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Punctal plugs present dry eye treatment option for children
Br J Ophthalmol. 2012; 96(1):90-92.
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Punctal plugs offer an alternative to topical lubrication in treating dry eye syndrome in children, a study found.
"Dry eye severe enough to warrant lubrication is rare in children, and compliance of frequent eye drop instillation is often difficult to achieve in this age group," the study authors said. "Dry eye syndrome in children is often accompanied by systemic disease, so in a child with persistent symptoms, this should be explored. Punctal plugs offer a safe and effective form of treatment especially as compliance of frequent lubrication is limited in children."
Investigators retrospectively analyzed case reports from 25 patients with ocular surface disease or deficient tear film who received silicone punctal plugs.
Median patient age at the time of plug insertion was 7 years. The most common symptoms of dry eye were photophobia, soreness and blepharospasm; the most common sign was punctate epithelial erosion. Eighteen children had concurrent systemic disease.
Median follow-up after initial plug insertion was 18 months. Eight patients underwent repeated plug insertion.
Study results showed improvement of subjective dry symptoms in 15 patients who were able to articulate those changes; attenuation of objective signs was observed in 24 patients.
Visual acuity improved by at least one line in 15 patients. Eight patients were able to reduce the frequency of lubricant use.
The most common complication was spontaneous extrusion of plugs, which occurred at 6 months in 19% of cases, the authors said.