Lifestyle Risk Factor for Dry Eye Symptoms in Children Aged 5 to <18 Years

Abstract

Purpose : To determine whether dry eye symptoms were associated with lifestyle factors including screen time, outdoor activities, diet, and body mass index (BMI) in children aged 5 to <18 years.

Methods : A total of 160 children presenting at the Illinois Eye Institute were recruited into the study. All children had a comprehensive eye exam. Children were surveyed regarding electronic screen time and a modified, child friendly OSDI. The second OSDI question (eyes that feel gritty) was modified to “eyes that feel something inside”. The seventh OSDI question (driving at night) was removed based on the age of our study population. The eighth OSDI question (working with a computer or bank machine (ATM)) was modified to “using an iPad or tablet”. The examiner was allowed to repeat questions if the child did not understand the question. Parents were surveyed on their child’s screen time, diet, and outdoor activity. BMI was calculated using measured height and weight. To determine relationships between OSDI and potential risk factors for dry eye (including age, gender, race/ethnicity, refractive error, screen time, diet, outdoor activity, and BMI), multiple linear regression analyses were performed.

Results : Among the 160 children recruited into the study, 76 were boys and 84 were girls (mean age = 10.9 years, ranged from 5.7 to 17.8). The mean OSDI score was 14.7± 15.2, with 16.9%, 8.8%, and 12.5% of the children having mild, moderate, and severe dry eye symptoms respectively. Average screen time per week was 9.2 and 8.5 hours reported by children and parents, respectively, with a statistically significant difference (P= 0.04). Significant correlation was found between the screen time reported by children and parents (r_s= 0.40, P< 0.0001). Multiple regression showed that high BMI was a significant risk factor for dry eye symptoms (β= 0.16, P = 0.04). BMI was significantly correlated with age (r_s= 0.54, P< 0.0001) and outdoor activity (r_s= -0.24, P= 0.008). However, the OSDI score was not associated with age, race, gender, screen time, outdoor activities, and diet (Ps >0.05).

Conclusions : High BMI was a significant risk factor for dry eye symptoms in children aged 5 to <18 years. Our findings may assist with defining strategies to prevent dry eye in children.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.