{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T04:54:53Z","timestamp":1793076893777,"version":"4.5.0"},"reference-count":66,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>This study aimed to estimate the prevalence, severity, and risk factors of dry eye symptoms (DES) among Iraqi university students and to examine associations with digital device use in an arid, dust-prone setting. A cross-sectional survey was conducted at Al-Mustaqbal University (Iraq) between February and May 2025 using paper-based questionnaires that captured demographics, device-use patterns, symptom burden, and self-management behaviors. Symptom severity was assessed with the Ocular Surface Disease Index (OSDI), and DES prevalence was estimated using the Women\u2019s Health Study (WHS) questionnaire. Binary logistic regression was applied to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Among 1,487 invited students, 1,154 completed the survey (response rate 77.6%); participants were aged 19\u201324 years, and 63.6% were female. The WHS-defined prevalence of symptomatic DES was 62.0%. Blurred vision, burning, and ocular redness were the most frequent symptoms. A dose\u2013response relationship was observed between daily screen time and OSDI severity, with the highest burden among students reporting more than 7 hours per day (trend p\u2009&lt;\u20090.001). In adjusted models, female participants had higher odds (aOR 2.34; 95% CI 1.56\u20133.56; p\u2009&lt;\u20090.001), screen time &gt;7\u2009h\/day (aOR 2.25; 95% CI 1.55\u20133.31; p\u2009&lt;\u20090.001), fourth academic year (aOR 1.75; 95% CI 1.18\u20132.60; p\u2009=\u20090.01), and use of glasses\/contact lenses (aOR 1.45; 95% CI 1.10\u20131.90; p\u2009=\u20090.01) were significant predictors. Laptops were most often associated with ocular redness, smartphones with burning and pain, and tablets with blurred vision. In conclusion, DES symptoms were highly prevalent and strongly associated with prolonged daily screen exposure. Female sex, advanced academic standing, and corrective lens use further increased risk. Findings support campus-level prevention focused on digital hygiene, ergonomic optimization, and periodic ocular screening, considering environmental stressors typical of arid, dust-prone settings.<\/jats:p>","DOI":"10.1371\/journal.pone.0337335","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T18:30:27Z","timestamp":1766169027000},"page":"e0337335","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence of dry eye symptoms and associated risk factors among students at Al-Mustaqbal University, Iraq"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4892-1346","authenticated-orcid":true,"given":"Hassan A.","family":"Aljaberi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Rahmani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab A.","family":"Elzahra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir H.","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"issue":"3","key":"pone.0337335.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"},{"key":"pone.0337335.ref002","article-title":"TFOS DEWS II pathophysiology report","volume":"30","author":"Y Ogawa","year":"2017","journal-title":"Ocul Surf"},{"issue":"2","key":"pone.0337335.ref003","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S1542-0124(12)70081-2","article-title":"The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007)","volume":"5","year":"2007","journal-title":"Ocul Surf"},{"issue":"3","key":"pone.0337335.ref004","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jtos.2017.05.005","article-title":"TFOS DEWS II Introduction","volume":"15","author":"JD Nelson","year":"2017","journal-title":"Ocul Surf"},{"issue":"5","key":"pone.0337335.ref005","doi-asserted-by":"crossref","first-page":"102441","DOI":"10.1016\/j.clae.2025.102441","article-title":"Effect of soft contact lens wear on corneal endothelial cell characteristics","volume":"48","author":"HA Aljaberi","year":"2025","journal-title":"Cont Lens Anterior Eye"},{"key":"pone.0337335.ref006","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.jtos.2017.03.006","article-title":"TFOS DEWS II Tear Film Report","volume":"15","author":"JP Craig","year":"2017","journal-title":"Ocul Surf"},{"issue":"2","key":"pone.0337335.ref007","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/S0002-9394(03)00218-6","article-title":"Prevalence of dry eye syndrome among US women","volume":"136","author":"DA Schaumberg","year":"2003","journal-title":"Am J Ophthalmol"},{"issue":"1","key":"pone.0337335.ref008","article-title":"Coping with dry eyes: a qualitative approach","volume":"18","author":"S Yeo","year":"2018","journal-title":"BMC Ophthalmol"},{"issue":"1","key":"pone.0337335.ref009","doi-asserted-by":"crossref","DOI":"10.1136\/bmjophth-2018-000146","article-title":"Digital eye strain: prevalence, measurement and amelioration","volume":"3","author":"AL Sheppard","year":"2018","journal-title":"BMJ Open Ophthalmol"},{"issue":"3","key":"pone.0337335.ref010","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.survophthal.2005.02.008","article-title":"Computer vision syndrome: a review","volume":"50","author":"C Blehm","year":"2005","journal-title":"Surv Ophthalmol"},{"key":"pone.0337335.ref011","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.jtos.2017.05.004","article-title":"TFOS DEWS II Epidemiology Report","volume":"15","author":"JAP Gomes","year":"2017","journal-title":"Ocul Surf"},{"key":"pone.0337335.ref012","doi-asserted-by":"crossref","first-page":"925876","DOI":"10.3389\/fmed.2022.925876","article-title":"Editorial: Advances in the Pathophysiology, Diagnosis, and Treatment of Dry Eye Disease","volume":"9","author":"Y Lu","year":"2022","journal-title":"Front Med (Lausanne)"},{"issue":"1","key":"pone.0337335.ref013","doi-asserted-by":"crossref","DOI":"10.2174\/18743641-v17-e230214-2022-36","article-title":"Contact Lens as Drug Delivery System for Glaucoma Treatment: A Review","volume":"17","author":"HA Aljaberi","year":"2023","journal-title":"TOOPHTJ"},{"issue":"5","key":"pone.0337335.ref014","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1111\/j.1475-1313.2011.00834.x","article-title":"Computer vision syndrome: a review of ocular causes and potential treatments","volume":"31","author":"M Rosenfield","year":"2011","journal-title":"Ophthalmic Physiol Opt"},{"key":"pone.0337335.ref015","doi-asserted-by":"crossref","first-page":"1173683","DOI":"10.3389\/ftox.2023.1173683","article-title":"The environment and dry eye-manifestations, mechanisms, and more","volume":"5","author":"S Patel","year":"2023","journal-title":"Front Toxicol"},{"issue":"20","key":"pone.0337335.ref016","doi-asserted-by":"crossref","first-page":"8438","DOI":"10.3390\/su12208438","article-title":"Impacts of the COVID-19 Pandemic on Life of Higher Education Students: A Global Perspective","volume":"12","author":"A Aristovnik","year":"2020","journal-title":"Sustainability"},{"key":"pone.0337335.ref017","doi-asserted-by":"crossref","first-page":"112934","DOI":"10.1016\/j.psychres.2020.112934","article-title":"The psychological impact of the COVID-19 epidemic on college students in China","volume":"287","author":"W Cao","year":"2020","journal-title":"Psychiatry Res"},{"key":"pone.0337335.ref018","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.pmedr.2018.10.003","article-title":"Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study","volume":"12","author":"JM Twenge","year":"2018","journal-title":"Prev Med Rep"},{"key":"pone.0337335.ref019","volume-title":"Children and parents: media use and attitudes report 2020\/21","author":"OfCom.org","year":"2016"},{"issue":"1","key":"pone.0337335.ref020","doi-asserted-by":"crossref","first-page":"30","DOI":"10.14710\/dimj.v2i1.9761","article-title":"The Effect of Using Blue Light Filter Feature on Smartphones with Asthenopia Occurrence","volume":"2","author":"AV Wiryawan","year":"2021","journal-title":"Diponegoro Int Med J"},{"issue":"12","key":"pone.0337335.ref021","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1097\/ICL.0000000000000843","article-title":"Effect of Blue Light Filters on Tear and Contrast Sensitivity in Individuals Using Electronic Devices","volume":"47","author":"MC S\u00e1nchez-Gonz\u00e1lez","year":"2021","journal-title":"Eye Contact Lens"},{"issue":"1","key":"pone.0337335.ref022","article-title":"Prevalence and Risk Factors of Dry Eye Disease in Association With the Increased Use of Electronic Devices Among University Students in Western Saudi Arabia","volume":"16","author":"NA Zarban","year":"2024","journal-title":"Cureus"},{"issue":"9","key":"pone.0337335.ref023","article-title":"Dry Eye Disease Prevalence and Associated Risk Factors Among the Middle East Population: A Systematic Review and Meta-Analysis","volume":"16","author":"Z Mohamed","year":"2024","journal-title":"Cureus"},{"issue":"1","key":"pone.0337335.ref024","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":"4","key":"pone.0337335.ref025","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.clae.2019.08.001","article-title":"Prevalence and risk factors of symptomatic dry eye disease in Lebanon","volume":"43","author":"A Sherry","year":"2020","journal-title":"Cont Lens Anterior Eye"},{"issue":"2","key":"pone.0337335.ref026","doi-asserted-by":"crossref","first-page":"72","DOI":"10.21315\/mjms2024.31.2.8","article-title":"Prevalence and Risk Factors of Dry Eye Disease in the South of Palestine","volume":"31","author":"M Aljarousha","year":"2024","journal-title":"Malays J Med Sci"},{"issue":"1","key":"pone.0337335.ref027","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1186\/s12886-025-04162-0","article-title":"Correlation between refractive errors and ocular biometric parameters at Al-Mustaqbal University, Iraq","volume":"25","author":"HA Aljaberi","year":"2025","journal-title":"BMC Ophthalmol"},{"key":"pone.0337335.ref028","doi-asserted-by":"crossref","first-page":"100662","DOI":"10.1016\/j.oor.2024.100662","article-title":"How to choose a sampling technique and determine sample size for research: A simplified guide for researchers","volume":"12","author":"SK Ahmed","year":"2024","journal-title":"Oral Oncology Reports"},{"key":"pone.0337335.ref029","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1055\/s-0040-1722104","article-title":"Sample Size Calculation in Medical Research: A Primer","volume":"57","author":"J Charan","year":"2021","journal-title":"ANAMS"},{"issue":"4","key":"pone.0337335.ref030","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1007\/s10792-022-02528-7","article-title":"The validity and reliability of the Arabic version of the ocular surface disease index (OSDI) questionnaire in a sample of the Gazan population: a study from Palestine","volume":"43","author":"M Aljarousha","year":"2023","journal-title":"Int Ophthalmol"},{"issue":"5","key":"pone.0337335.ref031","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1001\/archopht.118.5.615","article-title":"Reliability and Validity of the Ocular Surface Disease Index","volume":"118","author":"RM Schiffman","year":"2000","journal-title":"Arch Ophthalmol"},{"issue":"6","key":"pone.0337335.ref032","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1159\/000525696","article-title":"Prevalence and Incidence of Dry Eye Disease in Asia: A Systematic Review and Meta-Analysis","volume":"65","author":"Y Cai","year":"2022","journal-title":"Ophthalmic Res"},{"issue":"1","key":"pone.0337335.ref033","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s12886-023-03249-w","article-title":"Prevalence of dry eye and Meibomian gland dysfunction in Central and South America: a systematic review and meta-analysis","volume":"24","author":"H Chen","year":"2024","journal-title":"BMC Ophthalmol"},{"key":"pone.0337335.ref034","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jtos.2025.02.005","article-title":"The impact of dry eye disease on patient-reported quality of life: A Save Sight Dry Eye Registry study","volume":"37","author":"H Kandel","year":"2025","journal-title":"Ocul Surf"},{"issue":"3","key":"pone.0337335.ref035","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1093\/fampra\/cmac155","article-title":"Dry eye in primary care: the relationship between digital display device usage and dry eye syndrome (DES) in medical students","volume":"41","author":"ES Utlu","year":"2024","journal-title":"Fam Pract"},{"issue":"1","key":"pone.0337335.ref036","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1186\/s12886-025-04263-w","article-title":"Electronic device exposure and dry eye symptoms among medical and nonmedical Palestinian university students: a multicenter cross-sectional study of associated factors","volume":"25","author":"M Alashqar","year":"2025","journal-title":"BMC Ophthalmol"},{"issue":"1","key":"pone.0337335.ref037","doi-asserted-by":"crossref","first-page":"15149","DOI":"10.1038\/s41598-024-65297-6","article-title":"The severity of dry eye symptoms and risk factors among university students in Saudi Arabia: a cross-sectional study","volume":"14","author":"A Alqurashi","year":"2024","journal-title":"Sci Rep"},{"issue":"8","key":"pone.0337335.ref038","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0328235","article-title":"Incidence of dry eye symptoms and behavioural-cultural risk factors among university students population in Jordan","volume":"20","author":"MM Bakkar","year":"2025","journal-title":"PLoS One"},{"key":"pone.0337335.ref039","doi-asserted-by":"crossref","first-page":"3851","DOI":"10.2147\/OPTH.S385040","article-title":"Prevalence and Behavioral-Based Risk Factors (Eye Cosmetic and Tobacco Use) of Symptomatic Dry Eye Disease in Four Middle Eastern Countries: Lebanon, Syria, Jordan, and Palestine","volume":"16","author":"W Ghach","year":"2022","journal-title":"Clin Ophthalmol"},{"issue":"2","key":"pone.0337335.ref040","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.3390\/ijerph20021313","article-title":"Prevalence of Dry Eye Symptoms and Associated Risk Factors among University Students in Poland","volume":"20","author":"D Wr\u00f3bel-Dudzi\u0144ska","year":"2023","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0337335.ref041","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12886-023-03260-1","article-title":"Assessment of the prevalence and risk factors for dry eye symptoms among Romanian medical students using the ocular surface disease index - a cross-sectional study","volume":"24","author":"LD Preoteasa","year":"2024","journal-title":"BMC Ophthalmol"},{"key":"pone.0337335.ref042","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jtos.2025.01.006","article-title":"Prevalence of dry eye disease in Spain: A population-based survey (PrevEOS)","volume":"36","author":"JM Ben\u00edtez-Del-Castillo","year":"2025","journal-title":"Ocul Surf"},{"issue":"11","key":"pone.0337335.ref043","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0259399","article-title":"Prevalence and associated risk factors for dry eye disease among Brazilian undergraduate students","volume":"16","author":"I Yang","year":"2021","journal-title":"PLoS One"},{"issue":"1","key":"pone.0337335.ref044","doi-asserted-by":"crossref","first-page":"28470","DOI":"10.1038\/s41598-025-07228-7","article-title":"A nationwide population-based study on epidemiologic characteristics and treatment patterns of dry eye disease in South Korea","volume":"15","author":"JB Lee","year":"2025","journal-title":"Sci Rep"},{"issue":"1","key":"pone.0337335.ref045","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.jtos.2019.09.007","article-title":"Physical inactivity, prolonged sedentary behaviors, and use of visual display terminals as potential risk factors for dry eye disease: JPHC-NEXT study","volume":"18","author":"A Hanyuda","year":"2020","journal-title":"Ocul Surf"},{"issue":"3","key":"pone.0337335.ref046","doi-asserted-by":"crossref","first-page":"190","DOI":"10.3109\/02713683.2010.544442","article-title":"Blink rate, blink amplitude, and tear film integrity during dynamic visual display terminal tasks","volume":"36","author":"G Cardona","year":"2011","journal-title":"Curr Eye Res"},{"issue":"11","key":"pone.0337335.ref047","doi-asserted-by":"crossref","first-page":"6679","DOI":"10.1167\/iovs.15-16967","article-title":"Blink Rate and Incomplete Blinks in Six Different Controlled Hard-Copy and Electronic Reading Conditions","volume":"56","author":"M Argil\u00e9s","year":"2015","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"2","key":"pone.0337335.ref048","doi-asserted-by":"crossref","first-page":"101744","DOI":"10.1016\/j.clae.2022.101744","article-title":"The effects of breaks on digital eye strain, dry eye and binocular vision: Testing the 20-20-20 rule","volume":"46","author":"C Talens-Estarelles","year":"2023","journal-title":"Cont Lens Anterior Eye"},{"issue":"3","key":"pone.0337335.ref049","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.jtos.2017.04.001","article-title":"TFOS DEWS II Sex, Gender, and Hormones Report","volume":"15","author":"DA Sullivan","year":"2017","journal-title":"Ocul Surf"},{"issue":"2","key":"pone.0337335.ref050","doi-asserted-by":"crossref","first-page":"139","DOI":"10.18231\/j.ijooo.2021.029","article-title":"Sex hormones and dry eye disease: Current update","volume":"7","author":"R Prakash Maurya","year":"2021","journal-title":"IJOOO"},{"issue":"9","key":"pone.0337335.ref051","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1507\/endocrj.EJ20-0178","article-title":"The applications of androgen in the treatment of dry eye disease: a systematic review of clinical studies","volume":"67","author":"L Wang","year":"2020","journal-title":"Endocr J"},{"issue":"7","key":"pone.0337335.ref052","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1136\/bjophthalmol-2016-309498","article-title":"The effects of transdermal testosterone and oestrogen therapy on dry eye in postmenopausal women: a randomised, placebo-controlled, pilot study","volume":"101","author":"B Golebiowski","year":"2017","journal-title":"Br J Ophthalmol"},{"issue":"3","key":"pone.0337335.ref053","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0265733","article-title":"Prevalence of symptomatic dry eye disease with associated risk factors among medical students at Chiang Mai University due to increased screen time and stress during COVID-19 pandemic","volume":"17","author":"C Tangmonkongvoragul","year":"2022","journal-title":"PLoS ONE"},{"issue":"1","key":"pone.0337335.ref054","doi-asserted-by":"crossref","first-page":"100534","DOI":"10.1016\/j.optom.2024.100534","article-title":"Prevalence of refractive errors among school students in Iraq - A systematic review and meta-analysis","volume":"18","author":"HA Aljaberi","year":"2025","journal-title":"J Optom"},{"key":"pone.0337335.ref055","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jtos.2024.12.003","article-title":"Impact of particulate matter and air pollution on ocular surface disease: A systematic review of preclinical and clinical evidence","volume":"35","author":"S Iqbal","year":"2025","journal-title":"Ocul Surf"},{"issue":"3","key":"pone.0337335.ref056","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1111\/ceo.12183","article-title":"Prevalence of dry eye syndrome in an adult population","volume":"42","author":"H Hashemi","year":"2014","journal-title":"Clin Exp Ophthalmol"},{"issue":"4","key":"pone.0337335.ref057","doi-asserted-by":"crossref","first-page":"101865","DOI":"10.1016\/j.clae.2023.101865","article-title":"Symptoms of dry eye related to the relative humidity of living places","volume":"46","author":"EMO Research Group","year":"2023","journal-title":"Cont Lens Anterior Eye"},{"issue":"3","key":"pone.0337335.ref058","doi-asserted-by":"crossref","first-page":"242","DOI":"10.4103\/sjmms.sjmms_251_22","article-title":"Prevalence and Risk Factors of Dry Eye Disease among Adults in Saudi Arabia","volume":"11","author":"HB Helayel","year":"2023","journal-title":"Saudi J Med Med Sci"},{"key":"pone.0337335.ref059","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.2147\/OPTH.S474832","article-title":"Environmental and Occupational Triggers of Dry Eye Symptoms in the Ahsa Region of Saudi Arabia: A Cross-Sectional Study","volume":"18","author":"SK Al-Dossary","year":"2024","journal-title":"Clin Ophthalmol"},{"issue":"5","key":"pone.0337335.ref060","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1167\/tvst.9.5.25","article-title":"Climatic and Environmental Correlates of Dry Eye Disease Severity: A Report From the Dry Eye Assessment and Management (DREAM) Study","volume":"9","author":"EJ Berg","year":"2020","journal-title":"Transl Vis Sci Technol"},{"issue":"11","key":"pone.0337335.ref061","doi-asserted-by":"crossref","first-page":"3740","DOI":"10.3390\/jcm9113740","article-title":"Impact of Air Pollution and Weather on Dry Eye","volume":"9","author":"JT Mandell","year":"2020","journal-title":"J Clin Med"},{"key":"pone.0337335.ref062","doi-asserted-by":"crossref","first-page":"2311","DOI":"10.2147\/RMHP.S388331","article-title":"Concurrent Rising of Dry Eye and Eye Strain Symptoms Among University Students During the COVID-19 Pandemic Era: A Cross-Sectional Study","volume":"15","author":"A Uwimana","year":"2022","journal-title":"Risk Manag Healthc Policy"},{"issue":"12","key":"pone.0337335.ref063","article-title":"Prevalence of dry eye during the COVID-19 pandemic: A systematic review and meta-analysis","volume":"18","author":"H Ji","year":"2023","journal-title":"PLoS One"},{"issue":"8","key":"pone.0337335.ref064","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1001\/jamaophthalmol.2020.2237","article-title":"Association of the Indoor Environment With Dry Eye Metrics","volume":"138","author":"A Huang","year":"2020","journal-title":"JAMA Ophthalmol"},{"key":"pone.0337335.ref065","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.jtos.2024.12.008","article-title":"Clinical practice patterns in the management of dry eye disease: A TFOS international survey 2023-24","volume":"36","author":"JS Wolffsohn","year":"2025","journal-title":"Ocul Surf"},{"issue":"6","key":"pone.0337335.ref066","doi-asserted-by":"crossref","first-page":"101409","DOI":"10.1016\/j.clae.2021.01.004","article-title":"Modifiable lifestyle risk factors for dry eye disease","volume":"44","author":"MTM Wang","year":"2021","journal-title":"Cont Lens Anterior Eye"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0337335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T18:30:37Z","timestamp":1766169037000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0337335"}},"subtitle":[],"editor":[{"given":"Wissam","family":"Ghach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":66,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,19]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0337335","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,19]]}}}