Association Between Digital Device use and Dry Eye Symptoms Among Students at Medical Colleges in Punjab, Pakistan

Abstract

Background: Ocular discomfort is a concern among students who regularly use digital devices. We examined the association between digital-device use and dry-eye symptoms among students attending medical colleges in Punjab, Pakistan.

Methods: This analytical cross-sectional study included 194 students recruited through non-probability consecutive sampling between 12 July and 25 October 2026. A self-administered Google Forms questionnaire assessed digital-device use, ocular health, and lifestyle characteristics. Symptoms were measured using the Ocular Surface Disease Index (OSDI). Primary symptom analyses included participants completing all 12 items. Multivariable linear regression with HC3 robust standard errors examined weekday screen-time categories, adjusting for age, sex, contact-lens use, and current ocular conditions.

Results: Median participant age was 21 years (interquartile range: 19–23). Daily screen exposure of ≥6 hours was reported by 42.3% on weekdays and 64.9% on weekends. Among 114 participants completing the OSDI, the mean score was 39.3 ± 21.2; 103 screened positive (90.4%; 95% confidence interval [CI]: 83.5%–94.5%), including 62 (54.4%) with severe symptoms. In the adjusted analysis (n=113), weekday screen-time category was not significantly associated with symptom scores overall (p=0.214). Higher scores were associated with male sex (adjusted difference: 17.42 points; 95% CI: 8.81–26.02), regular contact-lens use (16.80; 3.47–30.13), and current ocular conditions (11.67; 2.76–20.59).

Conclusion: Symptom burden was high among respondents completing the OSDI. Weekday screen duration showed no significant adjusted association with severity, although estimates were imprecise. The findings support attention to student ocular health and further investigation using clinical examinations and prospective exposure measurement.