Predictive Model for Dry Eye Disease Risk in Myopic Pediatric Patients
Overview
This study identified key independent risk factors for dry eye disease (DED) in myopic children aged 8–16 years in northern China and developed a validated predictive nomogram. The prevalence of DED was 31.2%, with orthokeratology lens use, prolonged screen time, extensive near work, higher BMI, and short sleep duration as significant contributors.
Background
Myopia is highly prevalent among children in East Asia and is associated with increased susceptibility to ocular surface disorders such as dry eye disease. Behavioral factors like excessive near work and digital device use, as well as environmental conditions in northern China, may exacerbate tear film instability. Orthokeratology lens wear further elevates DED risk in this population. Despite this, comprehensive risk factor analyses and predictive tools for pediatric DED remain limited.
Data Highlights
Risk Factor
Odds Ratio (OR)
Significance (p-value)
Orthokeratology (Ortho-K) lens use
4.74
<0.05
Daily screen time ≥ 4 hours
4.21
<0.05
Near work ≥ 4 hours
3.53
<0.05
BMI ≥ 24
3.20
<0.05
Sleep duration < 6 hours
2.26
<0.05
Model AUC (Training set)
0.74
–
Model AUC (Validation set)
0.70
–
Key Findings
The prevalence of objectively diagnosed dry eye disease among myopic children was 31.2%.
Orthokeratology lens use was the strongest independent risk factor, increasing DED risk nearly fivefold.
Behavioral factors including daily screen time ≥4 hours and near work ≥4 hours significantly elevated DED risk.
Higher BMI (≥24) and sleep duration less than 6 hours were also independently associated with increased DED risk.
The developed nomogram demonstrated acceptable predictive accuracy with AUCs of 0.74 and 0.70 in training and validation cohorts, respectively.
Tear film instability, reduced lipid layer thickness, and increased partial blink rate were predominant ocular surface abnormalities observed.
Clinical Implications
Clinicians should be aware that dry eye disease is common yet under-recognized in myopic pediatric populations, particularly those using orthokeratology lenses or engaging in prolonged screen time and near work. Early identification using the validated nomogram can guide targeted interventions focusing on modifiable lifestyle factors such as reducing screen exposure and improving sleep duration. Monitoring ocular surface parameters in these children may facilitate timely management to prevent progression.
Conclusion
Dry eye disease affects a substantial proportion of myopic children in northern China, with modifiable behavioral and lifestyle factors playing a critical role. The predictive model developed offers a practical tool for early risk stratification and personalized preventive strategies in this vulnerable population.
References
Study Authors/2024 -- Creation and assessment of a predictive model for dry eye disease risk in myopic pediatric patients
Background music and multimedia exposure were associated with lower patient-reported anxiety in a quasi-experimental ophthalmology clinic study that used existing clinic audiovisual infrastructure at no additional cost.
