Ocular Surface Health in Myopic School-Age Children: An Observational Study

To examine the clinical characteristics of tear film and ocular surface parameters in schoolchildren with myopia.

This prospective study included 224 myopic schoolchildren aged 7-14 years. The Ocular Surface Disease Index (OSDI) questionnaire was administered, and tear volume was assessed using a strip meniscometry tube (SMTube) and Schirmer I test. An IDRA ocular surface analyzer (SBM Sistemi, Inc., Torino, Italy) measured the noninvasive first break time (NIBUTf), mean break time (NIBUTav), tear meniscus height (TMH), mean lipid layer thickness (LLTav), meibomian gland atrophy (MGA), blink frequency (BF), and blink quality (BQ). Differences in ocular surface parameters by sex, age, spherical equivalent (SE), and OSDI scores were analyzed.

Median values of ocular surface parameters were SMTube 6.0 mm, Schirmer I 17.0 mm, NIBUTf 7.4 s, NIBUTav 10.1 s, TMH 0.21 mm, LLTav 64 nm, superior MGA (Sup-MGA) 33%, inferior MGA (Inf-MGA) 21.5%, BF 4.1s, and BQ 100%. Significant differences in NIBUTf, NIBUTav, and LLTav were observed between the sexes (p < 0.05), while TMH differed by the age group (p = 0.001). Age, SMTube, and Schirmer values varied significantly with OSDI scores (p < 0.05). No significant differences in tear parameters were found among myopia groups. Correlation analysis revealed that SMTube positively correlated with Schirmer (r = 0.6236), NIBUTf (r = 0.1585), NIBUTav (r = 0.1931), and TMH (r = 0.0093) (all p < 0.005).

Nearly one-fourth of myopic schoolchildren have dry eye symptoms, primarily due to the reduced tear volume. Age and sex significantly influenced tear film quality and quantity, while myopia severity showed no significant association.