Eye Cosmetics and Dry Eye Disease: A Cross-sectional Study

Abstract Background: Eye cosmetic use is widespread, but its link with ocular surface health is still poorly understood. We investigated the relationship between eye cosmetic practices and dry eye disease (DED) severity measured by the ocular surface disease index (OSDI). Materials and Methods: We ran a cross-sectional, self-administered online survey of 634 adults who used at least one eye cosmetic product. The questionnaire covered demographics, cosmetic practices, hygiene habits, awareness, and ocular symptoms. The 12-item OSDI classified DED severity as normal (0–12), mild (13–22), moderate (23–32) or severe (33–100). Chi-square, Pearson correlation and one-way ANOVA with Tukey post hoc tests were run in IBM SPSS v27.0, with P < 0.05 taken as significant. Results: Mean age was 30.79 ± 9.78 years, and 277/634 (43.7%) participants were in the severe DED group. Applying eyeliner or mascara near the lash line ( P < 0.001) and sharing eye makeup ( P < 0.001) showed the strongest links with OSDI severity. Storing contact lenses in water instead of a proper solution was also associated with worse scores ( P = 0.036). Self-reported eye comfort correlated negatively with OSDI ( r = −0.567 and r = −0.545, both P < 0.001). Mean age rose across OSDI categories, with a 7.24-year gap between the severe and normal groups ( P < 0.001). Conclusion: Several eye cosmetic habits, especially lash-line application and product sharing, are associated with more severe dry eye. Clinicians should ask about cosmetic use during dry eye assessment, and public education should focus on safer practices. Prospective studies with objective ocular surface measures and better control for screen time and hormonal factors are needed to confirm these associations.