Abstract
<title>Abstract</title> <p>Background Ocular symptoms are common among workers who use video display terminals, but they are often considered separately from neck-related disability and psychosocial working conditions. We examined ocular symptoms among video display terminal workers in an occupational health program and assessed whether cervical dysfunction and job strain were associated with Ocular Surface Disease Index (OSDI)-defined ocular symptoms. Methods This cross-sectional study included workers participating in the 2025 Occupational Health Protection Action program in Shenzhen, China. Questionnaire data were linked with occupational health examination records at the individual level. Ocular symptoms were defined as an OSDI score of 13 or higher, and cervical dysfunction as a Neck Disability Index (NDI) score greater than 4. Multivariable logistic regression was used to estimate associations after adjustment for demographic, occupational, visual, and ocular examination variables. A supplementary model examined NDI total score as a continuous exposure. Results Among 664 participants, 389 (58.6%) had OSDI-defined ocular symptoms. Cervical dysfunction was associated with higher odds of ocular symptoms after adjustment for covariates (adjusted odds ratio [aOR], 3.78; 95% confidence interval [CI], 2.65–5.45; P < 0.001). Each 0.1-unit increase in the job strain ratio was also associated with higher odds of ocular symptoms (aOR, 1.16; 95% CI, 1.05–1.30; P = 0.006). In the supplementary model, each 1-point increase in NDI total score was associated with higher odds of ocular symptoms (aOR, 1.27; 95% CI, 1.20–1.34; P < 0.001). Conclusions In this occupational health program, ocular symptoms were common among video display terminal workers and were associated with cervical dysfunction and higher job strain. These findings support workplace health approaches that consider visual symptoms together with neck-related disability and psychosocial working conditions. Longitudinal studies with objective ocular assessments are needed to clarify temporal relationships.</p>