{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:59:54Z","timestamp":1783490394237,"version":"3.55.0"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019004","name":"Deanship of Research, Jordan University of Science and Technology","doi-asserted-by":"publisher","award":["20230271"],"award-info":[{"award-number":["20230271"]}],"id":[{"id":"10.13039\/501100019004","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\nPurpose<\/jats:title>\nTo estimate the incidence of dry eye (DE) symptoms among university students in Jordan and to examine the relationship between behavioral and cultural risk factors and DE symptom severity.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nA cross-sectional study involving 788 university students was conducted in Jordan. Participants\u2019 mean age was 21.87 years (SD\u2009=\u20093.824; range: 18\u201345 years). The incidence and severity of DE symptom were assessed using the validated Arabic version of the Ocular Surface Disease Index (ARB-OSDI) questionnaire, administered through Google Forms. The survey included demographic questions and behavioral-cultural risk factors (smoking and eye cosmetic use). One-Way ANOVA and multi-regression analyses were used to investigate the association between OSDI mean scores and behavioral-cultural risk factors.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nThe incidence of DE symptoms, defined as an OSDI score\u2009\u2265\u200913, was 74.2% among university students. Higher DE symptom severity was statistically associated with females\u2019 gender (p\u2009<\u20090.001), older age (\u226527 years) (p\u2009=\u20090.032), contact lens use (p\u2009=\u20090.001), frequent use of eye cosmetics (p\u2009<\u20090.001), and a history of DED (p\u2009<\u20090.001). Smoking habits, including the use of Dokha or Ajami, smoking in enclosed spaces, and daily smoking, were also associated with increased DE symptom severity (all p\u2009<\u20090.001). Contributing factors to the high incidence and severity of DE symptom included long-term use of eye cosmetics (particularly mascara and internal eyeliner) and sleeping while wearing contact lenses.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nDry eye symptoms are highly prevalent among university students in Jordan and are significantly associated with factors such as age, gender, contact lens use, cosmetic application, and tobacco consumption.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0328235","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T17:32:03Z","timestamp":1754587923000},"page":"e0328235","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Incidence of dry eye symptoms and behavioural-cultural risk factors among university students population in Jordan"],"prefix":"10.1371","volume":"20","author":[{"given":"May M.","family":"Bakkar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9606-1577","authenticated-orcid":true,"given":"Mona","family":"Aridi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4970-2663","authenticated-orcid":true,"given":"Mohammad A.","family":"Alebrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6933-2394","authenticated-orcid":true,"given":"Wissam","family":"Ghach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"issue":"3","key":"pone.0328235.ref001","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jtos.2017.05.008","article-title":"TFOS DEWS II definition and classification report","volume":"15","author":"JP Craig","year":"2017","journal-title":"Ocul Surf"},{"issue":"3","key":"pone.0328235.ref002","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jtos.2017.05.003","article-title":"TFOS DEWS II epidemiology report","volume":"15","author":"F Stapleton","year":"2017","journal-title":"Ocul Surf"},{"issue":"1","key":"pone.0328235.ref003","doi-asserted-by":"crossref","DOI":"10.4102\/aveh.v80i1.591","article-title":"A systematic review on prevalence, risk factors, clinical diagnosis and medical management of dry eye disease in the Arab population","volume":"80","author":"MA Aljarousha","year":"2021","journal-title":"African Vision and Eye Health"},{"issue":"3","key":"pone.0328235.ref004","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.clae.2016.01.003","article-title":"Epidemiology of symptoms of dry eye disease (DED) in Jordan: a cross-sectional non-clinical population-based study","volume":"39","author":"MM Bakkar","year":"2016","journal-title":"Cont Lens Anterior Eye"},{"issue":"6","key":"pone.0328235.ref005","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/j.1395-3907.2003.00158.x","article-title":"The effects of chronic smoking on the ocular surface and tear characteristics: a clinical, histological and biochemical study","volume":"81","author":"A Satici","year":"2003","journal-title":"Acta Ophthalmol Scand"},{"issue":"11","key":"pone.0328235.ref006","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.4236\/health.2021.1311100","article-title":"Toxicology of commonly found ingredients in e-cigarettes: a brief review","volume":"13","author":"HZ Alshareef","year":"2021","journal-title":"Health"},{"issue":"4","key":"pone.0328235.ref007","doi-asserted-by":"crossref","first-page":"221","DOI":"10.4066\/AMJ.2012.1035","article-title":"The effect of smoking on the ocular surface and the precorneal tear film","volume":"5","author":"J Thomas","year":"2012","journal-title":"Australas Med J"},{"key":"pone.0328235.ref008","unstructured":"Philanthropies B. 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