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Updated: Jan 12, 2026

Induction of Ocular Surface Inflammation and Collection of Involved Tissues

Induction of Ocular Surface Inflammation and Collection of Involved Tissues

Published on: August 4, 2022

Pediatric Ocular Surface Inflammatory Diseases: Clinical Features and Practice Patterns.

Simon S M Fung¹, Tanya Boghosian², Claudia Perez³

¹Department of Ophthalmology, University of California San Francisco, San Francisco, CA.

|November 6, 2025

Summary

Pediatric ocular surface inflammatory diseases (POSID) management shows over-reliance on corticosteroids and underuse of immunomodulators. This leads to progressive complications like amblyopia, highlighting the need for improved treatment strategies.

Keywords:

blepharokeratoconjunctivitis herpes simplex keratitis ocular surface disease pediatric vernal keratoconjunctivitis

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Area of Science:

Ophthalmology
Pediatric Medicine
Real-world Evidence

Background:

Pediatric ocular surface inflammatory diseases (POSID) encompass conditions like blepharokeratoconjunctivitis (BKC), herpes simplex keratoconjunctivitis (HSK), and vernal keratoconjunctivitis (VKC).
Understanding real-world practice patterns and complications is crucial for optimizing care in children.

Purpose of the Study:

To characterize nationwide real-world practice patterns and complications of pediatric ocular surface inflammatory diseases (POSID).
To identify risk factors for amblyopia in children with POSID.

Main Methods:

Retrospective cohort study of patients younger than 18 years diagnosed with POSID using a US health insurance claims database (2018-2019).
Analysis of clinical data from 6 months pre- to 3 years post-index visit.
Multivariate logistic regression to determine amblyopia risk factors.

Main Results:

HSK presented higher baseline corneal scarring (7.5%) and ulceration (5.5%) rates compared to BKC and VKC.
High-potency topical corticosteroids were frequently prescribed, while topical immunomodulators were underused (1.7%).
Amblyopia prevalence increased to 4.5% over 3 years, with stromal scarring and high-potency corticosteroid use as independent risk factors.

Conclusions:

POSID subtypes have distinct clinical features and management differences, with progressive complications over time.
Current nationwide practice shows over-reliance on corticosteroids and underuse of immunomodulators, diverging from guidelines.
Earlier recognition, steroid-sparing therapies, and sustained inflammation control are needed for better outcomes in pediatric ocular surface inflammatory diseases.