The ocular surface in children: A review of current knowledge and meta-analysis of tear film stability and tear secretion in children

Chidi-Egboka, Ngozi Charity; Briggs, Nancy; Jalbert, Isabelle; Golebiowski, Blanka

doi:10.1016/j.jtos.2018.09.006

Cited by 22 publications

(24 citation statements)

References 87 publications

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“…With more than 80 per cent of teenagers using smartphones, the impact on the visual and ocular health of this younger cohort needs to be investigated. Furthermore, normative data of tear break‐up time and Schirmer scores for young adults needs to be determined to enable objective evaluation of the impact of handheld digital devices on measures of ocular surface disease . The impact on higher‐risk groups such as patients with dry eye or accommodative/binocular vision anomalies also needs to be determined.…”

Section: Summary and Future Directionsmentioning

confidence: 99%

Ocular and visual discomfort associated with smartphones, tablets and computers: what we do and do not know

Jaiswal

Asper

Long

et al. 2019

Clinical and Experimental Optometry

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206

195

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Smartphone and tablet use in Australia and worldwide is reaching saturation levels and associated visual and ocular discomfort such as headaches, eyestrain, dry eyes and sore eyes are widespread. This review synthesises the available literature and considers these symptoms in the context of a binocular vision and/or ocular surface aetiology. Eye discomfort with smartphones and tablets is discussed alongside similar symptoms reported with desktop computer use. Handheld devices differ from computers in viewing position and distance, screen size and luminance, and patterns of use. Accommodation is altered with handheld device use, with increased lag and decreased amplitude. Smartphone and tablet use results in reduced fusional convergence and possibly a receded near point of convergence. This is similar to what happens with computer use. Findings related to blink rate with smartphone and tablet use are contradictory, perhaps due to the influence of task difficulty, and there is limited evidence related to blink amplitude. Reduced blink rate and amplitude are consistently reported with computer use. Use of handheld digital devices, like computers, may adversely impact tear stability. There is insufficient evidence to support the impact of handheld devices on tear volume, although this is reduced with computer use. The available literature does not conclusively link eye and visual discomfort symptoms reported with handheld digital devices, with changes in binocular vision, blinking or ocular surface. However, there is a gap in our understanding of symptoms which occur with smartphone and tablet use in the context of how these devices are used. In addition, studies are required in high users such as teenagers, and in patients with dry eye or accommodative/ binocular vision anomalies, all of whom may have a higher risk of symptoms. A better understanding of symptom aetiology can guide clinical advice to minimise adverse impacts on visual and ocular surface health and discomfort.

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Section: Summary and Future Directionsmentioning

confidence: 99%

Ocular and visual discomfort associated with smartphones, tablets and computers: what we do and do not know

Jaiswal

Asper

Long

et al. 2019

Clinical and Experimental Optometry

Self Cite

206

195

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“…2 Four studies in healthy children have reported a dry eye prevalence of 10%-44%, which is similar to that of adults. 2 A recent consensus definition considers dry eye to be a symptomatic disease, and stresses that the presence and severity of symptoms is an important diagnostic factor. 3 Hence, dry eye symptom questionnaires can be used as a screening or diagnostic tool to grade and assess indications for treatment, as well as in clinical trials to test the efficacy of new treatments.…”

Section: Introductionmentioning

confidence: 75%

“…Contact lens discomfort is a known problem for adult wearers; 14 however little is known about this condition in children. 2,15 Ocular surface health and symptoms have not been studied intensively in children. 2 Assessing symptoms requires a validated questionnaire; 16 however, none of the currently existing symptom questionnaires have been qualified for use in paediatric eye care, mirroring the dearth of validated questionnaires including patient-reported outcome measures in paediatric ophthalmology.…”

Section: Introductionmentioning

confidence: 99%

“…Dry eye affects approximately 5%–50% of adults worldwide; 1 however, knowledge regarding paediatric dry eye is sparse 2 . Four studies in healthy children have reported a dry eye prevalence of 10%–44%, which is similar to that of adults 2 . A recent consensus definition considers dry eye to be a symptomatic disease, and stresses that the presence and severity of symptoms is an important diagnostic factor 3 .…”

Section: Introductionmentioning

confidence: 99%

“…The increasing prevalence of myopia 12 is yet another challenge, with substantial risk of increased ocular surface symptoms in children attributed to myopia control interventions 13 such as contact lens wear and atropine drops. Contact lens discomfort is a known problem for adult wearers; 14 however little is known about this condition in children 2,15 …”

Section: Introductionmentioning

confidence: 99%

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Dry eye symptoms in children: can we reliably measure them?

Chidi-Egboka

Golebiowski

Lee

et al. 2020

Ophthalmic Physiologic Optic

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Purpose: Many dry eye questionnaires are available, but these may not be suitable for paediatric eye care. The feasibility of use and repeatability of symptom questionnaires administered to children was examined. Methods: Participants aged 6-15 years (n = 62; 25M:37F; 40% male) completed six questionnaires twice in random order at a single visit: Symptoms assessment in dry eye (SANDE), ocular surface disease index (OSDI), numerical rating scale (NRS), ocular comfort index (OCI, n = 30), dry eye questionnaire 5 (DEQ-5) and the instant ocular symptoms survey (IOSS). Completion time and need for assistance were recorded and relationships with age examined (Pearson correlation, independent t-test). The number of participants requiring assistance and with which items were compared (linear mixed model, pairwise test). Repeatability (coefficient of repeatability (CoR), limit of agreement, bias) and intraclass correlation coefficient (ICC) were examined. Results: Completion time was ≤2 min for each individual questionnaire. Younger participants took longer to complete (r = À0.43 to À0.60, p ≤ 0.01), and required more assistance (p ≤ 0.001). Forty-eight participants required assistance with at least one questionnaire. Older children (13-15 years) only required assistance with OSDI (p ≤ 0.004) and NRS (p ≤ 0.003). Participants required more assistance with SANDE, OSDI and NRS than with DEQ-5 and IOSS (p ≤ 0.02) and with gritty (OSDI, 77% of participants; OCI, 100%) and foreign body sensation (NRS, 92%) items. CoR was similar for all questionnaires with no evidence of a learning effect (p > 0.05). ICC was moderate to excellent. Conclusions: Dry eye questionnaires can be used reliably in paediatric eye care; more time and assistance may be required for younger children. The DEQ-5 and IOSS are recommended for use in younger age children.

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Ocular Surface Anatomy and Physiology

Douglas

2023

Pediatric Ocular Surface Disease

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The ocular surface in children: A review of current knowledge and meta-analysis of tear film stability and tear secretion in children

Cited by 22 publications

References 87 publications

Ocular and visual discomfort associated with smartphones, tablets and computers: what we do and do not know

Ocular and visual discomfort associated with smartphones, tablets and computers: what we do and do not know

Dry eye symptoms in children: can we reliably measure them?

Ocular Surface Anatomy and Physiology

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