Demographic characteristics of participants.

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’s 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 19–24 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–response 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 7 h/day (aOR 2.25; 95% CI 1.55–3.31; p