Objective <p>To investigate the association between visual display terminal (VDT) usage frequency and the prevalence of dry eye disease (DED), ocular surface signs, and their trends over a 1-year follow-up among adults in Beijing.</p> Methods <p>This prospective cohort study recruited 1040 adults (393 males, 647 females); with a mean age of 54.72 ± 17.99 years. Participants were categorised into three groups based on their VDT usage frequency: T1, T2, and T3. Data on the Ocular Surface Disease Index (OSDI) and clinical signs of DED were collected at baseline and after the 1-year follow-up. Examinations included measurements of tear meniscus height (TMH), non-invasive tear film break-up time (NIBUT), corneal fluorescein staining (CFS), and meibomian gland (MG) assessment.</p> Results <p>The prevalence of DED decreased from 34.1% to 32.2% after follow-up. T1 and T2 groups had a significantly higher prevalence of DED than T3 group at both time points (<i>P</i> &lt; 0.001). A decreasing trend in DED prevalence was observed with reduced VDT usage. The incidence of new DED cases was 9.27%. A significant transition between DED and non-DED status occurred during the follow-up (<i>P</i> &lt; 0.001). NIBUT and CFS showed slight increases, while MG assessment slightly decreased (<i>P</i> &lt; 0.05). OSDI and TMH Changes were not significant (<i>P</i> &gt; 0.05).</p> Conclusion <p>VDT usage is associated with a higher prevalence of DED. Reducing VDT usage may help lower the risk of DED.</p>