Association between Digital Screen Exposure and Dry Eye Disease among Medical Students: A Cross-Sectional Observational Study
Keywords:
Digital Screen Exposure, Dry Eye Disease, Medical Students, OSDI, Schirmer Test, Tear Break-Up Time.Abstract
Background: Medical students increasingly rely on digital displays for academic and recreational activities, creating sustained visual demand that may aggravate dry eye symptoms and tear film instability.
Objective: To evaluate the association between daily digital screen exposure and dry eye symptoms and ocular surface parameters among medical students.
Methods: A cross-sectional observational analysis included 40 medical students aged 20-24 years. Daily screen time, viewing distance, primary device type, Ocular Surface Disease Index (OSDI) score, Schirmer test, tear break-up time (TBUT), contact lens use, refractive error, and sleep quality were evaluated. OSDI scores were classified as normal (0-12), mild (13-22), moderate (23-32), and severe (33-100); OSDI >=13 was treated as symptomatic dry eye. Participant-level ocular surface analyses used the mean of right- and left-eye Schirmer and TBUT measurements. Associations were assessed using Spearman correlation and non-parametric group comparisons.
Results: The mean age was 21.82 ± 1.32 years and mean daily screen exposure was 6.79 ± 1.44 hours. OSDI-defined symptomatic dry eye was present in 36/40 (90.0%), with severe symptoms in 19 (47.5%). Daily screen time correlated strongly with OSDI score (Spearman rho=0.988, p<0.001) and inversely with mean Schirmer test (rho=-0.981, p<0.001) and mean TBUT (rho=-0.983, p<0.001). Shorter viewing distance was associated with higher OSDI scores (rho=-0.364, p=0.021). Students reporting poor sleep had higher OSDI scores than those reporting good sleep (median 40.5 vs 17.0, p<0.001).
Conclusion: Greater daily screen exposure was associated with more severe dry eye symptoms and poorer tear film measures in this cohort. The findings support attention to screen-use duration, viewing ergonomics, and ocular surface symptoms among medical students, while the cross-sectional design prevents causal inference.
