Prevalence and occupational risk factors of dry eye symptoms among Chinese healthcare workers

Healthcare workers (HCWs) in China are at a high risk of self-reported dry eye symptoms due to occupational exposures, yet population-based epidemiological data on this issue among Chinese HCWs remain scarce. This multicenter cross-sectional study aimed to quantify the prevalence of frequent dry eye symptoms, their diagnostic status, and independent occupational risk factors among Chinese HCWs. From September 2024 to December 2025, 269 active HCWs from 5 tertiary hospitals in Guangdong completed anonymous questionnaires covering demographics, occupational/lifestyle factors, and ocular symptoms. Multivariate logistic regression identified independent risk factors for frequent dry eye symptoms (≥3 times/wk). The prevalence of frequent dry eye symptoms among participants (mean age = 38.5 ± 8.2 years, 59.9% female, 74.4% were physicians) was 54.3%, but only 6.3% had a formal clinical diagnosis. Daily screen time of 7 hours or more emerged as the strongest modifiable risk factor (odds ratio [OR] = 2.31, P = .005). Other independent risk factors included perceived dry work environment (OR = 1.98), frequent night work (OR = 2.15), and myopia (OR = 1.89; all P < .01). A striking gap between knowledge, belief, and behavior was observed: 92.2% recognized screen-use risks, yet only 2.6% performed regular eye exercises. Chinese HCWs face a high burden of frequent dry eye symptoms, which remain severely underdiagnosed. The identified screen-time threshold (≥7 hours/d) is lower than conventional occupational health recommendations and should be considered a modifiable target for intervention. Importantly, current occupational health checkups for HCWs lack ocular surface screening, representing a systemic gap. Given that data were collected in the post-pandemic era (2024-2025), our findings likely reflect the new normal of digitally intensive healthcare work. Workplace-oriented interventions - such as incorporating symptom screening into annual exams, electronic medical record rest reminders, and eye care training - are urgently needed to bridge the awareness-behavior gap and protect HCWs' ocular health. Our findings are based on self-reported symptoms rather than clinical diagnosis, highlighting the need for objective screening in routine occupational health checkups.