When ODs think about dry eye, they quickly associate classic demographics: Over-40 menopausal female patients taking a high number of medications or individuals with autoimmune disease. But are ODs overlooking a younger, seemingly healthy demographic?
Optometrists are diagnosing dry eye more than ever before. Whether that is due to the culture’s screen-saturated lifestyles, an increased awareness about dry eye—or more likely—a combination of both, I have observed an increase in dry eye among my younger patients in their late teens and twenties. These are people who we rarely saw just a few years ago—even in my practice at an advanced dry eye treatment center.
Diagnosing dry eye in young patients
Journal articles and medical conferences have certainly increased awareness that dry eye is a pathology that can affect patients of all ages, although it is rare to see dry eye in healthy pediatric patients. ODs have made progress in monitoring the vision and health components of children at birth, but optometric efforts need to expand in scope to include the anterior segment and to be encouraging as children become more independent in caring for themselves.
Early in my career, I fell under the same pitfalls that I suspect many of my colleagues also did: I superficially treated dry eye symptoms, particularly in adolescent and young adult patients. As my own awareness and understanding of the chronic nature of dry eye increased, my propensity to be more aggressive in treating it with the younger patient population grew as well.
Related: Blog: Why dry eye?
1. Moon JH, Kim KW, Moon NJ. Smartphone use is a risk factor for pediatric dry eye disease according to region and age: a case control study. BMC Ophthalmol. 2016 Oct 28;16(1):188.
2. Sheppard, JD, Singh R, McClellan A, Weikert MP, Scoper SV, Joly TJ, Whitley WO, Kakkar E, Pflugfelder SC. Long-term Supplementation With n-6 and n-3 PUFAs Improves Moderate-to-Severe Keratoconjunctivitis Sicca: A Randomized Double-Blind Clinical Trial. Cornea. 2013 Oct;32(10):1297-304.
3. Oleñik A, Jiménez-Alfaro I, Alejandre-Alba N, Mahillo-Fernández I. A randomized, double-masked study to evaluate the effect of omega-3 fatty acids supplementation in meibomian gland dysfunction. Clin Interv Aging. 2013;8:1133-1138.
4. Creuzot-Garcher C, Baudouin C, Labetoulle M, Pisella PJ, Mouriaux F, Meddeb-Ouertani A, El Matri L, Khairallah M, Brignole-Baudouin F. [Efficacy assessment of Nurtilarm, a per os omega-3 and omega-6 PUFA dietary formulation versus placebo in patients with bilateral treated moderate dry eye syndrome.] J Fr Ophtalmol. 2011 Sep;34(7):448-55.
5. Barham JB, Edens MS, Fonteh AN, Johnson MM, Easter L, Chilton FH. Addition of eicosapentainoic acid to gamma-linolenic acid-supplemented diets prevents serum arachidonic acid accumulation in humans. J Nutr. 2000 Aug;130(8):1925-1931.
6. Viau S, Leclère L, Buteau B, et al. Polyunsaturated fatty acids induce modification in the lipid composition and the prostaglandin production of the conjunctival epithelium cells. Graefes Arch Clin Exp Ophthalmol. 2012 Feb;250(2):211-222.
7. National Eye Institute. Facts About the Cornea and Corneal Disease. Available at: https://nei.nih.gov/health/cornealdisease. Accessed 7/30/19.