{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:14:14Z","timestamp":1777950854453,"version":"3.51.4"},"reference-count":41,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Regional Innovation System & Education (RISE) program through the Gangwon RISE Center"},{"name":"The Ministry of Education (MOE) and the Gangwon State (G.S.), Republic of Korea","award":["2025-RISE-10-001"],"award-info":[{"award-number":["2025-RISE-10-001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non-strabismic binocular dysfunction can cause visual discomforts such as intermittent diplopia, blurriness, and asthenopia. This study investigates the impact of binocular dysfunction on cybersickness and postural control during Virtual Reality (VR) viewing, providing valuable insights for VR technology development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A sample of 46 young adults (mean age 22.3\u00a0\u00b1\u00a01.98 years; 22 males and 24 females) was divided into a binocular dysfunction group (23 individuals) and a normal group (23 individuals) for comparative analysis. The binocular dysfunction group consisted entirely of individuals with exophoria, indicating a convergence-related fusional deficit rather than an accommodative problem. Participants underwent visual function assessments and completed the Ocular Visual Discomfort and Quality of Life (COVD-QOL) survey, and the Virtual Reality Sickness Questionnaire (VRSQ). Postural control was evaluated using the BtrackS balance plate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Results showed that the binocular dysfunction group exhibited significantly greater near exophoria, lower accommodative amplitudes, and reduced positive fusional vergence at both distance and near (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). They also reported higher visual discomfort (COVD-QOL,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). After VR exposure, cybersickness significantly increased in both groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), with a greater rise in the binocular dysfunction group. This group also had higher oculomotor disorder and disorientation scores pre- and post-exposure. Postural instability significantly worsened after VR in the binocular dysfunction group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), and cybersickness severity positively correlated with in-creased medial-lateral sway and sway ellipse area. In conclusion, binocular dysfunction exacerbates cybersickness and impairs postural control, representing a critical human factor in VR environments. These findings underscore the importance of developing optical technologies to mitigate the risks associated with binocular dysfunction, thereby enhancing user safety in VR.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.21169","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:26:02Z","timestamp":1777883162000},"page":"e21169","source":"Crossref","is-referenced-by-count":0,"title":["Effects of virtual reality exposure on postural control: a comparative analysis before and after exposure in individuals with binocular dysfunction and normal vision"],"prefix":"10.7717","volume":"14","author":[{"given":"AeJin","family":"Park","sequence":"first","affiliation":[{"name":"Department of Medical Health Science, Kangwon National University, Samcheok, Republic of South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HyunGoo","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Optometry, Catholic Kwandong University, Gangneung, Republic of South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang-Yeob","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Optometry, College of Health Science, Kangwon National University, Samcheok, Republic of South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"issue":"1","key":"10.7717\/peerj.21169\/ref-1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.11648\/j.ijovs.20210601.12","article-title":"Effects of virtual reality head-mounted displays on oculomotor functions","volume":"6","author":"Alhassan","year":"2021","journal-title":"International Journal of Ophthalmology & Visual Science"},{"issue":"1","key":"10.7717\/peerj.21169\/ref-2","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/s0887-8994(00)00140-5","article-title":"Vertigo is an underestimated symptom of ocular disorders: dizzy children do not always need MRI","volume":"23","author":"Anoh-Tanon","year":"2002","journal-title":"Pediatric Neurology"},{"issue":"3","key":"10.7717\/peerj.21169\/ref-3","doi-asserted-by":"publisher","first-page":"100514","DOI":"10.1016\/j.optom.2024.100514","article-title":"Binocular vision parameters and visual performance in bilateral keratoconus corrected with spectacles versus rigid gas-permeable contact lenses","volume":"17","author":"Barba-Gallardo","year":"2024","journal-title":"Journal of Optometry"},{"issue":"5","key":"10.7717\/peerj.21169\/ref-4","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1136\/jnnp.59.5.472","article-title":"Visual vertigo syndrome: clinical and posturography findings","volume":"59","author":"Bronstein","year":"1995","journal-title":"Journal of Neurology, Neurosurgery and Psychiatry"},{"key":"10.7717\/peerj.21169\/ref-5","doi-asserted-by":"publisher","first-page":"1658","DOI":"10.1080\/10447318.2020.1778351","article-title":"Virtual reality sickness: a review of causes and measurements","volume":"36","author":"Chang","year":"2020","journal-title":"International Journal of Human\u2013Computer Interaction"},{"issue":"2","key":"10.7717\/peerj.21169\/ref-6","doi-asserted-by":"publisher","first-page":"55","DOI":"10.15207\/JKCS.2022.13.02.055","article-title":"The effect of convergence vision therapy on VR cybersickness","volume":"13","author":"Cho","year":"2022","journal-title":"Journal of the Korea Convergence Society"},{"issue":"6","key":"10.7717\/peerj.21169\/ref-7","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1097\/NHH.0000000000000823","article-title":"BTracks: a low-cost, portable force plate for objectively measuring balance deficits and fall risk","volume":"37","author":"Daniel","year":"2019","journal-title":"Home Healthcare Now"},{"key":"10.7717\/peerj.21169\/ref-8","first-page":"111","article-title":"Presence enhancing real walking user interface for firsted person video games","author":"Frank","year":"2009"},{"key":"10.7717\/peerj.21169\/ref-9","first-page":"11","article-title":"A theoretical approach of the design and evaluation of a virtual reality device. 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