Association between dry eye and myopia in schoolchildren: current evidence and possible mechanisms

The prevalence of myopia and dry eye disease (DED) has increased significantly in schoolchildren over the past few decades, particularly in East Asia, leading to intensive physical and emotional burdens on schoolchildren's growth. Current studies reported associations between myopia and DED, where myopic individuals tend to have a higher prevalence of DED compared to non-myopic individuals among adults and children. The current review aims to summarize existing literature to investigate the relationship between DED and refractive error in schoolchildren. Possible mechanisms have been discussed, including mechanical and behavioral factors (ocular surface exposure, High-Order Aberrations, ethnicity, behavioral habits), parasympathetic dysregulation and neurovascular coupling.