Background: Numerous factors have been shown to reduce symptomatic and non-symptomatic forms for computer vision syndrome. However, little is known on the impact among computer users diagnosed with severe symptoms of computer vision syndrome. The study assessed whether reduced visual acuity, ocular pathology and refractive error are associated with computer vision syndrome. Methods: A cross sectional university based study in Kenya. Seven hundred and eighty three participants were included in the study. Visual acuity was determined using snellens chart and converted to logMAR chart. Ocular pathology was determined through comprehensive examination using a slit lamp. Computer vision syndrome was determined using a validated questionnaire. Finally Retinoscopy was conducted to determine the type of refractive error. Results: Participants with refractive error above ± 0.50 dioptres had a greater odds, multivariate adjusted ratio 0.73 (95% CI 0.63-0.90) for developing computer vision syndrome. Similar to visual acuity with multivariate adjusted odds ratio of 0.31 (95% CI 0.24-0.47) and ocular pathologies being significantly associated with computer vision syndrome (p=.04). Ocular condition like sub conjunctival hemorrhage was not significantly associated with computer vision syndrome (P=.12). Conclusion: Reduced visual acuity, presence of ocular pathology and refractive error were associated with greater likelihood of computer vision syndrome. Particularly among those who had never had optical correction. Eye care providers are well placed to come up with proper diagnosis of CVS.