Are we treating the right dry eye? - A comparative analysis of digital eye strain and traditional dry eye disease - a prospective comparative study

Sep 30, 2026

Uploaded by Franzy

Background: This prospective comparative study evaluated whether Dry Eye Disease (DED) and Digital Eye Strain (DES) share overlapping clinical profiles, focusing on symptom burden, tear-film characteristics, blinking dynamics, and treatment response, and sought predictors of poor outcomes. Methods: 264 participants (132 per group) completed OSDI and CVS-Q; objective measures included TBUT, Schirmer’s test, fluorescein staining, blink rate, and incomplete blink percentage, with outcomes assessed after 4–6 weeks. Results: DES showed longer TBUT, DED had higher fluorescein staining, and overall symptom scores were similar; female sex, greater screen exposure, higher baseline OSDI, and shorter TBUT predicted poorer response. Conclusions: DES and DED overlap yet differ, supporting tailored management targeting tear-film instability and screen-related behaviors.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Background

Epidemiology and risk factors of DED

Characteristics and symptoms of DES

Wang et al. BMC Ophthalmology (2026) 26:9 [https://doi.org/10.1186/s12886-025-04537-3](https://doi.org/10.1186/s12886-025-04537-3) BMC Ophthalmology RESEARCH Open Access Are we treating the right dry eye? A comparative analysis of digital eye strain and traditional dry eye disease: a prospective comparative study Hongjuan Wang 1*, Xueping Zhu 1 and Caiwen Ning2 Abstract Background The study aimed to compare the clinical features, tear-film characteristics, blinking dynamics, and treatment outcomes of patients with Dry Eye Disease (DED) and Digital Eye Strain (DES), and identify predictors of poor response. Methods This prospective comparative study included 264 participants, with 132 patients in each group (DES and DED) . Patients completed the Ocular Surface Disease Index (OSDI) and the Computer Vision Syndrome Questionnaire (CVS-Q) . Objective assessments included tear break-up time (TBUT), Schirmer’s test, fluorescein staining, blink rate, and incomplete blink percentage. Treatment outcomes were evaluated after 4 to 6 weeks. Multivariable models were adjusted for age, sex, screen exposure, baseline OSDI, TBUT, MGD, and blink rate. Results Mean age was similar in both groups (DES: 39.8 years; DED: 41.7 years; p= 0 . 222) . Median OSDI and CVS-Q scores showed no significant differences. TBUT was longer in DES (6 .3 s) vs. DED (5 .1 s; p = 0 . 005), while fluorescein staining was higher in DED (p = 0 . 027) . Schirmer’s test, blink rate, and incomplete blink percentages were comparable. Improvement was seen in 65. 2%(DES) vs. 56. 1%(DED) (p = 0 . 291) . Predictors of poor treatment response included female sex (OR 1. 30; 95% CI 1.05–1. 60; p = 0 . 016), greater daily screen exposure (OR 1. 17; 95% CI 1.02–1. 35; p = 0 . 024), higher baseline OSDI (OR 1.020 per point; 95% CI 1.004–1. 037; p = 0 . 013), and shorter TBUT (OR 0.846 per second; 95% CI 0 .716–0. 999; p = 0 . 048) . Conclusions DES and DED demonstrate overlapping but distinct clinical profiles. TBUT, screen time, age, and symptom severity significantly influence treatment outcomes. Tailored therapeutic approaches that address both tear-film instability and screen-related behaviours are essential for optimal management. Findings should be interpreted in light of differing symptom-versus sign-based group definitions. Clinical trial number Not applicable. Keywords Dry eye disease, Digital eye strain, Tear film, Blink rate, Treatment response *Correspondence: Hongjuan Wang [wanghongjuan2025@163.com](wanghongjuan2025@163.com) 1The First Affiliated Hospital of Nanchang Medical College, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi, China 2Jiangxi New Vision Eye Hospital, Nanchang, Jiangxi, China © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Wang et al. BMC Ophthalmology (2026) 26:9 Background Over the past decades, the use of digital devices has expanded exponentially worldwide, including smartphones, tabl

FAQs

What clinical aspects were compared between Dry Eye Disease (DED) and Digital Eye Strain (DES)?

The study compared clinical features including tear-film characteristics and blinking dynamics, along with symptom scores (OSDI and CVS-Q) and treatment outcomes.

Which objective findings differed most between the DES and DED groups?

TBUT was longer in the DES group, while fluorescein staining was higher in the DED group.

What factors predicted a poorer response to treatment?

Female sex, greater daily screen exposure, higher baseline OSDI scores, and shorter TBUT were associated with poorer treatment response.

Sep 30, 2026

Uploaded by Franzy