Dry Eye Syndrome and Allergic Conjunctivitis in the Pediatric Population

Handan Akil, Fatih Celik, Fatih Ulas, Ilknur Surucu Kara, Handan Akil, Fatih Celik, Fatih Ulas, Ilknur Surucu Kara

Abstract

Purpose: To assess the comorbidity of dry eye syndrome (DES) and changes in corneal curvature in children with allergies.

Materials and methods: This prospective, comparative, and observational interventional study included 49 patients, who presented to the Ophthalmology Clinic of a State Hospital in Turkey. There were 25 patients with clinically diagnosed seasonal allergic conjunctivitis (AC) (with complaints of itching and papilla formation of conjunctiva; AC group) and 24 healthy children (control group). There with no significant differences in age between groups. Using the ocular surface disease index (OSDI) questionnaire, we performed tear film break-up time (BUT), central reflex tear meniscus height (TMH-R) measurement, Schirmer test on both groups and evaluated keratometry (K1, K2) and spherical equivalent (SE).

Results: Patients ranged in age from 6 to 18 years (median age, 11.79 years; 46.9% male; 53.1% female). The papillary reaction was severe in 10% of patients with AC. The prevalence of dry eye in children with AC was 12%. There was no statistically significant difference between groups for K1, K2, and SE (P > 0.05, all comparisons). BUT was statistically different (P = 0.004) between groups, indicating that a higher OSDI the tear film BUT was lower (ρ = 0.567). Statistically, significant negative moderate correlations were found between papillary reaction and the Schirmer test, BUT, and TMH-R (ρ = 0.454, -0.412, -0.419, and P = 0.001, 0.003, 0.002, respectively).

Conclusions: The evaluation of pediatric patients with AC requires further attention to ensure an adequate diagnosis of DES.

Keywords: Allergic Conjunctivitis; Dry Eye; Tear Break-up Time; Tear Meniscus Height.

References

    1. Maziak W, Behrens T, Brasky TM, Duhme H, Rzehak P, Weiland SK, et al. Are asthma and allergies in children and adolescents increasing? Results from ISAAC phase I and phase III surveys in Münster, Germany. Allergy. 2003;58:572–9.
    1. Abelson MB, Leonardi A, Smith L. The mechanisms, diagnosis and treatment of allergy. Rev Ophthalmol. 2002;9:74–84.
    1. Bielory L. Ocular allergy overview. Immunol Allergy Clin North Am. 2008;28:1–23.
    1. Smith RE. The tear film complex: Pathogenesis and emerging therapies for dry eyes. Cornea. 2005;24:1–7.
    1. Fujishima H, Toda I, Shimazaki J, Tsubota K. Allergic conjunctivitis and dry eye. Br J Ophthalmol. 1996;80:994–7.
    1. Pflugfelder SC, Jones D, Ji Z, Afonso A, Monroy D. Altered cytokine balance in the tear fluid and conjunctiva of patients with Sjögren's syndrome keratoconjunctivitis sicca. Curr Eye Res. 1999;19:201–11.
    1. Dogru M, Katakami C, Nakagawa N, Tetsumoto K, Yamamoto M. Impression cytology in atopic dermatitis. Ophthalmology. 1998;105:1478–84.
    1. Dogru M, Okada N, Asano-Kato N, Tanaka M, Igarashi A, Takano Y, et al. Atopic ocular surface disease: Implications on tear function and ocular surface mucins. Cornea. 2005;24:S18–23.
    1. Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the ocular surface disease index. Arch Ophthalmol. 2000;118:615–21.
    1. McCarty CA, Bansal AK, Livingston PM, Stanislavsky YL, Taylor HR. The epidemiology of dry eye in Melbourne, Australia. Ophthalmology. 1998;105:1114–9.
    1. Korb DR. Survey of preferred tests for diagnosis of the tear film and dry eye. Cornea. 2000;19:483–6.
    1. García-Resúa C, Santodomingo-Rubido J, Lira M, Giraldez MJ, Vilar EY. Clinical assessment of the lower tear meniscus height. Ophthalmic Physiol Opt. 2009;29:487–496.
    1. Machado LM, Castro RS, Fontes BM. Staining patterns in dry eye syndrome: Rose bengal versus lissamine green. Cornea. 2009;28:732–4.
    1. Kari O, Määttä M, Tervahartiala T, Peltonen S, Kari M, Hagström J, et al. Tear fluid concentration of mmp-8 is elevated in non-allergic eosinophilic conjunctivitis and correlates with conjunctival inflammatory cell infiltration. Graefes Arch Clin Exp Ophthalmol. 2009;247:681–6.
    1. The epidemiology of dry eye disease: Report of the epidemiology subcommittee of the international dry eye workshop (2007) Ocul Surf. 2007;5:93–107.
    1. Onguchi T, Dogru M, Okada N, Kato NA, Tanaka M, Takano Y, et al. The impact of the onset time of atopic keratoconjunctivitis on the tear function and ocular surface findings. Am J Ophthalmol. 2006;141:569–71.
    1. Toda I, Shimazaki J, Tsubota K. Dry eye with only decreased tear break-up time is sometimes associated with allergic conjunctivitis. Ophthalmology. 1995;102:302–9.
    1. Uchida H, Imanaga Y. Effect of mild conjunctivitis complication on tear balance in dry eye. Cont Lens Anterior Eye. 2012;35:240–2.
    1. Li N, Deng XG, He MF. Comparison of the Schirmer I test with and without topical anesthesia for diagnosing dry eye. Int J Ophthalmol. 2012;5:478–81.
    1. Lapid-Gortzak R, Rosen S, Weitzman S, Lifshitz T. Videokeratography findings in children with vernal keratoconjunctivitis versus those of healthy children. Ophthalmology. 2002;109:2018–23.
    1. Kim WJ, Rabinowitz YS, Meisler DM, Wilson SE. Keratocyte apoptosis associated with keratoconus. Exp Eye Res. 1999;69:475–81.
    1. Rothman JS, Raizman MB, Friedlaender MH. Seasonal and perennial allergic conjunctivitis. In: Krachmer JH, Mannis MJ, Holland EJ, editors. 3rd ed. Cornea, St. Louis: Fundamentals, Diagnosis, and Management, Mosby Elsevier; 2011. pp. 570–1.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner