If a child always blinks, it may not be myopia, but dry eyes!

With the arrival of winter vacation, the number of children's ophthalmology outpatient visits has increased significantly. Many parents bring their children to the hospital for eye examinations, and "frequent blinking" has become one of the most frequently mentioned issues by parents. Does a child who blinks frequently mean he is myopic? The answer is: not necessarily!

During 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.

Common causes of dry eyes in children

1. Allergies

Allergic conjunctivitis is the most common. The incidence of allergic conjunctivitis in children in my country is as high as 28% [1], and it has been 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, and rubbing the eyes when it itches during an attack, which 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 meibomian glands, the structures that secrete oil in the child's eyelids, 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.

Common types of dry eyes in children

It is reported that about 70% of dry eye patients suffer from lipid abnormality type dry eye [2], the main cause of which is meibomian gland dysfunction (MGD) [3], that is, dry eyes are more due to "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.

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 doctors, dry eyes are divided into five types: water deficiency, oil deficiency, mucin deficiency, tear dynamics abnormality, and mixed. To determine which type of dry eyes a child has and to provide targeted treatment, multiple tests are needed, such as the common slit lamp examination, meibomian gland photography, and confocal microscopy.

As for the most common type of dry eye, according to the global consensus of dry eye experts, intense pulsed light technology can treat meibomian gland dysfunction (MGD) and related dry eyes . As one of the more advanced treatment technologies in the world, intense pulsed light can significantly relieve the symptoms and signs of dry eye patients.

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 or even require corneal transplantation in severe cases. This requires the joint attention of parents and doctors.

In order to detect, intervene and treat diseases early, and pay attention to the eye health of children and adolescents, please pay attention to whether your child has the following problems:

1. Do you blink frequently?

2. Do you rub your eyes frequently?

3. Do you often have red and itchy eyes?

4. Do you easily suffer from visual fatigue?

5. Do you tend to get lumps or pimples on your eyelids?