Shocking 47% Prevalence of Symptomatic Dry Eye Disease Among UAE University Students

A groundbreaking study published in PLOS ONE on February 26, 2026, has revealed that nearly half of university students in the United Arab Emirates suffer from symptomatic Dry Eye Disease (DED). Titled "Behavioral and cultural determinants of symptomatic dry eye disease among university students in the UAE," the research conducted by experts from Abu Dhabi University and Canadian University Dubai highlights alarming rates of ocular discomfort among young adults in higher education. Using the validated Ocular Surface Disease Index (OSDI) questionnaire, the cross-sectional survey of 654 students from April to December 2023 found 47.1% experiencing mild-to-severe symptoms, with 29.5% mild-to-moderate and 17.6% severe cases. This underscores a pressing public health issue in UAE campuses, where academic pressures meet environmental and lifestyle challenges.

The findings emphasize behavioral factors like prolonged screen time and cultural practices such as eye makeup use and traditional smoking, positioning DED as a significant concern for student well-being and productivity. As UAE universities expand, addressing this could enhance learning outcomes and long-term eye health.

What Is Dry Eye Disease? A Comprehensive Overview

Dry Eye Disease, also known as Dry Eye Syndrome or keratoconjunctivitis sicca, is a multifactorial condition characterized by insufficient tear production or excessive tear evaporation, leading to ocular surface damage and inflammation. According to the Tear Film & Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II), DED manifests through symptoms like grittiness, burning, redness, foreign body sensation, blurred vision, and light sensitivity, often fluctuating throughout the day.

The tear film—a three-layered structure of lipid (outer, prevents evaporation), aqueous (middle, hydration), and mucin (inner, adhesion)—maintains ocular health. Disruptions, such as reduced blink rates from screen staring or low humidity from air conditioning (AC), destabilize it. In arid climates like the UAE, where temperatures exceed 40°C and indoor AC is ubiquitous, evaporation accelerates, mimicking a desert wind on the eyes.

Globally, DED prevalence ranges 5-50%, higher in Asia (20-30%) and the Middle East due to climate and habits. In Dubai, a 2021 study reported 62.6% prevalence in the general population, with severe cases dominant. For Middle Eastern populations, meta-analyses peg it at 28.33%, linked to female gender, age, and smoking.

How the Study Was Conducted: Methods and Participant Insights

Researchers employed convenience sampling via social media and university channels, targeting students aged 18+ without prior eye surgeries or conditions. The online Google survey featured the 12-item OSDI (scored 0-100: normal 0-12, mild-moderate 13-32, severe 33-100), with Cronbach's alpha 0.856 confirming reliability. Sections probed demographics, screen/study hours, smoking (cigarettes, e-cigarettes, Dokha, waterpipes like Mouassal/Ajami), eye cosmetics (mascara, eyeliner, shadow, lashes; usage duration/frequency/cleansing), and contact lenses.

Non-parametric stats (Kruskal-Wallis, Mann-Whitney U, Spearman's rho) revealed robust associations. Notably, 82% lacked prior DED diagnosis, highlighting under-detection.

Gender Disparities: Why UAE Female Students Face Higher Risk

Females reported significantly higher median OSDI scores (14.58 vs. males' 10.42; P<0.001), aligning with regional trends where hormonal factors (e.g., estrogen influencing meibomian glands) and behaviors amplify risk. Middle Eastern studies consistently show females 1.2-2x more affected.

• Hormonal fluctuations reduce tear stability.
• Cultural makeup use prevalent among females.
• Contact lens wear higher in women.

No age or study level differences, suggesting broad vulnerability across UAE campuses.

Screen Time and Academic Demands: The Digital Strain on Student Eyes

Prolonged screen exposure emerged as a top culprit, with Spearman's rho r=0.694 (P<0.001) for daily hours and r=0.661 for study time. UAE students average 7-8 hours daily on devices, exacerbated by hybrid learning post-COVID. Reduced blinking (from 15-20/min to 4-5/min) evaporates tears faster.

A related 2026 Frontiers study on UAE students linked excessive digital use to eye strain and DED precursors. Universities can counter via 20-20-20 rule promotions.

Smoking Habits: Dokha and Shisha's Hidden Toll on Ocular Health

Smokers showed higher OSDI (16.67 vs. 10.42; P<0.001), with Dokha/Mouassal users peaking at 20.83-39.59. Dokha (high-nicotine UAE pipe) and shisha (waterpipe) cause oxidative stress via irritants. Prevalence among UAE students: cigarettes/shisha ~5.5%, but indoor/daily use worsens. Years smoked correlated moderately (r=0.38).

Recommendations: campus cessation programs, no-smoking zones.

Cultural Practices: Eye Makeup and Poor Removal Habits Fuel DED

Eye cosmetics linked to higher scores: daily eyeliner (19.79), mascara (18.75), shadow/false lashes. Shorter users paradoxically higher, perhaps new irritants. Water-only cleansing (17.71) vs. soap/creams (12.50); sleeping with makeup/lenses (52.08). Kohl/kajal, traditional in Middle East, risks lead toxicity and lipid disruption.

• Ingredients clog glands, alter tear film.
• Incomplete removal overnight exacerbates.
• Cultural beauty norms drive daily use.

Contact lenses amplified risks (always users 22.92; P<0.001).

UAE's Harsh Environment: AC and Climate Amplify Student Risks

Though not directly measured, UAE's low humidity (20-30%) and pervasive AC (reduces to 10-20%) accelerate evaporation. Dubai studies note 62.6% prevalence tied to AC exposure. Combined with screens/smoking, perfect storm for campuses.

Implications for UAE Higher Education: Beyond Vision to Academic Performance

DED impairs concentration, reading—critical for students. Untreated, risks chronic issues. UAE unis like Abu Dhabi University should integrate eye health into wellness: awareness workshops, free screenings (e.g., Al Ain University's checkups). Ties to career advice for health-focused roles.

Actionable Prevention Strategies for UAE Students

TFOS DEWS recommends:

• 20-20-20 rule: every 20 min, 20 sec, 20 ft away.
• Blink exercises, humidifiers in AC rooms.
• Artificial tears (preservative-free).
• Proper makeup removal: oil-free wipes, no sleeping with products/lenses.
• Quit smoking; hydration, omega-3 diet.
• Annual eye exams.

Universities: integrate into orientation. Explore UAE university jobs in health sciences.

Photo by Zayyinatul Millah on Unsplash

Future Outlook: Research, Policy, and University Initiatives

Authors urge targeted campaigns for smokers, makeup users, screen addicts. Regional comparisons (Saudi/Jordan 50-60%) suggest pan-GCC efforts. UAE's Vision 2031 health focus ideal for DED programs. Check Rate My Professor for eye health experts; pursue higher ed jobs in optometry.Career advice on wellness roles awaits.

This study spotlights actionable insights, empowering UAE students for healthier eyes and brighter futures.