title: Management of dry eye related to systemic diseases in childhood and longterm follow-up.
abstract: OBJECTIVE
  Dry eye in children is not common in general practice and is usually referred to tertiary centres for diagnostic confirmation. In the present review we examine the potential causes of dry eye in children and report the management and longterm follow-up of dry eye in childhood with reference to clinical diversity, systemic associations, ocular outcomes and treatment trends.
  
  
  METHODS
  A retrospective, consecutive case series was studied by evaluating the clinical charts of children with dry eye over a 96-month period. Minimal diagnostic inclusion criteria were presence of ocular surface damage and tear deficiency.
  
  
  RESULTS
  Fourteen patients with an age range at presentation of 1-17 years were evaluated. Ten patients were female, four were male and all had bilateral involvement. The most frequent symptoms were red eye, photophobia and low visual acuity (VA). Four patients had corneal ulcers. Two patients had best corrected visual acuity (BCVA) < or = 20/200 at first examination. One of these plus another patient presented with BCVA < or = 20/200 at the last visit. All patients were treated with artificial tears; three received autologous serum tears and five submitted to conjunctival flaps to preserve the integrity of the eye. Associated systemic conditions were found in all patients and were congenital in six of them.
  
  
  CONCLUSIONS
  Early manifestations of dry eye in childhood are a potential indication of systemic disease. The ocular condition may be misdiagnosed and correct treatment delayed. Most diseases are bilateral and may jeopardize VA. Systemic investigation, close follow-up and preparing the family for longterm and multidisciplinary treatment are necessary to preserve ocular health and identify systemic associations.
authors.affiliation: Department of Ophthalmology & Otorhinolaryngology, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil.
authors.forename: Flávio
authors.initials: F
authors.lastname: Mac Cord Medina
authors.forename: Rosane
authors.initials: R
authors.lastname: Silvestre de Castro
authors.forename: Suzana C
authors.initials: SC
authors.lastname: Leite
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Rocha
authors.forename: Gutemberg
authors.initials: G
authors.lastname: de Melo Rocha
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004194:Disease / Q000209:etiology; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D012189:Retrospective Studies; D013666:Tears / Q000378:metabolism; D014792:Visual Acuity / Q000502:physiology
chemical_list: D009883:Ophthalmic Solutions