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The use of punctal plugs in children
A Mataftsi1, R G Subbu, S Jones
1Clinical and Academic Department of Ophthalmology, Great Ormond St Hospital for Children, London, UK.
Insights
Punctal plugs are safe and effective for treating dry eye syndrome in children, often linked to systemic diseases. This treatment improves ocular surface disease and visual acuity, especially when frequent lubrication is challenging for kids.
Area of Science:
- Ophthalmology
- Pediatric Eye Care
Background:
- Dry eye syndrome in children can be associated with underlying systemic conditions.
- Pediatric dry eye often presents with symptoms like photophobia, soreness, and blepharospasm.
Purpose of the Study:
- To assess the safety and efficacy of punctal plugs for treating dry eye syndrome in pediatric patients.
- To evaluate the impact of punctal plugs on ocular surface disease and visual acuity in children.
Main Methods:
- Retrospective case series analyzing patients who received silicone punctal plugs for dry eye.
- Data included symptoms, signs, concurrent systemic disorders, anesthesia type, and complications.
- Follow-up duration averaged 18 months.
Main Results:
- All patients showed significant improvement in ocular surface disease.
- Lubricant use decreased in some patients, and visual acuity improved in over half.
- Common complications included spontaneous plug extrusion within 6 months (19%).
Conclusions:
- Punctal plugs provide a safe and effective treatment option for pediatric dry eye syndrome.
- Systemic disease evaluation is crucial for children with persistent dry eye symptoms.
- Punctal plugs are particularly beneficial given children's limited compliance with frequent lubrication.
Background/Aims:
To evaluate the safety and efficacy of punctal plugs in children with dry eye syndrome.
Methods:
A retrospective case series of patients who had an insertion of silicone punctal plugs for dry eye syndrome. Data collected included presenting symptoms, signs, systemic disorders if present, type of anaesthesia and complications by the time of last follow-up.
Results:
Twenty-five patients (median age at insertion 7 years, range 1.5-13.8 years) were identified. Median follow-up was 18 months. The commonest symptoms were photophobia, soreness and blepharospasm, and the commonest sign was punctate epithelial erosions. Concurrent systemic disease was present in 18/25 patients. Repeated procedures were carried out in eight of 25 patients. Twenty-four of 35 insertions were performed under general anaesthesia. A substantial improvement in ocular surface disease was noted in all cases: frequency of lubricant use was reduced in eight of 25 and visual acuity improved in 15/25 patients. Spontaneous extrusion was the commonest complication and occurred within 6 months in 19% of cases.
Conclusion:
Dry eye syndrome in children is often accompanied by systemic disease, so in a child with persistent symptoms this should be explored. Punctal plugs offer a safe and effective form of treatment especially as compliance of frequent lubrication is limited in children.
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