Queensway Optometric Centre
101 Queensway W Suite 140 Mississauga ON L5B 2P7 (905) 848-2020
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Mississauga, Ontario
1 (905) 848-2020

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Dry Eye & Your Kids: What You Need to Know

Is my Child Suffering From Dry Eye?

young girl reading and rubbing her dry eyes

While dry eye disease has been around for decades, its prevalence in the last decade cannot be ignored. Current statistics estimate that upwards of 6 million Canadians suffer from dry eye disease. And those are only the diagnosed cases.

Although there is little data available on the prevalence of dry eye in children, pediatric dry eye is a very real condition. In fact, I seemingly perform more dry eye assessment examinations on my younger patients every single day.

So as a parent, what should you look for and is there a solution? And as an optometrist, how do I best diagnose and treat dry eye? We’ll discuss everything you need to know about dry eye and how it affects your children. 

Symptoms of Dry Eye

Depending on the age of your child, they may not be able to communicate the discomfort they feel from having dry eyes. So as parents, it is important to pay attention and watch for the following signs:

  • Frequent blinking and squinting
  • Constant eye rubbing
  • Redness around the eyes 
  • Gritty or sandy feeling in the eye
  • Itchy eyes
  • Sensitivity to light
  • Intermittent blurred vision

If your child is exhibiting one or more of the above behaviours, they may have dry eye. Make an appointment with your optometrist as soon as possible to discuss these symptoms and treatment options.

Diagnosing Dry Eye in Children

When a child comes into our clinic complaining of dry eye or their parents have noticed suspicious symptoms, it is my job to find out exactly what is going on. Some of the tests I conduct to diagnose dry eye in children include:

Schirmer’s Test

A common dry eye test is the Schirmer’s test, which determines whether a person’s eyes produce enough tears to keep their eyes moist. A piece of filter paper is placed inside the lower eyelid of both eyes, the patient closes their eyes for a few minutes, then the paper is removed. Then how far the tears have travelled on the paper is measured.

Depending on the age of the child, conducting this test can be challenging. Some children cannot sit still for the duration of the exam and the paper is uncomfortable on their eyes, causing excessive blinking and reflex tearing.  

Slit Lamp Exam

Depending on the patient, this exam is conducted with and without the use of fluorescein or dilating eye drops. Sitting in the examination chair, the patient then rests their chin and forehead against an instrument that uses a low-powered microscope and high-intensity light to examine all areas of the eye. In addition to diagnosing macular degeneration, detached retina, and cataracts, the slit lamp test allows us to properly diagnose and detect dry eye. 

Tear Break Up Time (TBUT) Test

The TBUT measures the stability of the tear film. I insert fluorescein sodium into the patient’s eyes, have them hold their eye open for 10 seconds, and measure the results. Typically if a dry area appears in their tear film within the 10-second time frame, they may have dry eye.

The fluorescein also allows us to detect stain patterns and corneal abrasions that may be consistent with dry eye. 

Dry Eye in Children: What are the Causes & Solutions?

So how do we explain the sudden surge of dry eye in children? There are many root causes at play, each one with a possible solution.

Contact Lenses

CAUSE:

If your child wears contact lenses, they simply may not be the right contact lens for their eye. Not every contact lens is created equal – and it is common practice to test out several brands before settling on the perfect one.

SOLUTION:

If you suspect your child’s dry eye is related to improper lenses, talk to your optometrist. They can suggest other alternatives such as daily disposables, or contacts with hydrogels that maintain moisture for longer periods.

Digital Eye Strain

young girl in the dark on digital device

CAUSE:

As parents, we know excess of screen time has been linked to obesity, irregular sleep schedules, behavioural problems, and more. We can now add dry eyes to that list.

Digital eye strain is becoming an increasing problem in today’s technological world. Whether its phones, gaming devices, or a personal computer, staring at an electronic device for long periods can dry the cornea. 

SOLUTION:

We suggest limiting screen time and having your child follow the 20/20/20 rule and take breaks from their device frequently. 

Blepharitis

CAUSE:

Blepharitis is an inflammation of the oil glands of the eyelid most commonly caused by bacteria or abnormal production and secretion of these oil glands. Along with inflammation and crusts around the eyelashes, blepharitis can cause loss of eyelashes and dry eye.

SOLUTION:

BlephEx is an in-office procedure that removes debris from the eyelids. While it is safe for patients of all ages, I don’t recommend BlephEx for very small children, as they must be able to sit somewhat still during the treatment. However, for older children, it can be an excellent option against blepharitis and dry eye.

Medical Conditions and Medications

CAUSE:

There are several medical conditions directly correlated to dry eye symptoms. 

Several inflammatory conditions, such as Sjogren’s syndrome and juvenile rheumatoid arthritis have been linked to pediatric dry eye. Similarly, the prevalence of dry eye in children with diabetes is greater in recently conducted studies. Poor nutrition and congenital disorders are other conditions associated with dry eye. 

If your child is taking medication for the above conditions or other reasons, the medications themselves may be the root cause of their dry eye. In fact, many common medications have dry eye as a listed side effect. Some of these include:

  • Antihistamines taken for allergies 
  • Acne medications that lower oil production
  • Antidepressants and other drugs that block signals between nerve cells and the brain

SOLUTION:

Talk to your doctor about your child’s dry eye symptoms and all current medications your child is taking. There are often alternatives to common drugs that have different side effects that your doctor may prescribe.

In addition, preservative-free artificial tears are a safe way to restore moisture and nourishment to the eye. Foods rich in omega-3 fatty acids and vitamin C and E have been shown to prevent oil in our tear film from drying up too quickly. In addition to adding fish, citrus, nuts and seeds, and leafy green vegetables to your diet, omega-3 supplements may also be taken. Do your research and talk to your optometrist before giving any supplements to your children.

platter of omega 3 rich foods

Future Treatment Strategies

Eyes are my passion. I am continuously keeping up with advancements in overall eye care and am particularly interested in research studies relating to dry eye. Of them, there are a few strategies for children that are proving interesting. While research is still in the infancy stage, two new dry eye treatments for children I am keeping my eye on include:  

PROSE Lenses

Developed at the Boston Foundation for Sight, PROSE lenses are permanent, custom-made, gas-permeable lenses that vault the cornea, retaining a layer of tears over the corneal surface. While it is used only for patients with severe ocular diseases, it’s gaining traction as an effective dry eye treatment for adults as well as showing promise in children

Punctal Plugs

Although punctal plugs are a common therapy for dry eye in adults, to date it has rarely been considered for children. However, studies evaluating the safety and efficacy of punctal plugs in children with dry eye are ongoing with some trials concluding they offer a safe and effective form of dry eye treatment for children

Written by Miranda Ranieri

Dr. Ranieri graduated with a Bachelor of Science from Yale University in 2008 and received her Doctor of Optometry with Honours from Nova Southeastern University in 2016. She was born and raised in Waterloo, and after living in the United States for the past ten years, she is happy to put down roots in Mississauga and join the team at the Queensway Optometric Centre.

Though Dr. Ranieri enjoys providing comprehensive eye care to patients of all ages, her particular areas of interest are ocular pathology and contact lenses. She cultivated this passion while still in Optometry school, where she volunteered her time in Boquete, Panama, providing eye care to an underserved community.

She was also part of the research team that conducted the “Contact Lens Assessment in Youth” study regarding the cornea, contact lenses, and public health. She hopes to continue volunteering her time and helping her community.

Before she began pursuing a career in optometry, Dr. Ranieri was a professional squash player, competing in tournaments around the world and winning the Canadian Women’s Championship. The highlight of her squash career was earning three medals, including a team event gold medal at the Pan American Games in Guadalajara, Mexico in 2008.

In her spare time, Dr. Ranieri enjoys playing sports, including squash, tennis, and soccer. She also enjoys travelling and spending time with her family.

More Articles by Miranda Ranieri

Finding Us
Is Easy

Our practice is conveniently located across the street from the Trillium Health Partners Mississauga Hospital.

Queensway
Optometric Centre

101 Queensway West, Suite 140
Mississauga, Ontario, L5B 2P7

Contact Information

Phone: 1 (905) 848-2020
Email: [email protected]

Business Hours

Monday:8:00 AM - 6:30 PM
Tuesday:8:00 AM - 5:30 PM
Wednesday:8:00 AM - 5:30 PM
Thursday:8:00 AM - 6:30 PM
Friday:8:00 AM - 3:30 PM
Select Saturdays (See Below)8:00 AM - 3:30 PM
SundayClosed

Next Saturday Opening(s)

  • Jul 11,
  • Jul 25,
  • Aug 15,
  • Aug 29

EXPERIENCING AN EYE EMERGENCY? CALL NOW!

Sometimes you need to see the optometrist right away. If you have an ocular emergency, call our office at 1(905) 848-2020. We can see patients for emergency appointments on short notice, so please don’t wait!

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