While tear film and ocular surface investigations have traditionally focused on adults, a recent study reports healthy children had at least one abnormal ocular surface test result, and about 33% were diagnosed with dry eye disease (DED) based on DEWS II criteria.

The cross-sectional study included 60 healthy kids aged seven to 17 who completed a symptom questionnaire and underwent ocular surface testing. The researchers reported that every child had an alteration in at least one test. Additionally, the pediatric DED prevalence was higher than what has been previously reported in the literature, which the researchers attributed to environmental factors.

The investigators also found lid margin irregularity in three eyes and thin lipid layers in nearly half of participants. Over 50% of the participants had positive fluorescein corneal staining, and almost 80% had positive conjunctival lissamine green staining. Of note, nearly 40% of the children showed some degree of meibomian gland loss.

Other findings included:

• A mean Ocular Surface Disease Index score of about 10 points.
• No statistical association between screen use and test results, despite participants  spending approximately six hours a day on computers or digital devices, with smartphones being the most popular.
• A blink frequency of about seven times per minute while reading on paper and about nine times per minute while reading on a screen.
• Normal lid margin, tear meniscus height, non-invasive tear breakup time, temporal and nasal conjunctival redness, osmolarity and Schirmer’s score.

The study authors cited the need for additional multi-center studies with larger, more diverse groups of children.