Multi-regression analysis results.

Purpose
To 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.
Methods
A cross-sectional study involving 788 university students was conducted in Jordan. Participants’ mean age was 21.87 years (SD = 3.824; range: 18–45 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.
Results
The incidence of DE symptoms, defined as an OSDI score ≥ 13, was 74.2% among university students. Higher DE symptom severity was statistically associated with females’ gender (p < 0.001), older age (≥27 years) (p = 0.032), contact lens use (p = 0.001), frequent use of eye cosmetics (p < 0.001), and a history of DED (p < 0.001). 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 < 0.001). 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.
Conclusion
Dry 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.