPA), accommodative facility, vergence), and the ocular surface break-up tear (BUT) test. The questionnaires were validated using Cronbach\u2019s alpha. Interobserver variability for BUT was assessed using Cohen\u2019s Kappa, Intraclass Correlation Coefficient (ICC), and Bland\u2013Altman analysis involving three observers (A, B, and C), compared against an expert as the gold standard. Results: A total of 18 students were included in the validation phase (mean age: 21.50 \u00b1 0.62 years; females: 77.8%). The internal consistency of the CVS-Q (\u03b1 = 0.773) and the CISS (\u03b1 = 0.756) was considered good, while the DEQ-5 showed a reasonable internal consistency (\u03b1 = 0.594). Observer A had the highest agreement with the gold standard (Cohen\u2019s Kappa = 0.710 and p &lt; 0.001; ICC = 0.924, p &lt; 0.001). Conclusions: We provide a protocol to assess binocular vision and the ocular surface, with an emphasis on objective measures while integrating other assessment approaches. Further studies are necessary to validate this protocol, potentially incorporating new measures to enhance its validity across different populations.<\/jats:p>","DOI":"10.3390\/jpm15050168","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T04:08:24Z","timestamp":1745554104000},"page":"168","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of Binocular Vision and Ocular Surface Assessment Tools in Digital Eye Strain Syndrome: The DESIROUS Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0889-4809","authenticated-orcid":false,"given":"Maria Jo\u00e3o","family":"Barata","sequence":"first","affiliation":[{"name":"Ophthalmology Department, Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9, 1150-199 Lisbon, Portugal"},{"name":"University of Evora, 7004-516 Evora, Portugal"},{"name":"Department of Therapy and Rehabilitation Sciences, Escola Superior de Tecnologia da Sa\u00fade de Lisboa (ESTeSL), Instituto Polit\u00e9cnico de Lisboa, 1990-096 Lisbon, Portugal"},{"name":"Comprehensive Health Research Center (CHRC), Escola Nacional de Sa\u00fade P\u00fablica, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-7732","authenticated-orcid":false,"given":"Pedro","family":"Aguiar","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Center (CHRC), Escola Nacional de Sa\u00fade P\u00fablica, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal"},{"name":"Department of Health Strategies, National School of Public Health, NOVA University of Lisbon, 1600-560 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3724-2391","authenticated-orcid":false,"given":"Andrzej","family":"Grzybowski","sequence":"additional","affiliation":[{"name":"Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, 61-701 Poznan, Poland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9918-787X","authenticated-orcid":false,"given":"Carla","family":"Lan\u00e7a","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Center (CHRC), Escola Nacional de Sa\u00fade P\u00fablica, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal"},{"name":"Division of Science, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0320-1839","authenticated-orcid":false,"given":"Andr\u00e9","family":"Moreira-Ros\u00e1rio","sequence":"additional","affiliation":[{"name":"NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"},{"name":"Comprehensive Health Research Center (CHRC), NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e000146","DOI":"10.1136\/bmjophth-2018-000146","article-title":"Digital eye strain: Prevalence, measurement and amelioration","volume":"3","author":"Sheppard","year":"2018","journal-title":"BMJ Open Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.survophthal.2005.02.008","article-title":"Computer vision syndrome: A review","volume":"50","author":"Blehm","year":"2005","journal-title":"Surv. 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