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Purpose: Dry Eye Disease (DED) is increasingly prevalent in younger populations. The current study investigated lifestyle factors, and clinical signs and symptoms, in young adults with evaporative DED, compared with healthy participants, and for progression over one year.

Methods: Fifty young adults aged 18 to 25, with or without DED based on the TFOS DEWS II criteria, were recruited following institutional ethics approval. Participants with any recent history of allergy or use of medications known to affect the eyes were not included. All participants completed the Ocular Surface Dry Eye Index questionnaire and a lifestyle questionnaire, including questions about screen use, contact lens wear, exercise, sleep, and self-perceived health, diet, and stress. Detailed clinical parameters of the ocular surface, tear film and meibomian glands were assessed over one year, including MMP-9 assessment with a point-of-care …