Gaze Stabilization vs Oculomotor Exercises on Cybersickness in Computer Users (GAZE-CS)

Effectiveness of Gaze Stabilization Exercises Versus Oculomotor Exercises on Cybersickness in Computer Users: A Randomized Clinical Trial

Many people who use computers for long hours experience "cybersickness" (dizziness, nausea, blurred vision) because their eyes see movement on the screen but their body feels still. This study aims to see which type of eye and head exercises works best to fix this. We will compare Gaze Stabilization Exercises (head movements) against Oculomotor Exercises (eye movements). Forty-six computer users will perform these exercises for 4 weeks. We will measure their dizziness, vision, and quality of life before, during, and after the treatment.

Study Overview

• Status: Active, not recruiting
• Conditions: Vestibular Diseases; Motion Sickness; Cybersickness
• Intervention / Treatment: Behavioral: Gaze Stabilization Exercises; Behavioral: Oculomotor Exercises

Detailed Description

This is a single-blinded, randomized clinical trial. Participants (n=46) will be recruited from The University of Faisalabad. Inclusion criteria include screen time >6 hours/day, computer usage for at least 10 years, and a Simulator Sickness Questionnaire (SSQ) score between 20 and 40.

Group A (Intervention): Gaze Stabilization Exercises. Week 1: View X1 exercises. Week 2: View X2 exercises. Week 3: Gaze shift exercises. Week 4: Imaginary Target exercises. (3 sessions/week, 1 minute per exercise, 3 times each).

Group B (Active Comparator): Oculomotor Exercises. Week 1: Range exercises. Week 2: Saccadic exercises. Week 3: Pursuit exercises. Week 4: Vergence exercises. (3 sessions/week, 1 minute per exercise, 3 times each).

Outcomes: The primary outcome is the change in Dynamic Visual Acuity (LogMAR scale) and Cybersickness (SSQ score). The secondary outcome is Quality of Life (SF-36 questionnaire). Measurements will be taken at baseline, Week 2, and Week 4. Data will be analyzed using SPSS version 20.

• Study Type: Interventional
• Enrollment (Actual): 46
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Faisalābad, Punjab Province, Pakistan, 3800
      • The University of Faisalabad

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Screen time > 6 hours per day
• Computer usage history of at least 10 years
• Complaints of vertigo, blurred vision, and nausea during computer usage
• Positive Romberg's test
• Abnormal VOR (4-6 lines lost on LogMAR scale)
• SSQ score between 20 and 40

Exclusion Criteria:

• Diagnosed vestibular disorders (e.g., BPPV, Meniere's)
• History of falls in the past 6 months
• Pregnancy
• Any neurological or neurodegenerative disease
• Use of walking aids
• Severe visual impairments (worse than 6/12 on Snellen)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Gaze Stabilization Exercises; Participants in this arm will receive Gaze Stabilization Exercises (GSE) for 4 weeks, 3 sessions per week. The protocol includes View X1, View X2, Gaze Shift, and Imaginary Target exercises. Each exercise is performed for 1 minute, repeated 3 times per session. Exercises target the vestibulo-ocular reflex (VOR) by coordinating head and eye movements to reduce sensory conflict.	Behavioral: Gaze Stabilization Exercises; Week 1 - View X1: Patient sits upright. Target held at eye level 1 meter away. Patient turns head horizontally (left/right) or vertically (up/down) while keeping eyes fixed on target. Speed: slow (1Hz). Duration: 1 minute. Repetitions: 3 times per direction. Week 2 - View X2: Same as View X1 but head movement speed increased to 2Hz. Week 3 - Gaze Shift: Two targets placed 30 cm apart horizontally or vertically. Patient rotates head to face Target 1, then shifts gaze to Target 2 while continuing head rotation toward Target 2. Duration: 1 minute. Repetitions: 3 times. Week 4 - Imaginary Target: Patient fixates on a target (e.g., a sticker on wall). Closes eyes. Rotates head 30-45 degrees away from target. While eyes closed, patient imagines still looking at target. Opens eyes and checks if fixation is accurate. Duration: 1 minute. Repetitions: 3 times per direction. All exercises are performed under supervision for the first 3 sessions, then home-based with weekly follow-up calls.
Active Comparator: Oculomotor Exercises Group; Participants in this arm will receive Oculomotor Exercises for 4 weeks, 3 sessions per week. The protocol includes Range, Saccadic, Pursuit, and Vergence exercises. Each exercise is performed for 1 minute, repeated 3 times per session. Exercises target isolated eye movements without head motion to improve oculomotor control and reduce visual strain.	Behavioral: Oculomotor Exercises; Week 1 - Range Oculomotor Exercises: Eyes closed. Patient moves eyes slowly in horizontal (left-right), vertical (up-down), diagonal (top-left to bottom-right), and rotational (clockwise/counterclockwise) directions. Duration: 1 minute per direction. Repetitions: 3 times. Week 2 - Saccadic Exercises: Two stationary targets (e.g., two fingers) held 30 cm apart at eye level. Patient rapidly shifts gaze between targets without moving head. Duration: 1 minute. Repetitions: 3 times. Week 3 - Pursuit Exercises: A single target (e.g., pen) is moved slowly horizontally and vertically. Patient follows target smoothly with eyes only (head still). Speed: approx 20 degrees/second. Duration: 1 minute per direction. Repetitions: 3 times. Week 4 - Vergence Exercises: Target (e.g., pen) starts at 50 cm from patient's nose. Patient focuses on target as it is slowly moved toward nose to 5 cm (convergence), then back to 50 cm (divergence). Duration: 1 minute. Repetitions: 3 times under supervision.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Vestibulo-Ocular Reflex (VOR) Function	Measured by Dynamic Visual Acuity (DVA) test using a LogMAR chart. Patient reads smallest line possible while head is stationary (static VA). Then patient rotates head horizontally at 2Hz while reading. Number of lines lost between static and dynamic conditions is recorded. Normal VOR: 1-2 lines lost. Abnormal: 4-6 lines lost. Higher lines lost = worse VOR function.	Baseline (Week 0), Week 2, Week 4
Change in Cybersickness Severity	Measured by the Simulator Sickness Questionnaire (SSQ). Contains 16 symptoms rated 0-3 (0=not at all, 3=severe). Total score range 0-48. Subscales: Nausea (symptoms 1,2,6,7,8,9,14,15), Oculomotor (3,4,5,10,11,12,13), and Disorientation (5,10,11,12,13,14,15). Higher score = worse cybersickness.	Baseline (Week 0), Week 2, Week 4

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Quality of Life	Measured by the Short Form-36 (SF-36) Health Survey. Contains 36 items measuring 8 domains: Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, Mental Health. Scores transformed to 0-100 scale per domain. Higher score = better quality of life.	Baseline (Week 0), Week 4

Collaborators and Investigators

• Sponsor: University of Faisalabad

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2026
• Primary Completion (Actual): May 10, 2026
• Study Completion (Estimated): May 22, 2026

Study Registration Dates

• First Submitted: May 23, 2026
• First Submitted That Met QC Criteria: May 23, 2026
• First Posted (Actual): June 1, 2026

Study Record Updates

• Last Update Posted (Actual): June 1, 2026
• Last Update Submitted That Met QC Criteria: May 23, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Physical Therapy; Dynamic Visual Acuity; Vestibulo-Ocular Reflex; Computer Users; Oculomotor Exercises; Gaze Stabilization Exercises
• Additional Relevant MeSH Terms: Otorhinolaryngologic Diseases; Ear Diseases; Labyrinth Diseases; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Vestibular Diseases; Motion Sickness
• Other Study ID Numbers: TUF/EIRB/ 211 /26

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No