# Functional Visual Symptoms, Accommodative Dysfunction, and Visual Performance Alterations in Chronic Work-Related Stress: A Narrative Review

## TL;DR

This review explores how chronic work-related stress may cause visual symptoms like eye strain and focusing issues, even without eye damage, possibly due to stress affecting the nervous system.

## Contribution

The paper proposes a novel framework linking chronic stress, autonomic nervous system dysregulation, and functional visual disorders.

## Key findings

- Chronic stress is associated with asthenopia and accommodative inefficiency without structural eye damage.
- Altered parasympathetic control of the ciliary muscle is a plausible mechanism for stress-related visual dysfunction.
- The ocular system may be a peripheral target of prolonged stress-related autonomic alterations.

## Abstract

Background: Chronic work-related stress, including exposure to mobbing, is associated with a wide range of psychological and somatic consequences. However, its potential impact on visual function, particularly in the absence of structural ocular damage, remains underexplored. This narrative review critically examines the evidence linking chronic stress, autonomic nervous system (ANS) dysregulation, and functional visual disorders, focusing on accommodative function and asthenopia. Methods: A qualitative narrative review of the literature published between 2000 and 2025 was conducted using major biomedical databases. Studies addressing chronic stress, ANS activity, accommodative function, digital eye strain, and functional ocular symptoms were identified and integrated into a coherent pathophysiological framework. Results: The ocular system, being richly innervated by the ANS, may represent a peripheral target of prolonged stress-related autonomic alterations. Available evidence suggests that chronic stress is associated with asthenopia, accommodative inefficiency, and ocular discomfort even in the absence of overt ocular pathology. In particular, altered parasympathetic control of the ciliary muscle emerges as a plausible mediating mechanism. Conclusions: Functional visual disorders may represent peripheral manifestations of stress-related ANS dysregulation. Although causality cannot be established conclusively, the proposed framework supports the need for multidisciplinary research to clarify the clinical and medico-legal relevance of stress-related visual dysfunction.