Effect of Digital Screen Use on Dry-Eye Disease among Adults Attending a Tertiary-Care Eye Hospital in Karachi, Pakistan

Background Dry eye disease (DED) is a multifactorial ocular condition characterized by tear film instability and inflammation. Prolonged use of visual display terminals (VDTs), including computers and smartphones, is an emerging modifiable risk factor for DED, especially in digitally connected regions like Pakistan. Despite increasing complaints of digital eye strain, population-level data on DED prevalence and screen time are limited in South Asia. Objective To determine the frequency of DED and its association with digital screen exposure among adults attending ophthalmology clinics in Karachi, Pakistan. Methods A descriptive cross-sectional study was conducted at Aga Khan University Hospital from December 2023 to May 2024. Consecutive adults (n = 146) reporting ≥ 4 hours/day of habitual screen use were evaluated. DED was diagnosed using OSDI ≥ 13 with either TBUT < 10s or Oxford staining ≥ 1. Participants self-reported screen time across devices. Logistic regression was used to assess associations between screen time and DED. Results DED was diagnosed in 30.8% (n = 45) of participants. Median screen time was significantly higher in the DED group (7 vs. 6 hours/day; p = 0.001). DED patients also reported greater computer (6 vs. 4 hours/day; p = 0.001) and smartphone use (2 vs. 1 hour/day; p = 0.002). Total screen time was independently associated with DED (aOR = 1.538; p = 0.001). Conclusion DED is prevalent among urban adults with prolonged screen exposure in Pakistan. Computer and smartphone use were key risk factors. These findings support the need for public health interventions promoting safe screen practices to reduce DED burden.