Pediatric dry eye may indicate systemic disease

In children, symptoms of dry eye such as photophobia and red eye may signal the presence of underlying systemic disease, according to a study by researchers in Brazil. "Systemic investigation, close follow-up and preparing the family for long-term and multidisciplinary treatment are necessary to preserve ocular health and identify systemic associations," the study authors said.

Flávio Mac Cord Medina, MD, and colleagues reviewed records for 14 children aged 1 year to 17 years who were treated for dry eye over a period of 96 months. All children had bilateral ocular surface damage and tear deficiency.

The most frequent complaints included red eye, photophobia and low visual acuity. Specifically, two children had a baseline best corrected visual acuity of 20/200 or less, and one of these children as well as one other child had a BCVA of 20/200 or less at final follow-up.

All children were treated with artificial tears, and three also received autologous serum eye drops.

Regarding ocular findings, seven children had punctate keratitis, three had leukoma, three had corneal pannus and two had meibomian gland dysfunction. Also, two children developed corneal ulcers, and four received conjunctival flap treatment, according to the study.

Investigators identified associated systemic conditions in all children, including six children with congenital disorders.

Specifically, two children had anidrotic ectodermal dysplasia, one had epidermolysis bullosa, one had ectrodactyly ectodermal dysplasia-clefting syndrome, two had graft-versus-host disease, two had Riley-Day syndrome, one had short bowel syndrome, two had Sjögren's syndrome and two had toxic epidermal necrolysis, according to the study, published in the November issue of Acta Ophthalmologica Scandinavica.