Project – Digital Device Use and Dry-Eye Symptoms among Undergraduate Students: A Study of Students of the University of Lagos

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

The rapid development of digital technology has significantly transformed education, communication, entertainment and social interaction among young people. University students increasingly depend on smartphones, laptop computers, tablets and other digital devices for accessing lecture materials, attending online classes, conducting research, communicating with lecturers and classmates, completing assignments and engaging in recreational activities. Although these devices provide substantial educational and social benefits, prolonged visual exposure to digital screens has raised concerns about ocular health. One of the major concerns is digital eye strain, which may present with symptoms such as eye dryness, burning, itching, foreign-body sensation, excessive tearing, blurred vision, eye pain, difficulty focusing and headache. The Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II) defines dry eye disease as a multifactorial ocular-surface disease involving loss of tear-film homeostasis and ocular symptoms, with tear-film instability, hyperosmolarity, inflammation, ocular-surface damage and neurosensory abnormalities playing important roles (Craig et al., 2017). The increasing dependence of undergraduate students on digital devices therefore makes the relationship between screen exposure and dry-eye symptoms an important area of public-health and eye-health research.

Digital device use can influence ocular comfort through several physiological and behavioural mechanisms. Sustained viewing of a digital screen requires continuous near visual activity and may be accompanied by reduced blinking, incomplete blinking and prolonged exposure of the ocular surface. Reduced or incomplete blinking can interfere with the normal distribution of the tear film over the eye and may increase tear evaporation, thereby contributing to dryness and discomfort. Talens-Estarelles et al. (2021), in a review of digital-display use and ocular-surface alterations, reported that abnormal blinking during digital-device operation, including reduced blink rate and incomplete eyelid closure, may contribute to dry-eye signs and symptoms among digital-device users. Similarly, the relationship between digital screen use and dry eye has been attributed partly to changes in blinking dynamics during screen viewing (Mowatt et al., 2018). These mechanisms are important among undergraduate students because academic screen activities may require sustained concentration for long periods, potentially increasing visual demands and reducing normal blinking behaviour (Talens-Estarelles et al., 2021; Mowatt et al., 2018).

The amount of time spent using digital devices is another factor that has received considerable research attention. Students may use multiple devices within the same day, moving from smartphones to laptops and tablets for academic activities and then continuing with screens for social media, streaming, gaming or other forms of entertainment. A systematic review by Mataftsi et al. (2023), involving 2,365 young digital-device users across ten studies, found evidence that screen use exceeding approximately four to five hours per day was associated with higher digital-eye-strain symptom scores. The review also identified poor ergonomic parameters as a factor associated with increased symptoms and concluded that reducing excessive screen exposure and improving ergonomic conditions may help minimize digital eye strain. These findings suggest that duration of exposure should be considered when examining ocular symptoms among undergraduate students because the total daily burden of digital-device use may be substantial when academic and non-academic screen activities are combined (Mataftsi et al., 2023).

The symptoms associated with digital eye strain overlap considerably with symptoms of dry-eye conditions, making the issue particularly important among university students. Common symptoms include dryness, burning, irritation, redness, excessive tearing, tired eyes, blurred vision, sensitivity to light and difficulty focusing. In a cross-sectional study of university students, increased digital-device use was associated with dry-eye and digital-eye-strain symptoms, with students spending more than nine hours daily on screens showing increased likelihood of symptoms (Kaur et al., 2022). Another study among university students undertaking online learning reported that 97.9% of participants experienced at least three symptoms associated with digital-device use, while 88.1% reported average daily screen exposure exceeding four hours (Madhav et al., 2023). These findings demonstrate that digital-device-related ocular symptoms can be common among university populations and that prolonged exposure deserves attention as a potential contributor to ocular discomfort.

The issue is also relevant because university students are a particularly screen-dependent population whose academic responsibilities increasingly involve electronic learning resources. Digital lecture notes, electronic journals, online databases, learning management systems, virtual classes and electronic submission platforms have made screen-based academic work an important component of university education. During and after the COVID-19 pandemic, the adoption of online and blended learning further increased dependence on digital devices among students. Adepoju et al. (2025) investigated digital eye syndrome among tertiary-institution students in Nigeria and reported symptoms including eye fatigue, irritation or gritty sensation, burning, dryness, blurred vision, itching and tearing. The study found that 25.4% of participants reported a dry feeling in the eyes and that prolonged screen exposure of eight to eleven hours was significantly associated with increased symptom severity. The findings are particularly relevant to the Nigerian university context because they demonstrate that digital-eye symptoms remain important among tertiary students even in the post-COVID period (Adepoju et al., 2025).

Evidence from Lagos further strengthens the need to examine digital-device use and dry-eye symptoms within the local environment. Balogun and Fashola (2025), in a study conducted at Lagos State University Teaching Hospital involving 295 digital-device users, found that smartphones were the most frequently used devices and that more than half of the participants reported ten or more hours of daily screen exposure. The researchers observed significant relationships between prolonged screen time and abnormal Schirmer test results, reduced tear break-up time and corneal fluorescein staining. More than half of the participants also reported varying degrees of dry-eye symptoms, with prolonged screen exposure associated with greater symptom severity. Although the study population included a broad age range and was hospital-based rather than university-based, its findings provide important local evidence that prolonged digital-device exposure is associated with measurable ocular-surface changes and dry-eye symptoms in Lagos (Balogun & Fashola, 2025).

Despite the growing evidence on digital eye strain and dry-eye symptoms, there remains a need for institution-specific research among undergraduate students of the University of Lagos. Students at the University of Lagos operate within a highly digital academic environment in which smartphones, laptops, tablets and other electronic devices may be used for lectures, research, communication, assignments and leisure. However, the extent of students’ digital-device exposure, the frequency and severity of dry-eye symptoms they experience, and the relationship between duration and pattern of device use and these symptoms require empirical investigation. The validated Computer Vision Syndrome Questionnaire developed by Seguí et al. (2015) demonstrates that visual symptoms related to screen exposure can be systematically assessed using a reliable instrument covering 16 symptoms, while contemporary evidence continues to show an association between prolonged digital-screen use and digital-eye-strain symptoms (Seguí et al., 2015; Mataftsi et al., 2023). Therefore, investigating digital device use and dry-eye symptoms among undergraduate students of the University of Lagos is important for generating local evidence, increasing awareness of digital eye health and informing appropriate preventive measures for students.

1.2 Statement of the Problem

The increasing dependence on smartphones, laptop computers, tablets and other digital devices has created a new visual-health concern among university students. Undergraduate students often spend long periods viewing digital screens for academic activities and may continue using the same devices for social communication, entertainment and other personal activities. Such prolonged exposure may be accompanied by reduced blinking, sustained near focusing and increased tear evaporation, potentially resulting in symptoms such as dryness, burning, eye fatigue, blurred vision and irritation. The TFOS DEWS II report recognizes dry eye as a multifactorial ocular-surface disease involving tear-film instability and ocular symptoms, while research on digital displays indicates that screen viewing can alter blinking behaviour and contribute to ocular-surface discomfort (Craig et al., 2017; Talens-Estarelles et al., 2021).

The problem is particularly important among undergraduate students because their academic activities increasingly require continuous interaction with digital technology. Online learning, electronic textbooks, digital libraries, online examinations, electronic assignments and internet-based research may require students to remain in front of screens for several hours each day. Evidence from young screen users indicates that more than four to five hours of daily screen use is associated with higher digital-eye-strain symptom scores (Mataftsi et al., 2023). Similarly, studies among university students have reported substantial levels of dry-eye and digital-eye-strain symptoms, with longer daily screen exposure associated with greater symptom severity (Kaur et al., 2022; Madhav et al., 2023). The concern is that students may consider dryness, burning or tired eyes to be ordinary consequences of studying and may therefore fail to recognize them as symptoms requiring preventive attention.

The Nigerian situation provides further reason for concern. Adepoju et al. (2025), in a study among tertiary-institution students in Nigeria, found that students reported several symptoms associated with digital-device use, including eye fatigue, irritation, burning, dryness, blurred vision, itching and tearing. The study also identified a significant association between prolonged screen exposure of eight to eleven hours and increased symptom severity. In Lagos, Balogun and Fashola (2025) similarly found a significant association between prolonged digital-device use and objective indicators of ocular-surface disturbance, while 65.4% of their participants experienced varying degrees of dry-eye symptoms. These findings demonstrate that digital-device-related ocular symptoms are relevant in Nigeria and Lagos, but they do not specifically establish the magnitude of dry-eye symptoms among undergraduate students of the University of Lagos.

The central problem, therefore, is the limited institution-specific evidence on the relationship between digital-device use and dry-eye symptoms among undergraduate students of the University of Lagos. Although international studies and recent Nigerian research have demonstrated associations between prolonged screen exposure and ocular symptoms, differences in academic workload, device preferences, duration of exposure, environmental conditions, screen-viewing practices and preventive behaviours may produce different experiences across student populations. There is consequently a need to determine the pattern and duration of digital-device use among University of Lagos undergraduates, identify the common dry-eye symptoms experienced by these students and establish whether digital-device use is significantly associated with reported dry-eye symptoms. Generating such evidence will help provide a basis for visual-health education and preventive interventions aimed at promoting safer digital-device practices among undergraduate students (Adepoju et al., 2025; Balogun & Fashola, 2025).

1.3 Purpose of the Study

The main purpose of this study is to examine digital device use and dry-eye symptoms among undergraduate students of the University of Lagos.

Specifically, the study seeks to:

1. determine the pattern and duration of digital-device use among undergraduate students of the University of Lagos;
2. identify the common dry-eye symptoms experienced by undergraduate students of the University of Lagos;
3. determine the level of awareness of digital-device-related dry-eye symptoms among undergraduate students; and
4. determine the relationship between digital-device use and dry-eye symptoms among undergraduate students of the University of Lagos.

1.4 Research Questions

The following research questions will guide the study:

1. What are the pattern and duration of digital-device use among undergraduate students of the University of Lagos?
2. What are the common dry-eye symptoms experienced by undergraduate students of the University of Lagos?
3. What is the level of awareness of digital-device-related dry-eye symptoms among undergraduate students of the University of Lagos?
4. What relationship exists between digital-device use and dry-eye symptoms among undergraduate students of the University of Lagos?

1.5 Research Hypothesis

The following null hypothesis will be tested at the 0.05 level of significance:

H₀: There is no significant relationship between digital-device use and dry-eye symptoms among undergraduate students of the University of Lagos.

1.6 Significance of the Study

The study will be significant to undergraduate students because it will increase awareness of the possible ocular effects associated with prolonged digital-device use. The findings may help students recognize symptoms such as dryness, burning, eye fatigue, blurred vision, irritation and difficulty focusing and encourage them to adopt healthier screen-viewing practices.

The study will also be useful to the University of Lagos management and relevant student-support units. Findings from the study may provide evidence for developing visual-health education programmes, awareness campaigns and guidance on appropriate digital-device use. The university may also use the findings to encourage practices such as regular breaks, appropriate screen positioning, suitable lighting and reduction of unnecessarily prolonged screen exposure.

The study will be beneficial to optometrists, ophthalmologists, public-health practitioners, occupational-health professionals and other healthcare providers. The findings may assist healthcare professionals in understanding the pattern of ocular symptoms among young adults who are heavily dependent on digital technology and may provide a basis for targeted preventive and health-education interventions.

The study will also be useful to lecturers and academic advisers because they may gain a better understanding of the visual-health challenges that students may experience during prolonged digital academic activities. Such awareness may encourage consideration of reasonable screen breaks and alternative learning approaches where appropriate.

The study will further be useful to parents and caregivers of undergraduate students by providing information about the potential consequences of excessive screen exposure and the importance of encouraging healthy digital-device practices.

Finally, the study will serve as a reference for researchers and students interested in optometry, ophthalmology, public health, health education, occupational health and related disciplines. It may provide baseline information for future research on digital eye strain, dry-eye disease, screen exposure and visual health among university students in Nigeria.

1.7 Scope of the Study

The study will focus on digital device use and dry-eye symptoms among undergraduate students of the University of Lagos.

The geographical scope will be limited to the University of Lagos, Lagos State, Nigeria.

The content scope will cover the pattern and duration of digital-device use, types of devices used, purposes of use, daily screen exposure, screen-viewing practices, awareness of ocular effects of digital-device use and common symptoms associated with dry eye. The symptoms of interest will include dryness, burning, itching, foreign-body sensation, eye redness, excessive tearing, eye pain, tired eyes, blurred vision, difficulty focusing and related visual discomfort.

The population of the study will comprise undergraduate students of the University of Lagos. Postgraduate students, academic staff, administrative staff and other non-undergraduate populations will fall outside the main population of the study.

1.8 Operational Definition of Terms

Digital Device: An electronic device with a digital screen used for activities such as communication, education, research, entertainment or information access. Examples include smartphones, laptop computers, tablets and desktop computers.

Digital Device Use: The use of smartphones, tablets, computers, laptops and other screen-based electronic devices for academic, communication, social, recreational or other activities.

Dry-Eye Symptoms: Subjective ocular complaints associated with ocular dryness or instability of the tear film, including dryness, burning, itching, foreign-body sensation, redness, excessive tearing, eye discomfort and visual disturbance.

Dry Eye Disease: A multifactorial disease of the ocular surface characterized by loss of tear-film homeostasis and accompanied by ocular symptoms, with tear-film instability, hyperosmolarity, ocular-surface inflammation and damage and neurosensory abnormalities contributing to its development (Craig et al., 2017).

Digital Eye Strain: A group of ocular and visual symptoms associated with the use of digital screens, including dryness, burning, blurred vision, eye fatigue, headache, eye pain and difficulty focusing.

Undergraduate Student: A student formally enrolled in a bachelor’s degree or other undergraduate programme at the University of Lagos.

Screen Time: The amount of time an individual spends viewing or interacting with a digital screen during a specified period, particularly within a typical day.

Prolonged Digital-Device Use: Continuous or cumulative exposure to digital screens for extended periods, particularly when exposure is associated with limited breaks or prolonged visual concentration.

Visual Symptoms: Subjective complaints affecting visual comfort or function, including blurred vision, difficulty focusing, eye fatigue, sensitivity to light and headache.

Ocular Surface: The exposed surface structures of the eye, including the cornea, conjunctiva and associated tear-film system that contribute to ocular protection and visual function.

Project – Digital Device Use and Dry-Eye Symptoms among Undergraduate Students: A Study of Students of the University of Lagos