Attention! Children's dry eye syndrome should not be ignored

Parents often bring their children to the ophthalmology clinic and ask: "Recently, my child keeps blinking, and nothing I say helps. Is there something wrong with his eyes?" After examination, the doctor finds that the child has dry eyes, which is why he blinks frequently.

Can children get dry eyes at such a young age? Isn't dry eyes something that only adults experience? This is not the case.

Dry eye syndrome is more than just dry eyes

In recent years, more and more people have symptoms of dry eyes. What is dry eye? Is dry eye just "dry eyes"? Of course not. Dry eye is a series of symptoms caused by abnormal tear quality and quantity due to various reasons. In addition to feeling dry eyes, people may also experience foreign body sensation, burning sensation, tearing, and fluctuating vision. People with dry eyes are mostly concentrated in the middle-aged and elderly population, and are more common in women.

Children and adolescents secrete more tears than adults, so the onset of dry eye in children and adolescents was once considered very rare. But now we find that dry eye is not uncommon among children and adolescents who visit the outpatient clinic.

Children usually lack the ability to accurately describe their eye symptoms. Therefore, we rarely hear children say "dry eyes", "foreign body sensation", "blurred vision" and other symptoms of dry eye. However, they will have symptoms of frequent blinking (blinking) and rubbing their eyes. Some children also have red eyes and photophobia. These are also common reasons for parents to take their children to the hospital for eye examinations.

Causes of dry eyes in children

Different from the causes of dry eye in adults, children and adolescents suffer from dry eye mostly due to the following reasons.

Conjunctival allergy. Conjunctival allergy is also called allergic conjunctivitis. It is very common in children and adolescents. The incidence rate among children in my country is as high as 28%, and it has been increasing year by year. Parents may think that their children "rub their eyes with dirty hands" or "have ADHD and always like to blink hard". But in fact, the child may just be allergic.

When the conjunctiva is allergic, children will experience itchy eyes, red eyes, rubbing eyes, blinking, etc. When they feel uncomfortable in their eyes, they will relieve the itchiness by squeezing the eyelids when blinking, or improve dryness by redistributing tears when blinking.

Use of electronic products. For children and adolescents, the use of electronic products is more likely to cause dry eyes. Long-term use of electronic products (such as mobile phones, computers, televisions, etc.) means an average of more than 4 hours of use per day. The longer the use time, the more obvious the dry eye symptoms. Why? Because when children use electronic products, they blink less, the incidence of incomplete blinking increases, and the tear evaporation rate is accelerated, resulting in various eye discomfort symptoms. Therefore, some children will have red eyes and tears when using electronic products, and they will also blink frequently after using electronic products.

In the long run, if electronic products are used for a long time, the structure that secretes oil in the child's eyelids may atrophy, and dry eye symptoms will appear and gradually worsen, developing from a functional problem to an organic problem.

Refractive error (myopia, hyperopia, astigmatism). The outermost surface of our eyes is not the cornea, but the transparent tear film. The refractive state of the eye affects the stability of the tear film. The stability of the tear film determines whether dry eye symptoms will occur.

Studies have shown that the prevalence of dry eye in children with refractive errors is significantly higher than that in children without refractive errors. When children's myopia and hyperopia are not corrected, they are prone to visual fatigue, and may even lead to chronic inflammatory reactions on the ocular surface and changes in blinking frequency. These factors will directly affect the stability of the tear film. Children with astigmatism have irregular corneal surfaces and greater tear film tension, resulting in unstable tear film. Therefore, if a child has refractive errors, they must be corrected in a timely manner.

Wearing contact lenses. Nowadays, wearing contact lenses is no longer exclusive to adults. More functional contact lenses have been used for children and adolescents, such as orthokeratology lenses, RGP (rigid gas permeable corneal contact lenses), defocused soft lenses, etc. However, when children wear contact lenses, because the lenses are in direct contact with the tear film, the tears are divided into the front and back of the lens, making the oil layer of the tear film thinner, which will increase the instability of the tear film and make children more prone to dry eye symptoms. In reality, children use relatively more hard contact lenses. Compared with soft contact lenses used by adults, hard contact lenses have less impact on the tear film.

Prevention of dry eyes in children

Because the symptoms of dry eye in children are not typical, they are often ignored. For general cases of dry eye, you can reduce the time children spend using electronic products and urge them to use eye drops on time and in the right amount to relieve the symptoms of dry eye. However, if dry eye recurs, it may lead to acute infections such as meibomian gland inflammation, meibomian gland cysts, and styes. Therefore, when children suffer from dry eye, they should go to the hospital for treatment in time to avoid worsening symptoms and induce other eye diseases.

(Author: Chen Hui)