Khalid M. Al-Zubi
Waqar A. Al-Kubaisy
Yazan E. Al-Azzeh
Batool K. Batayneh
Hazim A. Alqaraleh
Loay A. Abid
Ghazi O. Al-Jadid Al-Majali
Noor T Alhajaj

Abstract Background: Dry eye disease (DED) is a multifactorial condition often characterized by a reduction in tear film quantity or quality. This study aimed to determine the frequency of DED and its associated subjective symptoms among students of Mu’tah University. Methods: In this cross-sectional study conducted at Mu’tah University, Mu’tah, Jordan, from January to April ۲۰۲۲, ۴۸۹ students completed an online patient-reported DED symptom questionnaire and the ocular surface disease index (OSDI) questionnaire. Moreover, ۱۰۶ participants underwent clinical examinations using the Schirmer test I and fluorescein tear breakup time (TBUT). Results: Approximately ۷۴.۶% of the students self-reported experiencing DED symptoms, and ۷۲.۶% had an OSDI score > ۱۲, which is considered the threshold for an abnormal ocular surface. Clinical examinations revealed low Schirmer test scores (< ۱۰ mm) in ۲۶.۴% (n = ۲۸) and ۲۵.۵% (n = ۲۷) of the right and left eyes, respectively. We observed low TBUT scores (< ۵ s) in ۱۹.۸% (n = ۲۱) and ۱۸.۹% (n = ۲۰) of the right and left eyes, respectively. We noted significant differences between the self-reported DED symptoms and the Schirmer test scores (P = ۰.۰۰۳ for both right and left eyes), TBUT (P < ۰.۰۰۱ for both right and left eyes), and OSDI score (P < ۰.۰۰۱ for each self-reported DED symptom). We observed a weak significant positive correlation between Schirmer test scores and TBUT in the right (r = + ۰.۳۰; P = ۰.۰۰۲) and left (r = + ۰.۳۴; P < ۰.۰۰۱) eyes; a negligible significant inverse correlation between OSDI scores and Schirmer test scores in the right (r = - ۰.۲۴; P = ۰.۰۱۳) and left (r = - ۰.۲۳; P = ۰.۰۱۹) eyes; and a negligible significant inverse correlation between the OSDI score and TBUT of the left eye (r = - ۰.۲۵; P = ۰.۰۱۱) but not of the right eye (r = - ۰.۱۷; P = ۰.۰۷۷). Conclusions: The frequency of DED symptoms in this study was higher than that previously reported based on foreign statistics. The presence of self-reported DED symptoms was significantly associated with higher OSDI scores. Self-reported DED symptoms were more frequent than the abnormalities detected using objective methods. Therefore, a combination of subjective and objective measures may provide a higher diagnostic yield for DED. Further studies are required to confirm this hypothesis.