Does a child who blinks all the time mean he is nearsighted? Not necessarily! Beware of dry eyes in children

Every weekend, the number of outpatient visits to the pediatric ophthalmology department of Huaihua Aier Eye Hospital increases significantly. Many parents bring their children to the hospital for eye examinations, and "frequent blinking" becomes one of the most frequently mentioned problems by parents.

Does a child who always blinks have myopia? Answer: Not necessarily!

In clinical consultation, many children were found to have dry eye syndrome after professional examination, that is, they blinked frequently because of dry eyes.

"Doesn't dry eye syndrome only occur in adults? How come children also get it?" Many people think that dry eye syndrome only occurs in adults. In fact, with changes in lifestyle such as the use of electronic products, children and adolescents are becoming a high-risk group for dry eye syndrome.

1. Common causes of dry eyes in children

1. Allergies

Allergic conjunctivitis is the most common. The incidence of allergic conjunctivitis in children in China is as high as 28%[1], and is increasing year by year. Allergic conjunctivitis often recurs, leading to chronic inflammation of the ocular surface, damaging the goblet cells that secrete proteins on the ocular surface. Rubbing the eyes when it itches during an attack can also cause the meibomian glands to twist and deform, all of which can easily lead to dry eyes.

2. Use electronic products

Normal people blink 15-20 times per minute, but when we stare at the screen to work or study, we only blink 5 times per minute . When children use electronic products, they blink less, the incidence of incomplete blinking increases, and the tear evaporation speed is accelerated, which can lead to various eye discomfort symptoms.

Therefore, some children will have red eyes and tears when using electronic products, and will blink frequently after using electronic products.

In the long run, if electronic products are used for a long time, the structure that secretes oil in the child's eyelids, namely the meibomian glands, may atrophy, and dry eye symptoms will appear and gradually worsen, developing from a functional problem to an organic problem.

3. Refractive error (myopia, hyperopia, astigmatism )

The outermost surface of our eyes is not the cornea, but the transparent tear film. The refractive state of the eye will affect the stability of the tear film. The stability of the tear film determines whether dry eye symptoms will occur.

When children's myopia and hyperopia are not corrected, they are prone to visual fatigue , and may even cause chronic inflammatory reactions on the ocular surface and changes in blinking frequency. These factors will directly affect the stability of the tear film. Children with astigmatism have an irregular corneal surface and a high tension in the tear film, which leads to an unstable tear film.

2. Common types of dry eyes in children

It is reported that about 70% of dry eye patients suffer from lipid dysregulation dry eye[2]. The main cause of the disease is meibomian gland dysfunction (MGD)[3]. In other words, dry eyes are more likely to be caused by "lack of oil" rather than "lack of water".

The lipids secreted by the meibomian glands, commonly known as "oil", have the main function of "locking in moisture". Therefore, once the secretion duct is blocked, the "oil" cannot be secreted, and the water-locking function will be destroyed. Meibomian gland dysfunction is an important factor in dry eyes in children.

3. How to treat dry eyes in children?

Once you have dry eyes, you cannot just use eye drops to relieve or improve the symptoms. The reason is that the tear film is divided into three layers, and problems in any layer may cause dry eyes. There are many types of dry eyes, so accurate classification and treatment are important.

According to Xiang Mei, director of the cornea and ocular surface department of Huaihua Aier Eye Hospital , dry eyes are divided into five types: water deficiency type, oil deficiency type, mucin deficiency type, abnormal tear dynamics type and mixed type.

To determine which type of dry eye a child has and to provide targeted treatment, multiple tests are needed, such as the common slit lamp examination, meibomian gland photography, and comprehensive ocular surface analysis examination.

Once dry eyes occur, it is difficult to relieve or improve symptoms by just using eye drops. The reason is that the tear film is divided into three layers, and problems in any layer may cause dry eyes. There are many types of dry eyes, so accurate classification and treatment are important.

For the most common types of dry eyes, there are mainly physical therapy and drug treatments.

(1) Physical therapy: Meibomian gland dysfunction (MGD) requires intense pulsed light and thermal pulsation therapy to improve the function of the meibomian glands.

(2) Drug treatment: mainly artificial tears and anti-inflammatory drugs. Mite removal treatment is required when there is mite infection.

Because the symptoms of dry eyes in children are not typical and the main complaint is not clear, they are often ignored. Some children's dry eyes symptoms are so severe that they affect their vision. Without a clear diagnosis, they are easily misdiagnosed and even require corneal transplantation in severe cases .

Therefore, if a child frequently rubs his eyes, squints, or has red eyes, a foreign body sensation, a burning sensation, or other discomfort, then parents should be alert to whether the child has dry eye problems and take the child to an eye doctor for a timely examination.

Source: Huaihua Aier Eye Hospital

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(Edited by YT)