Abstract
AIM: To characterize the ocular surface characteristics in the Nepalese population across all age groups who have used digital screens for extended durations over several years. METHODS: In a cross-sectional, observational study, 144 digital screen users were assessed for dry eye disease (DED) using subjective and objective measures. The Ocular Surface Disease Index (OSDI) Questionnaire evaluated symptoms, followed by clinical assessments, including slit lamp biomicroscopy, tear breakup time (TBUT), Oxford Scheme grading, and Schirmer I test. DED was diagnosed if a patient had an OSDI score over 13 and at least two clinical signs (OSDI, Schirmer I test, or ocular staining). The prevalence of DED was calculated based on the proportion of patients meeting these criteria. RESULTS: Of the 144 participants (mean age: 34.6±15.2y), 78 (54.2%) were female. The use of digital screens varied between 2-8h (mean duration: 4.1±2.7h) per day. The mean OSDI score, TBUT score, and the Schirmer I scores were 22.7±10.5 (max-min: 24.4-20.9), 6.8±4.2s (max-min: 7.5-6.1), and 12.3±4.6 mm (max-min: 13.1-11.5) respectively with 95% confidence interval (β=1.96), and a two-tailed statistical significance level of 5% (α=0.05). With increased screen use, TBUT shortened and OSDI scores increased significantly (P<0.01), though Schirmer I scores were unaffected (P>0.05). The prevalence of DED ranged from 6.3% to 22.9% in those using screens for more than 2h, with an overall prevalence of 67.4% among digital screen users. CONCLUSION: There is a significant association between prolonged use of digital screens and clinical markers of dry eye signs and symptoms.