Problematic internet use (PIU) increased prevalence of symptomatic dry eye disease (DED) in male medical students, researchers found in a Peruvian study published in Clinical Ophthalmology.

Prevalence rates of DED in Peru had previously not been investigated, the researchers reported. In Peru, 68.4% of individuals in the university population have PIU, which entails feeling concerned about using it “irresistibly for longer periods than usual” and “anguish that results from not doing it,” but not mania or hypomania. The emotional dysregulation and lack of confidence and social support people with PIU possess produce psychological stress that could lead to DED, according to the investigation.

“The aforementioned would indicate the association between these variables, however, as far as we know, there are no investigations that report this relationship,” the researchers said.


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Researchers analyzed data of 844 adult medical students (301 men, mean age 21.8±3.3 years). They sent the students questionnaires from December 7, 2020, to February 12, 2021, that were based on the Ocular Surface Disease Index (OSDI) and the Internet Addiction Test (IAT).

Researchers excluded students with Sjögren syndrome, refractive surgery procedures, glaucoma, uncorrected ametropia, use of contact lenses, active ocular surface disease, previous psychiatric illnesses, or previous diagnosis of DED.

Two-thirds of the students spent at least 6 hours on the internet, nearly half (48.7%) did not use blue-light blocking lenses, 41% set brilliant screen, and 56.9% maintained less than 40 cm of distance from the screen. Prevalence of symptomatic DED was 70.9%, and uncontrolled use of the internet was 14.7%. Men with more severe PIU were more likely to experience severe symptomatic DED (80%), but women experienced the same frequency of severe symptomatic DED regardless of whether they had severe PIU or were average internet users.

Nonadjusted Poisson regression models indicated that PIU increased prevalence of symptomatic DED 19% in the overall population (PR 1.19 95% CI 1.08-1.31) and 35% among men (PR 1.35 95% CI 1.16-1.57). In adjusted models, PIU was associated with symptomatic DED in the overall population (PR 1.17 95% CI 1.06-1.29) and men (PR 1.27 95% CI 1.09-1.49) but not in women.

“PIU has become a public health problem, which if left untreated can generate symptomatic DED,” the researchers said. “Therefore, it deserves institutional policy implementations that incorporate strategies to promote mental health, as well as ocular health, focused on education of good visual habits and self-control, to improve the correct functioning and tear stability concerning the ocular surface, which will consequently prevent symptomatic DED.”

Limitations include lack of physical evaluation. There was no consideration of anxiety, depression, or sleep patterns and no evaluation of causality of variables. 

Reference

Condori-Meza IB, Dávila-Cabanillas LA, Challapa-Mamani MR, et al. Problematic internet use associated with symptomatic dry eye disease in medical students from Peru. Clin Ophthalmol. 2021:15(10):4357-4365. doi:10.2147/OPTH.S334156