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Ophthalmic Drug Delivery Systems01:23

Ophthalmic Drug Delivery Systems

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Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...
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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.

The Ocular Surface
|April 7, 2025
PubMed
Summary

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.

Keywords:
ChildrenConsensusDelphiDry eye diseaseOcular surfacePediatric dry eye diseaseTear film

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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.