The authors aimed to determine the prevalence of ocular surface symptoms in a high school population and to evaluate its association with contact lens wear and other factors. The study had a population of 3240 students. This was a cross-sectional study using a self-administered and Spanish-validated version of the Ocular Surface Disease Index (OSDI) questionnaire with extra questions about contact lens wear, type, duration of daily wear, frequency, and overnight wear. Seven hundred and forty-nine students completed the questionnaire with mean age of 16 ±0.96 years (55% female). Mean OSDI score was 25.11 ±20.61 points (0-88.63); 0 represents a healthy eye and 100 indicates severe symptoms of OSD. Higher scores were found for girls: 28.25 ±21.48 versus 21.14 ±18.74 for boys. Forty-six students wore contact lenses: three-quarters using soft lenses. These were worn on average 6.26 days / week with average duration of 17.80 ±16.77 months. Twenty-three percent wore them overnight. Contact lens wearers had higher OSDI scores than non-lens wearers: 34.26 ±23.13 versus 25.51 ±20.31. OSDI >22 points signified presence of dry eye disease. After adjustment, girls were more symptomatic than boys (OR 1.84) and contact lens wear was associated with ocular surface symptoms (OR 2.76). The results suggest that prevalence of OSD in high school children is high. It is important to identify risk factors for this group and ensure appropriate monitoring.