Study: Kids, dry eye, systemic disease

Nothing too surprising or remarkable here. Focus is presumably on severe aqueous deficient dry eye which indeed is rare in kids and parents need to be proactive about searching out possible implications and tie-ins with systemic disease. I am disappointed that no mention was made of sclerals in these cases - I think that when you've got developing eyes and dryness severe enough to cause ulcers and loss of BCVA that ought to be a very attractive treatment route to consider.

Management of dry eye related to systemic diseases in childhood and longterm follow-up.

Mac Cord Medina F, Silvestre de Castro R, Leite SC, Rocha EM, de Melo Rocha G.
Acta Ophthalmol Scand. 2007 Nov;85(7):739-44. Epub 2007 Jun 8.

Purpose: Dry eye in children is not common in general practice and is usually referred to tertiary centres for diagnostic confirmation. In the present review we examine the potential causes of dry eye in children and report the management and longterm follow-up of dry eye in childhood with reference to clinical diversity, systemic associations, ocular outcomes and treatment trends. Methods: A retrospective, consecutive case series was studied by evaluating the clinical charts of children with dry eye over a 96-month period. Minimal diagnostic inclusion criteria were presence of ocular surface damage and tear deficiency. Results: Fourteen patients with an age range at presentation of 1-17 years were evaluated. Ten patients were female, four were male and all had bilateral involvement. The most frequent symptoms were red eye, photophobia and low visual acuity (VA). Four patients had corneal ulcers. Two patients had best corrected visual acuity (BCVA) less than or equal to 20 200 at first examination. One of these plus another patient presented with BCVA less than or equal to 20 200 received autologous serum tears and five submitted to conjunctival flaps to preserve the integrity of the eye. Associated systemic conditions were found in all patients and were congenital in six of them. Conclusions: Early manifestations of dry eye in childhood are a potential indication of systemic disease. The ocular condition may be misdiagnosed and correct treatment delayed. Most diseases are bilateral and may jeopardize VA. Systemic investigation, close follow-up and preparing the family for longterm and multidisciplinary treatment are necessary to preserve ocular health and identify systemic associations.

...But while we're talking about kids, let's not forget the more frequent problem of good ol' meibomian gland dysfunction, which sure seems to be on the rise amongst youngsters. Parents, if you want to invest in your kids' eye health... feed them right, don't overdo the drugs, and if they're wearing contacts, make sure you VIGOROUSLY reinforce all doctor instructions about caring for them.