Abstract
BACKGROUND: Dry eye disease (DED) is a prevalent ocular surface disorder that compromises vision-related function and overall quality of life. Data about African populations are scanty and episodic. OBJECTIVE: To systematically estimate the pooled prevalence of Dry eye disease in African Populations, asses differences by region and diagnostic methodology, and discus implications for clinical practice and public health. METHODS: We conducted a PRISMA 2020 systematic review and meta-analysis. We conducted a structured PubMed, Google Scholar, AJOL, ResearchGate, and university repository search for observational studies that had reported prevalence of DED among African populations. Inclusion and exclusion were performed. Data extraction, quality appraisal using the JBI checklist, and meta-analysis using a random-effects model with logit transformation were conducted. Heterogeneity and publication bias were examined. RESULTS: Fifteen studies involving 7,000 + individuals from eight countries of Africa were included. The overall prevalence of DED was 43.6% (95% CI: 34.2%–46.1%), with notable inter-country heterogeneity (range: 30.7% in Egypt to 86.5% in South Africa). Moderate heterogeneity (Q = 10.375, p = 0.110) was present. Funnel plot and Egger's test (p < 0.001) indicated possible publication bias. Conclusion: DED is very prevalent in Africa, with extensive regional diversity. Standardized diagnosis and improved surveillance are needed. CONCLUSION: Dry eye disease in highly prevalent in Africa, with significant regional variations driven by environment and diagnostic inconsistencies. Standardized diagnostic criteria greater awareness, and integrating DED into public health policy, research and clinical training are needed to mitigate its impact on vision and quality of life. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12886-025-04290-7.