Correlation Between Dry Eye and Screen Viewing Time Among Young Adult

Screen use especially computers, phone and other visual display devices are now an essential part of our daily life. With the increased use, a large population is experiencing ocular symptoms globally such as dry eyes, eye strain, irritation and redness of the eyes. This study determined the correlation between dry eye and screen viewing time among young adult in Madonna university teaching hospital. This is an observational cross-sectional study with 100subjects. 50(50%) male and 50 (50%) female within the ages of 18-32years. A total of 100 questionnaire were collected, quantitative approach was used to determine dry eye using schimer’s strip and the data were analyzed using Pearson chi-square. The study discovered the percentage of age group of the participant which 53(53%) fell within 23-27 years with 28(28.0%) males and 25(25%) females, while 18-22years 38(38%) with 18(18%) males and 20(20%) females, 28-32years 9(9.0%) in which 4(4.0%) were males and 5(5.0%) were females. The study showed that the mean age was 23.18 and standard deviation of ±3.160. The mean and standard deviation gotten for dry eye were 21.43±10.96. The study also showed the screen viewing time distribution among the participants within the duration of 4-6hours as the highest occurring duration with 38(38.0%), while 7-9hours was 25(25%), 1-3hours was 19(19%) and above 9hours with the least 18(18%) with the total mean of 1.42 and standard deviation ± 0.997. Correlation between dry eye and screen time in respect to gender, for screen viewing time above 9hours were (p=0.00, p<0.05) while correlation between dry eye and screen viewing time in relation to age group from 18-22years were (p=0.051, p< 0.05), 23-27years (p=0.017, p<0.05) and 28-32 (p=0.126, p<0.05) with the total Pearson chi-square of 0.00 (p=0.00, p<0.05). In conclusion there is statistical correlation between dry eye and screen viewing time especially for constant screen users. The researcher recommends proper orientation and institutional education on screen usage especially for constant users.

ocular surface components may worsen dry eye disease [2].
The tear film is a well-organized moist film which covers the bulbar and palpebral conjunctiva and cornea, which is formed and maintained in an elaborate system that comprises the lacrimal apparatus interface.
Tears have similar structure to saliva and mostly made of water but also contain salt, fatty oils and over 1500 different proteins [3]. Tear dysfunction is one of the most common problems encountered by eye doctors resulting from disease of one or more component of lacrimal functional unit that consist of the tear producing glands and their neural connection. It has a reported prevalence ranging with age from the 4 th and 8 th decade of life and more prevalent in women than men [4], it forms a thin layer over the cornea and conjunctiva which is also known as precorneal tear film. Guillion and Cecile [5] conducted a study on effect of age, gender and tear film evaporation, a total of 160 subject less than 45years or more were used as the study population. The result revealed a significant effect of age (P<0.001), gender (P< 0.001) and the interaction (P<0.001). The rate of evaporation was higher in older age group at both humidity the rate of evaporation was overall higher for women and the synergic effect of age and gender was very marked. Dry eye disease is a chronic ocular pathology and a major global health problem that manifest a plethora of symptoms such as burning, photophobia, tearing and grittiness [6]. Tityal and Kumar [6], conducted a study on 15625 patients, were OSDI questionnaire were administered over a period of 2years clinically dry eye disease was detected in 32% patient. 9.8% mild dry eye,61.2% had moderate dry eye disease and 28.9% severe dry eye disease and the questionnaire consist of 12 questions were 1.58% answered 11, 32.34% answered 10 questions, 0.08% answered 9 questions. In another study conducted by Agbonlahor [7], the prevalence of computer vision syndrome among working class in F.C.T was calculated to be 65%. Prevalence of computer vision syndrome was highest in female gender 74% as compared to male 56%. Association between the dependent variable (presence of computer vision syndrome) and most of the independent variable were not statically significant; the only association that was statistically significant was presence of computer vision syndrome with knowledge of computer vision syndrome (x^2.7.748; df:1; p = 0.005), and presence of computer vision syndrome with work productivity (x^2: 6.641, df :2; p = 0.036).
Mufti, sheikh and Sania [8], conducted a study on prevalence rate of dry eye on 100 undergraduate medical student department of physiology, government medical college which shows that increased duration of usage of digital screen increases the risk of dry eye. Eye strain was the most common symptom reported by 53 subjects (58.8%) followed by headache (23.3%) followed by blurring of vision. 37% of the students had never heard of dry eye whereas 53% had some knowledge about it. 62% of the students believed that digital screen exposure affects their lifestyle majority of students 75% were willing to reduce their screen time as a preventive measure towards dry eye. Computer vision use has become worldwide. One side of these technology made our lifestyle too much relaxed but on the other side produce many dangers for human health which increases day by day. In increasing the use of computers in homes or offices as well as professional and educational life there is a requirement to explore whether students, professional and other computer users as implement ergonomic principles when they are using these devices [9].
Screen time is the amount of time spent using device with a screen such as a smart phone, computer, television or video game. Studies shows that screen time directly impact child development, mental and physical health. Screen time may represent a significant risk factor for dry eye syndrome in children with symptoms of tearing, eye redness, eye rubbing and headache which may indicate screen time associated dry eye within the pediatric population [10]. Computer vision syndrome is applied collectively to set of different symptoms in computer use who are either habitually or on compulsion are using computers for a long time during the day and night [11]. Moldovan et al.,[12], conducted a study on the correlation between pc screen exposure of over 8hrs and dry eye syndrome in 18-25years, among 59 participant of this study 26 were exposed 8hours of Pc screen exposure=exposed and 33 were not exposed which indicate that dry eye syndrome incidence and intensity of symptoms increases proportionally with hours.
American optometry association recommends that the center study is significant at it will create awareness on the possible effect of screen viewing time on the eyes. It will help to enlighten the public on how well to protect their eyes from screen rays to avoid further eye complication like dry eye. It will help to educate the public how necessary it is to stay away from screen after over usage of screen. It will also educate the public on how important it is to visit an eye doctor in case of any discomfort.

Research Questions
This research design aims at providing answers to the following questions.
• What would be the effect of screen viewing time on dry eye on young adults?
• What could be the relationship between dry eye and screen viewing time in relation to gender • What could be the relationship between dry eye and screen viewing time in relation to age?
• What could be the effect of screen viewing time on dry eye in relation to hours?

Research hypothesis
The study focuses on the testing the following research hypothesis.
Null hypothesis (HO1): There is no statistically significant correlation between dry eye and screen viewing time among young adults.
Alternate Hypothesis (HA1): There is a statistically significant correlation between dry and screen viewing time. (P < 0.05).

Materials and method
Legal and ethical consideration: Ethical consent was obtained from the ethical committee of the department of optometry, Madonna university Nigeria, Elele, Rivers State. Verbal consent was obtained from the participant with their right duty protected. Confidentiality of the data was maintained.

Research design and Area of Study:
The research design is observational cross-sectional study.

Reliability And Validity:
In this study, all data were collected by the researcher alone, hence no inter-ratter influence. All the data that was presented in this study was exactly the same situation and phenomenon.
Efforts were made to ensure accuracy of data. Also, the data for this study was collected using some tests and the

Results
The respondents were asked to indicate their gender. Result in the table above shows 50(50%) of respondents were females, 50(50%) males. The first question of the questionnaire was to profile the selected participants in terms of their age. were females, 9(9.0) % within 28-32years in which 4(4.0%) were males and 5(5.0%) were females, with the mean age of 23.18 and SD of ± 3.160  The first question of the questionnaire was to profile the selected participants in terms of their age. Table 3 shows the gender distribution among age group from 18 to 32years in which 53(53)% fell within 23-27years in which 28(28.0%) were males and 25(25.0%) were females, 38(38.0)% within 18-22years in which 18(18.0%) were males and 20(20.0%) were females, 9(9.0)% within 28-32years in which 4(4.0%) were males and 5(5.0%) were females, with the mean age of 23.18 and SD of ± 3.160.

Level of Education
Results obtained show that 0% of the respondents had primary education and as well as uneducated, a fact worth noting is that 100% of all respondents have good level of education, 2% have secondary education and 98% have attended colleges and university education. The data gathered from the field work on the level of education of the participants is presented above

Dry eye and screen viewing time in relation to gender
Gender distribution of the effect of screen viewing time on dry eye as stated in the table above shows that males had dry eye more than females for the screen duration of 4-6hours, an equal distribution for those within screen time group of 7-9hour and females had higher distribution than males for screen viewing time. for the screen duration of 4-6hours, for those within 23-27years had higher frequency for screen time groups of 7-9hour and above 9 and those within 28-32 had equal distribution for both 7-9hours and above 9hours.   Table above it also shows correlation between dry eye and screen time in respect to gender for the screen time of above 9hours (p=0.00, ρ<0.015).

Conclusion and Recommendations
In conclusion, the results of the study showed that according that Dry Eye Syndrome incidence and intensity of symptoms had increased proportionally with the hours of exposure. The duration of exposure plays an important role in the severity of these symptoms, suggesting a behavioural change in the exposed participants.