Dry eye among computer operators at a tertiary care centre in India

**Background:** Dry eye disease affects an estimated 25-30 million people worldwide and is associated with symptoms such as eye strain, redness, dryness, tiredness, itching, blurring, and double vision. Extended visual tasking during computer use can provoke these symptoms due to decreased blink rate and reduced mucin concentration. This study aimed to evaluate the effects of long-term computer use on tear production and evaporation among computer operators/clerks at a tertiary care centre in India.

**Methods:** A cross-sectional study was conducted from January 2022 to April 2022 at Sri Devaraj Urs Medical College, RL Jalappa Hospital & Research Centre, Kolar. The sample size was 97, estimated based on a reported 74% prevalence of dry eyes, with an absolute error of 10% and 95% confidence interval. Inclusion criteria were: both male and female subjects aged 20-40 years, computer users for more than 2 hours per day for at least 1 year, and willing to provide consent. Exclusion criteria included history of allergic conjunctivitis, gross lid abnormalities, life-threatening systemic disease, acute ocular infections, extra/intraocular surgery within the last 6 months, use of systemic or topical medications known to cause dry eyes (e.g., antihistamines, anticholinergics, antiglaucoma drugs, topical steroids), and contact lens users. After ethical clearance and informed consent, demographic details were recorded. Participants completed the Ocular Surface Disease Index (OSDI) questionnaire, which consists of 12 questions divided into three sections: symptoms of dry eye, effects of dry eye, and aggravating symptoms. The OSDI score was calculated as (A+B+C) x 25 / N, where N is the number of questions answered, with higher scores indicating greater disability. Tear quality and quantity were assessed using tear breakup time (TBUT) test and Schirmer I test, respectively. For Schirmer I, a strip was placed in the lateral one-third of the lower eyelid for 5 minutes, and wetting in millimeters was recorded. For TBUT, fluorescein was applied to the lower bulbar conjunctiva, and the interval from the last blink to the first dry spot on the cornea was noted under cobalt blue light. Data were analyzed using SPSS with descriptive statistics. Using Craig et al. criteria, subjects with an OSDI score ≥35 and Schirmer I <10 mm or TBUT <10 seconds were considered to have dry eye.

**Key Results:** A total of 97 computer operators were examined, of whom 59.2% were males and 40.8% were females. Age distribution: 37.1% were 36-40 years, 20.6% were 31-35 years, 19.6% were 26-30 years, 9.3% were 41-45 years, 7.2% were <25 years, and 6.2% were >45 years. The overall prevalence of dry eye was 51%. The mean OSDI score was 39. When the OSDI cutoff was set at ≥35, the prevalence of dry eye was 41%. Mean Schirmer I test values were 10 mm in the right eye and 10.6 mm in the left eye. Mean TBUT was 12.3 seconds in the right eye and 13 seconds in the left eye.

**Clinical Implications:** This study demonstrates a high prevalence (51%) of dry eye among computer operators, consistent with other Indian studies reporting prevalence rates from 12.3% to 61.54% in high-exposure occupational groups. The mean OSDI score of 39 indicates moderate to severe symptoms. The findings support that prolonged computer use reduces blink rate and increases tear evaporation, contributing to dry eye. The study emphasizes the importance of patient education on ergonomic practices, such as maintaining a one-arm distance (40 inches) from the screen, a downward gaze of 14° or more, avoiding screen reflections and glare, and reducing air conditioning drafts. Blinking exercises and artificial tear drops may help minimize symptoms and prevent complications. As internet use increases, ophthalmologists should be familiar with quick, reliable diagnostic tests like OSDI, Schirmer I, and TBUT to manage dry eye effectively.