INTRODUCTION: The rapid evolution of the Internet of Things (IoT) and Artificial Intelligence (AI) has opened new possibilities for public healthcare. Effective integration of these technologies is essential to ensure precise and efficient healthcare delivery. This study explores the application of IoT-enabled, AI-driven systems for detecting and managing Dry Eye Disease (DED), emphasizing the use of prompt engineering to enhance system performance. METHODS: A specialized prompt mechanism was developed utilizing OpenAI GPT-4.0 and ERNIE Bot-4.0 APIs to assess the urgency of medical attention based on 5,747 simulated patient complaints. A Bidirectional Encoder Representations from Transformers (BERT) machine learning model was employed for text classification to differentiate urgent from non-urgent cases. User satisfaction was evaluated through composite scores derived from Service Experiences (SE) and Medical Quality (MQ) assessments. RESULTS: The comparison between prompted and non-prompted queries revealed a significant accuracy increase from 80.1% to 99.6%. However, this improvement was accompanied by a notable rise in response time, resulting in a decrease in SE scores (95.5 to 84.7) but a substantial increase in MQ satisfaction (73.4 to 96.7). These findings indicate a trade-off between accuracy and user satisfaction. DISCUSSION: The study highlights the critical role of prompt engineering in improving AI-based healthcare services. While enhanced accuracy is achievable, careful attention must be given to balancing response time and user satisfaction. Future research should optimize prompt structures, explore dynamic prompting approaches, and prioritize real-time evaluations to address the identified challenges and maximize the potential of IoT-integrated AI systems in medical applications.