# Toward a clearer vision: epidemiology and symptom-based clinical patterns of dry eye disease in the Saudi population

## TL;DR

This study explores the prevalence and factors influencing dry eye disease in Saudi Arabia, highlighting the role of digital device use and gender differences.

## Contribution

The study provides the first large-scale population-based analysis of DED in Saudi Arabia, identifying key demographic and behavioral predictors.

## Key findings

- Females and individuals aged 35–44 showed the highest prevalence of dry eye symptoms.
- Prolonged digital device use and female gender were the strongest predictors of increased DED symptom burden.
- Symptoms were significantly associated with age, gender, education, and occupation.

## Abstract

Dry Eye Disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability and inflammation, leading to ocular discomfort, irritation, and visual disturbance. In Saudi Arabia, environmental conditions, ergonomic, and behavioral factors such as digital device use and contact lens wear may exacerbate DED symptoms. However, large-scale population-based studies examining the epidemiological and clinical determinants of DED remain limited.

This cross-sectional study was conducted using a validated online questionnaire distributed across Saudi Arabia. The survey comprised four domains: sociodemographic characteristics, awareness and knowledge of eye health, behavioral and environmental risk factors, and clinical symptoms related to DED and contact lens use. Data from 1,009 participants were analyzed using SPSS version 29. Potential associations between DED domains and demographic or behavioral variables were examined using chi-square and t-tests, with significance set at p < 0.05.

Among the 1,009 respondents, females represented 56.7%, and the majority were aged 35–44 years (29.3%). The mean domain scores indicated that “Irritation/Dryness” was the most affected domain (47.5 ± 22.8). The “Symptoms domain” was significantly associated with age, gender, marital status, education, and occupation (p < 0.001), whereas the “Activity Limitations domain” significantly correlated with age, marital status, education, and occupation (p < 0.05). Both “Eye Discomfort” and “Irritation/Dryness” domains were significantly related to gender (p < 0.001) and lifestyle factors, particularly hours spent on phones and computers (p < 0.001). Prolonged digital exposure and female gender were the strongest predictors of increased DED symptom burden.

Dry Eye Disease is a prevalent and multifactorial health concern among the Saudi population, strongly influenced by demographic, behavioral, ergonomic, and environmental determinants. Women and younger adults with high exposure to digital devices are particularly vulnerable. Implementing public health interventions, including awareness programs, workplace ergonomics, and AI-based digital screening, may be crucial to reducing the disease burden and advancing Vision 2030 goals for preventive eye health.