Prevalence and Association of Dry Eye Disease with the Increased Use of Electronic Devices Among University Students in Libya

Abstract

The increasing reliance on personal electronic devices for higher education has raised significant public health concerns regarding visual safety and digital eye strain. Dry eye disease (DED), an ocular surface condition characterized by a loss of tear film homeostasis and chronic discomfort, is increasingly affecting young adults. Prolonged screen immersion induces mechanistic blink reflex suppression, accelerating tear film evaporation and triggering localized ocular surface inflammation. This multi-institutional study investigated the prevalence and clinical severity of DED symptoms among university students across Libya, while isolating independent socio-demographic, behavioral, and digital ergonomic risk factors. A descriptive cross-sectional study was carried out between September and December 2025. Data collection and coordination through the Faculty of Pharmacy, Attahadi University (Tripoli, Libya). A total of 652 university students completed a self-administered digital survey (Google Forms) comprising socio-demographic profiles, screen behavior tracking arrays, and the validated 12-item Ocular Surface Disease Index (OSDI) questionnaire. Bivariate distributions and categorical risk markers were evaluated using Pearson’s Chi-square tests in SPSS Version 26.0. The mean population OSDI score was critically high at 42.01 ± 24.6, with an overall active DED symptom prevalence of 83.3% (n = 543). Clinical stratification revealed that an overwhelming majority of the entire cohort suffered from advanced manifestations, with 67.9% (n = 443) meeting the diagnostic criteria for severe DED. Bivariate inferential analysis isolated the regular use of eyeglasses (p = 0.038) as a highly significant marker for ocular distress. Crucially, students utilizing eyeglasses exclusively dedicated to electronic screen viewing exhibited a heightened symptom prevalence of 89.9% (p = 0.038), contrasting with an 80.2% rate among general medical prescription wearers. Traditional demographic markers, including biological sex (p = 0.364), age distribution (p = 0.865), and bedtime device interactions (p = 0.523), did not demonstrate statistically significant associations with symptom development, illustrating a uniform risk trajectory across student blocks. A critically high prevalence of severe, screen-induced DED exists among Libyan university students. The data indicate that intense academic digital workloads override generic demographic variables. The unexpected risk peak among specialized eyeglass wearers warns against a false sense of security that leads to decreased blinking awareness. Institutional, campus-level public health interventions—such as digital hygiene orientations, ergonomic workstation filters, and the structured promotion of the 20-20-20 resting rule—are urgently required to protect student vision from chronic ocular surface damage.