Purpose

To describe the etiological causes and clinical profile of dry eye disease (DED) among children and adolescents seeking eye care in India.

Methods

This was a cross-sectional study of 1023 new patients (≤21 years of age) diagnosed with DED presenting between 2010 and 2018 to a multi-tier ophthalmology hospital network. Children and adolescents with both symptoms and signs of dry eyes were considered as subjects. The data entry and retrieval were done using an electronic medical record system and analyzed using appropriate statistical tests.

Results

The mean age of the patients was 15.2 ± 5.6 years and 76% were in their early and late adolescence. Overall, the main etiologies responsible for DED in children and adolescents were Meibomian gland dysfunction (MGD) in 49% of cases, Stevens-Johnson Syndrome (SJS) in 33% and Vitamin A deficiency (VAD) in 9%. Aqueous deficiency dry eye (ADDE) because of SJS and VAD accounted for most of the cases in infancy (92%), toddlerhood (96%), early childhood (76%) and middle childhood (68%). While Meibomian gland dysfunction (MGD) related evaporative dry eye (EDE) was the leading cause of DED in early (51%) and late adolescence (66%). Severe visual impairment and blindness was significantly greater in eyes with ADDE as compared to those with EDE (p < 0.0001), 81% of which were affected by SJS.

Conclusion

The causes of and visual morbidity due to DED varied significantly in different age-groups. Most of the visual morbidity in children and adolescents was limited to eyes with ADDE due to SJS.

中文翻译：

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印度儿童和青少年的干眼症。

目的

描述在印度寻求眼保健的儿童和青少年中干眼病（DED）的病因和临床特征。

方法

这是一项横断面研究，研究了2010年至2018年之间在多层眼科医院网络中就诊的1023名新诊断为DED的新患者（≤21岁）。既有症状又有干眼症状的儿童和青少年被认为是受试者。数据输入和检索使用电子病历系统进行，并使用适当的统计测试进行分析。

结果

患者的平均年龄为15.2±5.6岁，其中76％处于青春早期和晚期。总体而言，造成儿童和青少年DED的主要病因是49％的睑板腺功能障碍（MGD），33％的史蒂文斯-约翰逊综合症（SJS）和9％的维生素A缺乏症（VAD）。由于SJS和VAD而引起的水缺乏性干眼症（ADDE）占婴儿期（92％），幼儿期（96％），幼儿期（76％）和幼儿期（68％）的大多数情况。睑板腺功能障碍（MGD）相关的蒸发性干眼症（EDE）是早期（51％）和青春期晚期（66％）DED的主要原因。与EDE相比，ADDE眼的严重视力障碍和失明显着更大（p  <0.0001），其中81％受SJS影响。

结论

DED引起的原因和视觉发病率在不同年龄组中差异很大。由于SJS，儿童和青少年的大多数视觉发病率仅限于ADDE眼。