Dry Eye Syndrome Associated With Smartphone Use in the General Saudi Population | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Dry Eye Syndrome Associated With Smartphone Use in the General Saudi Population Jumanah Alsairafi, Sari Alrehaili, Abdullah Alqthmi, Mohammed Alhazmi, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8901488/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background and aim Dry eye disease (DED), also known as dry eye syndrome (DES), is a multifactorial ocular condition characterized by tear film instability and discomfort, significantly affecting quality of life. With the widespread use of digital screens, particularly smartphones, concerns about their association with DES have increased. This study aims to assess the prevalence of DES and its relationship with smartphone use .among the general population in Saudi Arabia Method This study was a descriptive cross-sectional analysis conducted online among the general population in Saudi Arabia. The work has been reported in line with the STROCSS (Strengthening the Reporting of Cohort Studies in Surgery) criteria. The questionnaire underwent a pilot test with 40 individuals from the target population to evaluate its efficacy. Using OpenEpi version 3.0 (released 2013, Atlanta, GA, USA; www.OpenEpi.com ), the minimum required sample size was calculated to be 385 participants based on a population of 34.1 million in Saudi Arabia, with a 95% .confidence interval and an expected frequency of 50% Results A total of 438 participants were included in the study, of whom 177 (40.4%) were diagnosed with DES. The most commonly used electronic device was the mobile phone (277, 63.2%), and the most frequently used application was Snapchat (228, 52.1%). Participants who did not primarily use TikTok had a higher prevalence of DES (p < 0.05). Frequent dryness or irritation (p < 0.05), vision deviation, use of eyeglasses, and reporting television as the most used electronic device were significantly associated with DES prevalence (p 0.05 Discussion This study found a 40.4% prevalence of dry eye syndrome (DES) among the Saudi population sampled, aligning with some regional reports but higher than national averages. The results suggest environmental factors and lifestyle habits, including frequent use of smart devices, may contribute to DES risk. Unlike some international studies, no significant association was observed between DES and age or gender, highlighting possible population-specific differences. Significant correlations were identified between DES and pre-existing eye conditions, use of eyeglasses, and poor sleep quality. Notably, total duration of smartphone use was not linked to DES prevalence, suggesting that factors beyond screen time (such as blink rate and environmental conditions) may play a more critical role in DES development. Limitations include the study’s reliance on self-reported data and its cross-sectional .design, which restricts causal inference Conclusion This study reports a high prevalence of DES among the Saudi Arabian population, with significant associations observed with pre-existing ocular conditions, vision correction methods, and sleep disturbances. However, no direct correlation was found between DES and total smartphone usage duration. These findings underscore the need for further research using objective clinical diagnostic tools to validate self-reported symptoms and to explore targeted interventions for DES .prevention and management Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Health sciences/Risk factors Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 03 May, 2026 Reviewers agreed at journal 18 Apr, 2026 Reviewers agreed at journal 18 Apr, 2026 Reviewers invited by journal 01 Apr, 2026 Editor invited by journal 31 Mar, 2026 Editor assigned by journal 27 Mar, 2026 Submission checks completed at journal 18 Mar, 2026 First submitted to journal 18 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8901488","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":608522704,"identity":"fc6085b1-98a8-414f-b681-50553de42eb9","order_by":0,"name":"Jumanah Alsairafi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+UlEQVRIiWNgGAWjYBAC9gYogw2IPyRUAElm5gacykGAEUkL44yEMyAtcDECWkDsGYxt6GLYtMzITvxcUFMnzyd9+GHDw3m10fztQC0/Krbh0ZK7WXrGscOGbXxphg2J247nzjjM2MDYc+Y2Pi0bpHnYDjC28TCYP0jcdiy3AaiFmbENr5bNv3n+1dm38bB/bEiccyx3PiEtgjNyt0nztjEntvHwAB3WUJO7gZAWaZ6326x5+w4nA7UUNiQcO5C7EajlID6/8LHnbr7N863Odn4P+8bGHzV1ufPOHz744EcFbi3o4DCYPEC0eiCoI0XxKBgFo2AUjBAAAFKSXAcyh+gMAAAAAElFTkSuQmCC","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":true,"prefix":"","firstName":"Jumanah","middleName":"","lastName":"Alsairafi","suffix":""},{"id":608522705,"identity":"a9ad43f9-f4ce-4ed9-b393-3742245155f8","order_by":1,"name":"Sari Alrehaili","email":"","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":false,"prefix":"","firstName":"Sari","middleName":"","lastName":"Alrehaili","suffix":""},{"id":608522707,"identity":"f2974bb6-1ae4-495c-993c-51aaa481801c","order_by":2,"name":"Abdullah Alqthmi","email":"","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":false,"prefix":"","firstName":"Abdullah","middleName":"","lastName":"Alqthmi","suffix":""},{"id":608522709,"identity":"d9995f3c-8021-4406-9e4e-c4c3d9779c1c","order_by":3,"name":"Mohammed Alhazmi","email":"","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":false,"prefix":"","firstName":"Mohammed","middleName":"","lastName":"Alhazmi","suffix":""},{"id":608522713,"identity":"1e4ad661-2ac4-46f1-b571-2ca9a44f69ea","order_by":4,"name":"Ghady Sambas","email":"","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":false,"prefix":"","firstName":"Ghady","middleName":"","lastName":"Sambas","suffix":""},{"id":608522714,"identity":"029631ee-43e0-40c2-b544-6d63d62889d3","order_by":5,"name":"Dina Abdulmanan","email":"","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":false,"prefix":"","firstName":"Dina","middleName":"","lastName":"Abdulmanan","suffix":""},{"id":608522719,"identity":"5178bdcf-18f9-4a74-909d-6abf992ac744","order_by":6,"name":"Basant Othman","email":"","orcid":"","institution":"Hospital alnoor specialist","correspondingAuthor":false,"prefix":"","firstName":"Basant","middleName":"","lastName":"Othman","suffix":""}],"badges":[],"createdAt":"2026-02-17 13:23:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8901488/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8901488/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105030583,"identity":"65e05952-7226-45a5-b64c-1115b6037156","added_by":"auto","created_at":"2026-03-20 06:25:39","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":467564,"visible":true,"origin":"","legend":"","description":"","filename":"Document4.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8901488/v1_covered_78851d97-06e7-4ba9-87b0-58c3f01c59f5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Dry Eye Syndrome Associated With Smartphone Use in the General Saudi Population","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"
[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8901488/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8901488/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground and aim\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDry eye disease (DED), also known as dry eye syndrome (DES), is a multifactorial ocular condition characterized by tear film instability and discomfort, significantly affecting quality of life. With the widespread use of digital screens, particularly smartphones, concerns about their association with DES have increased. This study aims to assess the prevalence of DES and its relationship with smartphone use\u003c/p\u003e\n\u003cp\u003e.among the general population in Saudi Arabia\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was a descriptive cross-sectional analysis conducted online among the general population in Saudi Arabia. The work has been reported in line with the STROCSS (Strengthening the Reporting of Cohort Studies in Surgery) criteria. The questionnaire underwent a pilot test with 40 individuals from the target population to evaluate its efficacy. Using OpenEpi version 3.0 (released 2013, Atlanta, GA, USA; \u003ca href=\"http://www.openepi.com/\"\u003ewww.OpenEpi.com\u003c/a\u003e), the minimum required sample size was calculated to be 385 participants based on a population of 34.1 million in Saudi Arabia, with a 95%\u003c/p\u003e\n\u003cp\u003e.confidence interval and an expected frequency of 50%\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 438 participants were included in the study, of whom 177 (40.4%) were diagnosed with DES. The most commonly used electronic device was the mobile phone (277, 63.2%), and the most frequently used application was Snapchat (228, 52.1%). Participants who did not primarily use TikTok had a higher prevalence of DES (p \u0026lt; 0.05). Frequent dryness or irritation (p \u0026lt; 0.05), vision deviation, use of eyeglasses, and reporting television as the most used electronic device were significantly associated with DES prevalence (p \u0026lt; 0.05). No significant association was found between DES and age, gender, contact lens use, or duration of\u003c/p\u003e\n\u003cp\u003e.(smartphone use (p \u0026gt; 0.05\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study found a 40.4% prevalence of dry eye syndrome (DES) among the Saudi population sampled, aligning with some regional reports but higher than national averages. The results suggest environmental factors and lifestyle habits, including\u003c/p\u003e\n\u003cp\u003efrequent use of smart devices, may contribute to DES risk. Unlike some international studies, no significant association was observed between DES and age or gender, highlighting possible population-specific differences. Significant correlations were identified between DES and pre-existing eye conditions, use of eyeglasses, and poor sleep quality. Notably, total duration of smartphone use was not linked to DES prevalence, suggesting that factors beyond screen time (such as blink rate and environmental conditions) may play a more critical role in DES development.\u003c/p\u003e\n\u003cp\u003eLimitations include the study’s reliance on self-reported data and its cross-sectional\u003c/p\u003e\n\u003cp\u003e.design, which restricts causal inference\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study reports a high prevalence of DES among the Saudi Arabian population, with significant associations observed with pre-existing ocular conditions, vision correction methods, and sleep disturbances. However, no direct correlation was found between DES and total smartphone usage duration. These findings underscore the need for further research using objective clinical diagnostic tools to validate self-reported symptoms and to explore targeted interventions for DES\u003c/p\u003e\n\u003cp\u003e.prevention and management\u003c/p\u003e","manuscriptTitle":"Dry Eye Syndrome Associated With Smartphone Use in the General Saudi Population","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-20 06:24:58","doi":"10.21203/rs.3.rs-8901488/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-04T00:00:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"16980797946254698773768635551294488892","date":"2026-04-18T18:16:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"138818950800017093603920936470572763830","date":"2026-04-18T08:58:35+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-01T04:49:15+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-31T11:53:30+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-27T08:20:27+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-18T23:17:02+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2026-03-18T20:59:27+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"
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