Many factors such as poor nutrition, prolonged screen time, and allergies can cause dry eyes in children. Sometimes, it can be a sign of a more serious condition.
Doctors consider dry eyes rare in children. However, experts note that people may often neglect and overlook dry eyes, making the condition underdiagnosed.
As with adults, dry eyes can be uncomfortable and painful for children. It can affect their vision and impact their ability to perform activities like schoolwork.
This article discusses dry eyes in children, its causes, symptoms, and treatments. It also explores home remedies that can help with dry eyes in children.
Dry eye, also known as keratoconjunctivitis sicca or dry eye disease (DED), causes the loss of homeostasis of the tear film and other related ocular symptoms.
There is lacking data on the prevalence of dry eyes in children. Different epidemiological studies of DED in children showed varying results. A 2016 Korean study reported
The American Academy of Ophthalmology also noted a discrepancy between children diagnosed with dry eye and those reporting severe dry eye symptoms.
A parent or caregiver can take their child to an ophthalmologist if they have any concerns about their child’s eye health. An ophthalmologist can treat severe cases of dry eye or related conditions.
Many factors can cause dry eyes in children. They may range from common allergies to severe medical conditions.
Frequent use of electronic devices
A 2021 study associated prolonged smartphones with higher ocular surface disease index scores. The study also indicated that the longer a child uses their smartphone, the lower their blink rate.
A lower blink rate increases the ocular surface’s exposure and evaporation, which can cause instability of the tear layer, leading to dry eye.
Researchers in a
Ocular allergies, such as severe forms of keratoconjunctivitis, are a risk factor for DED. These types of allergies may cause the following issues:
- tear film instability
- ocular surface inflammation and damage
- neurosensory abnormalities — affecting nerves of touch, pain, and sense
Blepharitis occurs when the eyelid margins become inflamed. This condition can affect the quality of the tear film and cause dry eyes.
Doctors may also associate it with rosacea or other skin conditions.
Conjunctivitis is when the eye’s conjunctiva becomes inflamed, which can cause dry eyes.
Vitamin A deficiency can also cause changes in the cells lining the ocular surface, referred to squamous metaplasia, and xerophthalmia where the eyes do not produce tears. Both of these conditions can cause dry eyes.
Research typically associates this deficiency with malnutrition.
Poor nutrition can happen in children with:
- malabsorption syndrome
- eating disorders
- some children who eat vegan or vegetarian diets
Certain drugs can cause or worsen dry eye in children. These include topical and systemic medications for acne, antihistamines, and benzalkonium chloride-preserved eye drops.
Evaporative eye disease
Meibomian gland dysfunction is the cause of around
Skin conditions such as rosacea, allergies, or diseases including diabetes, Sjogren’s syndrome, and rheumatoid arthritis can disrupt the functioning of the meibomian gland.
Wearing contact lenses
Long-term use of contact lenses is another cause of dry eyes. A
However, it did not interfere with tear secretion upon follow-up.
Dry eyes can cause pain, irritation, and discomfort in children as with adults. Dry eye symptoms in children include:
- frequent rubbing
- itchy, stinging, or burning eyes
- tired, hot, and dry eyes
- eye redness
- feeling like there is sand or dirt inside the eyes
- blurred vision
- excessive watering of eyes
- light sensitivity
- discomfort when wearing contacts
- string-like mucus near the eyes
If a parent or caregiver notices any of these symptoms, they may consult a pediatrician to help diagnose the cause and provide suitable treatments.
While the treatment for dry eye in children will depend on its cause, a doctor will typically prescribe eye drops to replenish or maintain the moisture of the ocular surface. Treatments may include:
- artificial tears, gels, or ointments
- using punctal plugs
- surgery to permanently close tear ducts — punctal cauterization
- eye drops that increase tear production
- prosthetic replacement of the ocular surface ecosystem device
- prescription medicines such as topical corticosteroids, topical secretagogues, and topical cyclosporine
How to give a child eye drops
This step-by-step process guides parents and caregivers on how to administer eye drops to their child:
- Wash hands properly.
- Ensure the child is in a suitable position, such as:
- head tilted back
- lying flat
- parent or caregiver holding them safely
- wrapping the child in a light blanket to keep arms still
- Prepare the medication and follow instructions such as shaking the bottle.
- Remove the cap of the eye drop bottle and dispose of the plastic seal.
- Gently pull the child’s lower eyelid, and avoid touching the child’s eye, eyelashes, or any other surface.
- Hold the dropper above the child’s eye and squeeze 1 drop into the lower eyelid, avoiding the corner of their eye.
- Release the lower eyelid and allow the child blink a few times to ensure the drop spreads around the eye.
- Replace the bottle cap and wipe away any excess eye drops with a clean tissue.
Parents or caregivers can also try remedies at home to alleviate dry eyes in children. These remedies include:
- reducing screen time
- using a humidifier
- using drops regularly if the child is using contact lenses
- using preservative-free artificial tears regularly
- wearing sunglasses outdoors
- placing a warm compress for about 5 minutes daily to stimulate tear production
- taking breaks from the computer or smartphone
- following the 20-20-20 rule
- blinking often
- following a balanced diet and eating foods that benefit eye health
- taking omega-3 fatty acid supplements
Dry eyes is usually temporary and treatable after some lifestyle changes and at-home treatments.
It may be beneficial to speak with a doctor if any of the following are present:
- symptoms persist or worsen
- marked eye redness
- vision changes
- signs of infection like fever and thick discharge or pus
- deteriorating vision
- performing normal daily activities become difficult
Persistent dry eyes may be a symptom of a severe underlying medical condition. These include:
- autoimmune diseases such as Sjögren syndrome, juvenile idiopathic arthritis, and graft-vs-host disease
- neurologic disorders such as Riley-Day syndrome
- endocrine disorders such as hormonal issues and thyroid disorders
- vernal keratoconjunctivitis
- Stevens-Johnson syndrome
Infrequent dry eyes may not be a cause of concern in children. However, persistent dry eyes can affect a child’s quality of life and hinder them from performing optimally in different areas such as school.
Since the causes of dry eye are the same for everyone, lifestyle and dietary factors can cause children to have dry eye as adults. This is also true when the dry eye results from an unmanaged underlying condition.
Dry eye is uncommon in children. Doctors frequently associate it with an underlying condition. As a result, children who experience dry, stinging, burning, or itchy eyes should promptly receive medical advice.
Prolonged exposure to screens may be causing the rising cases of dry eye in children. Reducing screen time and adopting lifestyle changes as simple as taking a break or blinking more often can prevent dry eye caused by prolonged screen exposure.