Relationship between Dry Eye and Myopia in Children

Abstract

Purpose : To investigate the association between dry eye disease (DED) and myopia by evaluating higher order aberrations (HOAs) and choroidal thickness (CT) among myopic children with DED symptoms. The incidence of dry eye and myopia have increased dramatically in modern society. Is it a coincidence or related to the lifestyle in modern society?

Methods : In this cross-sectional study, we recruited 72 myopic (spherical equivalent of ≤ -0.5 diopter) children with DED symptoms (age, 12.8 ± 2.7 [mean ± standard deviation] years) who presented to Keio University Hospital Myopia Clinic. They were measured for the tear film breakup time (BUT), HOAs, CT, axial length (AL) and refraction. Lifestyle questionnaires were administered, and the correlations between the BUT and HOAs were evaluated. Multiple regression analyses were performed to identify relationships among myopia and BUT/lifestyle factors, myopia and corneal/intraocular/total ocular HOAs (spherical aberration [SA], 3rd-order [S3], 4th-order [S4] and the sum of the 3rd- to 6th-order aberrations [THOA] evaluated with a natural pupillary diameter [average value, φ = 6.1 mm]), CT and BUT/AL.

Results : The BUT, CT, AL, and cycloplegic refraction were 5.7 ± 3.1 seconds, 285.3 ± 38.4 μm, 25.52 ± 1.14 mm, and -4.61 ± 2.38 diopters, respectively. The BUT was correlated significantly with the corneal HOAs (SA, β = -0.323, P = 0.02; S4, β = -0.497, P < 0.001; THOA, β = -0.362, P = 0.009) and intraocular HOAs (S3, β = -0.299, P = 0.04; S4, β = -0.369, P = 0.008; THOA, β = -0.368, P = 0.009) but not with total ocular HOAs. Multiple regression analyses showed that the AL was associated significantly with the BUT (β = -0.067, P = 0.004) and the intraocular S3, intraocular THOA, total ocular S3, and total ocular THOA (β = -21.8, 21.2, -41.7, and 43.6, respectively; P = 0.02, 0.048, 0.045, and 0.049, respectively) but not with the corneal HOAs. The CT was associated significantly with the BUT and AL (β = 9.15 and -7.85, respectively; P < 0.001 and = 0.01, respectively).

Conclusions : We showed that the BUT was associated significantly with the CT that is related to the AL. As the parasympathetic nervous system affects the lacrimal glands and CT, the parasympathetic nervous system might be a common upstream factor in the association between DED and myopia.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.