Abstract

Objective: This study aimed to evaluate the prevalence of dry eye disease (DED) and identify its contributing factors, with a particular focus on sun exposure and protective behaviors such as sunglasses use.
Methods: This cross-sectional study included 626 participants from the Jazan region, Saudi Arabia, recruited via convenience sampling. Data were collected using an online questionnaire comprising four sections: socio demographic, medical and ophthalmic history, DED characteristics, and sun exposure and protection behaviors using the sun exposure and protection index (SEPI). A multivariable logistic regression model was used to identify independent predictors of self-reported DED.
Results: Among participants, 31.6% had DED. Significant independent risk factors included a history of blepharitis (OR = 33.72, p-value = 0.003), refractive surgery (OR = 7.49, p < 0.001), and weekly contact lens use (OR = 5.40, p-value = 0.009). Systemic conditions, such as hyperlipidemia (OR = 2.26, p-value = 0.049) and asthma (OR = 2.07, p-value = 0.048), were also significant risk factors, as were higher sun exposure scores on the SEPI scale (OR = 1.09, p-value = 0.001) and increasing age.
Conclusion: DED was highly prevalent in the Jazan region. The findings confirmed established risk factors and uniquely highlighted the modifiable risk of excessive sun exposure, as well as the protective role of sun protection behaviors, including sunglasses use, in an extreme climate.

Key words: Dry eye disease, sun exposure, sunglasses, Saudi Arabia, behavioral determinants