Characteristics of self-reported asthenopia in a large-scale crowdsourced study using the smartphone application DryEyeRhythm

This study identified the characteristics and factors associated with self-reported asthenopia using the DryEyeRhythm smartphone application. A cross-sectional digital cohort study was conducted between November 2016 and September 2019. DryEyeRhythm smartphone application users who completed the survey questionnaire were included in the analysis. Participants with incomplete or duplicate data, foreign data from outside of Japan, or missing Global Positioning System data were excluded from the analysis. Self-reported asthenopia was determined using the question "Do you have any symptoms of asthenopia?". Multivariate logistic regression was used to evaluate factors associated with self-reported asthenopia. Among 35,218 users who downloaded DryEyeRhythm, 3,593 completed the questionnaires and were included. Overall, 2,168 (60.3%) participants experienced self-reported asthenopia. Self-reported asthenopia was significantly more prevalent among individuals aged 30-50 years (P < 0.001). The self-reported asthenopia group had a significantly higher Japanese version of the Ocular Surface Disease Index (J-OSDI) total score than the non-self-reported asthenopia group (P < 0.001). The associated factors were older age, past dry eye disease diagnosis, eye drops usage for dry eye disease, extended screen exposure, and dry eye symptoms. Self-reported asthenopia was significantly associated with the following dry eye disease symptoms based on the J-OSDI: feeling gritty (P < 0.001), painful or sore eyes (P < 0.001), problems with reading (P < 0.001), and problems with working with a computer or bank machine (P = 0.004). Additionally, 1,773 of 2,168 participants (55.9%) reported both asthenopia and dry eye symptoms. This large-scale cross-sectional digital cohort study provides insights into the characteristics and factors associated with self-reported asthenopia in the general population. These findings may inform future efforts to raise awareness, support early identification, and guide preventative strategies, particularly in susceptible populations.