GLOBAL PREVALENCE AND ASSOCIATED RISK FACTORS OF DRY EYE DISEASE IN THE UNIVERSITY POPULATION: A REVIEW OF CURRENT EVIDENCE LITERATURE REVIEW
Abstract
Background: Dry eye disease (DED) is a multifactorial ocular surface disorder characterised by tear film instability, hyperosmolarity, inflammation, and neurosensory abnormalities. Although historically associated with older adults, converging epidemiological evidence now positions university students as a high-risk population. This literature review synthesises global evidence on DED prevalence among university students and critically examines the behavioural, environmental, demographic, clinical, and psychosocial risk factors underlying its development and severity.
References
1. Abdulmannan, D. M., Naser, A. Y., Ibrahim, O. K., Mahmood, A. S., Alkrad, J. A., Sweiss, K., Alrawashdeh, H. M., & Kautsar, A. P. (2022). Visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan. BMC Ophthalmology, 22(1), 265.
2. Abdulmannan, D. M., & Naser, A. Y. (2026). Prevalence and predictors of dry eye syndrome among the young population in Jordan: A cross-sectional survey study. Medicine, 105(8), e47780.
3. Abu-Ismail, L., Abuawwad, M. T., Taha, M. J., Khamees, A., Abu Ismail, D. Y., Sanwar, M., Al-Bustanji, Y., Nashwan, A., Alameri, O. H., Alrawashdeh, H. M., Abu Serhan, H., & Abu-Ismail, J. (2023). Prevalence of dry eye disease among medical students and its association with sleep habits, use of electronic devices and caffeine consumption: A cross-sectional questionnaire. Clinical Ophthalmology, 17, 3629-3641.
4. Acimovic, L., Stanojlovic, S., Kalezic, T., & Dacic Krnjaja, B. (2022). Evaluation of dry eye symptoms and risk factors among medical students in Serbia. PLoS ONE, 17(10), e0275624.
5. Alqurashi, A., Almaghrabi, H., Alahmadi, M., Alotaibi, A., Alotaibi, B., Jastaniah, A., Bukhari, A., Binhussein, M., Othman, B., & Khojah, A. (2024). The severity of dry eye symptoms and risk factors among university students in Saudi Arabia: A cross-sectional study. Scientific Reports, 14(1), 14167.
6. Al-Zubi, K. M., Al-Kubaisy, W. A., Al-Azzeh, Y. E., Batayneh, B. K., Alqaraleh, H. A., Abid, L. A., Al-Jadid Al-Majali, G. O., & Alhajaj, N. T. (2023). Symptomatic dry eye disease among university students. Medical Hypothesis, Discovery and Innovation in Ophthalmology, 12(2), 70-77.
7. Bakkar, M. M., Aridi, M., Alebrahim, M. A., & Ghach, W. (2025). Incidence of dry eye symptoms and behavioural-cultural risk factors among university students population in Jordan. PLoS ONE, 20(8), e0328235.
8. Barabino, S. (2022). Is dry eye disease the same in young and old patients? A narrative review of the literature. BMC Ophthalmology, 22(1), 85.
9. Britten-Jones, A. C., Wang, M. T. M., Samuels, I., Jennings, C., Stapleton, F., & Craig, J. P. (2024). Epidemiology and risk factors of dry eye disease: Considerations for clinical management. Medicina, 60(9), 1458.
10. Chai, Y., Cheng, M., Liu, X., Le, Q., & Hong, J. (2025). Blink frequency threshold for ocular surface health in the modern era. Scientific Reports.
11. Chaudhary, S., Ghimire, D., Basu, S., Agrawal, V., Jacobs, D. S., & Shanbhag, S. S. (2023). Contact lenses in dry eye disease and associated ocular surface disorders. Indian Journal of Ophthalmology, 71(4), 1142-1153.
12. Ezinne, N., Alemu, H. W., Cheklie, T., Ekemiri, K., Mohammed, R., & Sakeem, J. (2023). High prevalence of symptomatic dry eye disease among university students during the COVID-19 pandemic in University of West Indies, Trinidad and Tobago. Clinical Optometry, 15, 37-43.
13. Gorimanipalli, B., Khamar, P., Sethu, S., & Shetty, R. (2023). Hormones and dry eye disease. Indian Journal of Ophthalmology, 71(4), 1276-1284.
14. Hashmani, N., Munaf, U., Saleem, A., Javed, S. O., & Hashmani, S. (2021). Comparing SPEED and OSDI questionnaires in a non-clinical sample. Clinical Ophthalmology, 15, 4169-4173.
15. Huang, R., Su, C., Fang, L., Lu, J., Chen, J., & Ding, Y. (2022). Dry eye syndrome: Comprehensive etiologies and recent clinical trials. International Ophthalmology, 42, 3253-3272.
16. Jakhar, F., Rodrigues, G. R., Mendonca, T. M., Nayak, R. R., Kamath, G., Kamath, S. J., et al. (2023). Dry eye symptoms and digital eyestrain-Emerging epidemics among university students due to online curriculum amid the COVID-19 pandemic: A cross-sectional study. Indian Journal of Ophthalmology, 71(4), 1472-1477.
17. Magno, M. S., Daniel, T., Morthen, M. K., Snieder, H., Jansonius, N., Utheim, T. P., Hammond, C. J., & Vehof, J. (2021). The relationship between alcohol consumption and dry eye. The Ocular Surface, 21, 87-95.
18. Magno, M. S., Utheim, T. P., Snieder, H., Hammond, C. J., & Vehof, J. (2021). The relationship between dry eye and sleep quality. The Ocular Surface, 20, 13-19.
19. Meng, X., Geng, R., Yang, K., Wei, J., Xu, Z., Wang, M., & Ren, S. (2025). Comparison of the OSDI and SPEED questionnaires for assessing dry eye symptoms in Chinese healthy college students. BMC Ophthalmology, 25, 425.
20. Narang, P., Donthineni, P. R., D'Souza, S., & Basu, S. (2023). Evaporative dry eye disease due to meibomian gland dysfunction: Preferred practice pattern guidelines for diagnosis and treatment. Indian Journal of Ophthalmology, 71(4), 1348-1356.
21. Neti, N., Prabhasawat, P., Chirapapaisan, C., & Ngowyutagon, P. (2021). Provocation of dry eye disease symptoms during COVID-19 lockdown. Scientific Reports, 11(1), 24434.
22. Pastor-Zaplana, J. A., Borras, F., Gallar, J., & Acosta, M. C. (2022). OSDI questions on daily life activities allow to detect subclinical dry eye in young contact lens users. Journal of Clinical Medicine, 11, 2626.
23. Sahih Alnasab, S. S., Asharlous, A., Doostdar, A., Nabovati, P., Yekta, A., & Khabazkhoob, M. (2022). Epidemiology of dry eye and its determinants among university students. Journal of Ophthalmic and Vision Research, 17(4), 447-448.
24. Sheppard, J. D., Lee, B. S., & Periman, L. M. (2022). Recent advances in dry eye disease treatment. Expert Review of Ophthalmology.
25. Stapleton, F., Velez, F. G., Lau, C., & Wolffsohn, J. S. (2024). Dry eye disease in the young: A narrative review. The Ocular Surface, 31, 11-20.
26. Suarez-Cortes, T., & Herrera, I. (2025). Emerging age-specific therapeutic approaches for dry eye disease. Journal of Clinical Medicine, 14, 4147.
27. Supiyaphun, C., Jongkhajornpong, P., Rattanasiri, S., & Lekhanont, K. (2021). Prevalence and risk factors of dry eye disease among university students in Bangkok, Thailand. PLoS ONE, 16(10), e0258217.
28. Tangmonkongvoragul, C., Chokesuwattanaskul, S., Khankaeo, C., Punyasevee, R., Lapat, N., Moolsan, S., & Unruan, O. (2022). Prevalence of symptomatic dry eye disease with associated risk factors among medical students at Chiang Mai University due to increased screen time and stress during COVID-19 pandemic. PLoS ONE, 17(3), e0265733.
29. Tsai, C.-Y., Jiesisibieke, Z. L., & Tung, T.-H. (2022). Association between dry eye disease and depression: An umbrella review. Frontiers in Public Health, 10, 910608.
30. Uwimana, A., Ma, C., & Ma, X. (2022). Concurrent rising of dry eye and eye strain symptoms among university students during the COVID-19 pandemic era: A cross-sectional study. Risk Management and Healthcare Policy, 15, 2101-2112.
31. Wrobel-Dudzinska, D., Osial, N., Stepien, P. W., Gorecka, A., & Zarnowski, T. (2023). Prevalence of dry eye symptoms and associated risk factors among university students in Poland. International Journal of Environmental Research and Public Health, 20(2), 1313.
32. Yang, I., Wakamatsu, T., Sacho, I. B. I., Fazzi, J. H., de Aquino, A. C., Ayub, G., Rebello, P. A., Gomes, J. A. P., & Alves, M. (2021). Prevalence and associated risk factors for dry eye disease among Brazilian undergraduate students. PLoS ONE, 16(11), e0259399.
33. Zeleke, T. C., Adimassu, N. F., Alemayehu, A. M., Dawud, T. W., & Mersha, G. A. (2022). Symptomatic dry eye disease and associated factors among postgraduate students in Ethiopia. PLoS ONE, 17(8), e0272808.
