Evaluating Knowledge, Attitudes, and Practices of Patients on Lifestyle Factors Associated with Dry Eye Disease
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Abstract
Background: Dry eye disease is a multifactorial ocular surface disorder influenced by tear-film instability, inflammation, visual discomfort, and modifiable lifestyle factors such as prolonged screen exposure, poor sleep quality, smoking, physical inactivity, environmental exposure, and dietary habits. Objective: This study aimed to assess knowledge, attitudes, and practices regarding lifestyle-related dry eye disease among diagnosed adult patients and to examine associations between KAP domains and selected demographic, clinical, and behavioral characteristics. Methods: A cross-sectional observational study was conducted from 1 February 2026 to 1 April 2026 among adults aged 18–70 years diagnosed with dry eye disease. Data were collected using a structured 43-item questionnaire covering demographic characteristics, knowledge, attitudes, and practices. Of 535 enrolled participants, 529 valid responses were analyzed. Descriptive statistics, group comparisons, Pearson correlation analysis, and path analysis were performed. Results: The mean knowledge, attitude, and practice scores were 22.22 ± 4.078, 19.04 ± 2.547, and 22.50 ± 5.339, respectively. Knowledge was significantly associated with attitude (r = 0.184, p < 0.001), while attitude was weakly but significantly associated with practice (r = 0.098, p = 0.024). Knowledge was not significantly associated with practice (r = -0.051, p = 0.239). Path analysis showed significant effects of age, DED exposure among relatives or friends, daily exercise, gender, knowledge, and attitude on KAP domains. Conclusion: Participants showed uneven knowledge, generally favorable attitudes, and variable preventive practices, indicating that education alone may be insufficient without structured behavioral support
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