Effectiveness of I-Exercises: A Comprehensive Ocular Exercise Protocol for Reducing Ocular Fatigue Among Students With Myopia in a Randomized Controlled Trial

Background The prevalence of ocular fatigue associated with prolonged digital device use and sustained near-vision tasks is increasing among students with myopia. However, evidence regarding the effectiveness of structured ocular exercise programs remains limited. Objective To determine the effectiveness of a Comprehensive Ocular Exercise Module (I-Exercises) in reducing ocular fatigue symptoms among students with myopia. Methods A randomized controlled trial was conducted among 40 participants aged 18-25 years with myopia. Participants were randomly allocated using a computer-generated sequence to an experimental group (n = 20) that received I-Exercises or a control group (n = 20) that received no intervention. Participants in the experimental group performed supervised ocular exercises five times per week for three weeks. Ocular fatigue was assessed before and after the intervention using a 12-item ocular fatigue questionnaire adapted from a previously published instrument. Each symptom was scored independently from 0 to 6, with higher scores indicating greater severity. Results Participants receiving I-Exercises demonstrated significant improvement in several ocular fatigue symptoms compared with the control group (p < 0.05). Significant between-group improvements were observed in tired eyes, sore/aching eyes, irritated eyes, watery eyes, eyestrain, blurred vision, difficulty focusing, and visual discomfort, whereas red eyes, dry eyes, hot/burning eyes, and double vision did not show statistically significant between-group differences. Conclusion The I-Exercises Module may help reduce selected ocular fatigue symptoms among students with myopia and may serve as a non-invasive approach for reducing symptoms associated with prolonged near-vision tasks. These findings should be interpreted as preliminary given the small sample size, short intervention period, and exploratory nature of the individual symptom-level analyses.