Expert consensus on pediatric dry eye: Insights from a European Delphi study
Edoardo Villani1, Paolo Nucci2, Jose Manuel Benitez-Del-Castillo3
1Department of Clinical Science and Community Health, University of Milan, Italy; Eye Clinic San Giuseppe Hospital, IRCCS Multimedica, Italy.
Insights
Pediatric Dry Eye Disease (PeDED) is increasingly recognized, requiring age-specific diagnostic and treatment approaches. Expert consensus highlights lifestyle factors and the need to adapt adult DED protocols for children.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Ocular Surface Disease
Background:
- Dry Eye Disease (DED) is a multifactorial ocular surface condition.
- Pediatric DED (PeDED) is prevalent, influenced by modern lifestyle factors like increased screen time.
- PeDED is often underdiagnosed due to a lack of specific tools and symptom misattribution.
Purpose of the Study:
- To achieve expert consensus on pending challenges in pediatric Dry Eye Disease.
- To address the need for age-specific diagnostic criteria and treatment protocols for PeDED.
Main Methods:
- A European Delphi study involving six ophthalmology experts.
- Two rounds of surveys were conducted to reach consensus on 46 statements.
Main Results:
- 34 experts reached consensus on 39 of 46 statements regarding PeDED.
- Key risk factors identified include screen time and ocular allergies.
- Consensus was reached on adapting adult DED definitions and treatments for pediatric patients, with caution advised for topical steroids and oral macrolides.
Conclusions:
- Standardized clinical practices are necessary for diagnosing and managing PeDED.
- Improving the quality of life for children with PeDED is a primary goal.
- Further research is needed to validate findings and develop comprehensive pediatric guidelines.
Context:
Dry Eye Disease (DED) is a symptomatic multifactorial condition of the ocular surface, primarily characterized by tear film instability, which can lead to ocular surface damage. While traditionally associated with adults, recent studies have shown a significant prevalence of DED in pediatric populations, exacerbated by modern lifestyle changes such as increased screen time and environmental factors. Pediatric DED (PeDED) often goes underdiagnosed due to a lack of tailored diagnostic tools and the misattribution of symptoms to other conditions.
Methods:
This Delphi study, conducted by a European panel of six ophthalmology experts sought to address expert consensus in pending challenges of PeDED.
Results:
Over two rounds of surveys, 34 experts reached consensus on 39 of 46 statements, highlighting the need for age-specific diagnostic criteria and treatment protocols. The study identified environmental and lifestyle factors, such as screen time and ocular allergies, as significant risk factors for PeDED. There was strong consensus on the importance of adapting adult DED definitions and treatment approaches to better suit pediatric patients. The study also emphasized the cautious use of treatments like topical steroids or oral macrolides, especially in younger children.
Conclusion:
The findings underscore the necessity for standardized clinical practices in diagnosing and managing PeDED, with a focus on improving the quality of life for affected children. Further research is required to validate these findings and develop comprehensive guidelines that cater to the unique needs of the pediatric population.
More Related Videos
06:29Comparing Objective Conjunctival Hyperemia Grading and the Ocular Surface Disease Index Score in Dry Eye Syndrome During COVID-19
Published on: May 25, 2022
04:00Author Spotlight: Establishing a Practical and Cost-Effective Protocol for Corneal Sensitivity Testing in Clinical Settings
Published on: August 2, 2024
