Pediatric dry eye: A hospital-based study.

PURPOSE: To assess the hospital-based prevalence of dry eye disease (DED) among children aged 4 to 18 years and to identify associated risk factors. METHODS: A prospective observational case series was conducted at a tertiary care center. A total of 1,420 pediatric patients attending the ophthalmology outpatient department were initially screened using a symptom-based questionnaire. Those with suggestive symptoms underwent further evaluation, including the Ocular Surface Disease Index (OSDI), Schirmer's test, tear film break-up time (TBUT), fluorescein and lissamine green staining, and a comprehensive ocular examination. RESULTS: Of the total 1420 children, 124 reported symptoms consistent with DED, and 108 (7.60%) were confirmed to have dry eye. The male-to-female ratio was 2.08:1, with a mean age of 11.40 ± 3.86 years. Among affected children, 85.18% had OSDI scores between 33 and 100, and 14.81% scored between 23 and 32. Notably, 46.29% of patients used smartphones, 68.04% watched television for 1-2 h daily, and 63.88% were diagnosed with seasonal allergic conjunctivitis. Comorbidities included hematological malignancies (n = 3) and juvenile rheumatoid arthritis (n = 1). The mean Schirmer's test values were 30.33 ± 8.05 mm (right eye [RE]) and 30.68 ± 8.03 mm (left eye [LE]). The mean TBUT was 6.66 ± 2.32 s (RE) and 7.53 ± 3.16 s (LE). Most patients (92.59%) had evaporative DED, while 7.40% had the mixed type. CONCLUSION: DED should be considered in children presenting with nonspecific ocular complaints. Evaporative dry eye in this population is strongly associated with allergic conjunctivitis and prolonged use of digital devices.