Prevalence of Digital Eye Strain Symptoms Among Sudanese Medical Students During Conflict-Induced Online Learning: A Cross-Sectional Study.

BACKGROUND AND AIMS: Armed conflict in Sudan has severely disrupted traditional medical education, prompting a shift toward online learning as an alternative. While digital platforms enable educational continuity, they are associated with increased screen exposure and a rising incidence of digital eye strain (DES) among medical students. This study aimed to investigate the prevalence, symptoms, and associated factors of DES in this conflict-driven educational environment. To assess the prevalence, risk factors, and awareness of DES symptoms among Sudanese medical students engaged in online learning during the armed conflict.

METHODS

A descriptive cross-sectional study was conducted from April to June 2025 among undergraduate Sudanese medical students who transitioned to online learning during the conflict. A total of 1028 participants were recruited using convenience sampling. Data were collected using an online self-administered questionnaire adapted from a validated instrument used in a previously published study. Responses were analyzed using SPSS version 27. Descriptive statistics were used to summarize findings, binomial logistic regression was performed to identify predictors of DES symptoms, and the Wilcoxon signed-rank test assessed changes in screen time before and during the conflict.

RESULTS

About 80.6% of students reported that prolonged screen use negatively impacted their eye health and lifestyle. Eye-related symptoms were reported by 86.6% of participants, and 61.5% experienced physical discomfort. The average screen time increased significantly during the conflict. Awareness of the 20-20-20 rule was limited (24.2%), with only 13.5% reporting regular practice. However, 70.9% were willing to reduce screen time to help prevent DES.

CONCLUSION

Digital eye strain was highly prevalent among medical students and was associated with extended screen use, poor posture, and limited awareness. Its association with physical discomfort and academic stress highlights the need for targeted interventions. Medical institutions should integrate DES awareness and prevention strategies into curricula to promote student well-being and academic success.