The Dry Eye Zone

Rebecca's Blog


"Adolescents with dry eye disease are underserved"

This is a song sheet I can sing from, for sure! We NEVER see dry eye studies about kids!

Participants in this study were Japanese kids aged 10-19. Asians in general, and the Japanese in particular, are known to have higher rates of dry eye than caucasians, and the 21.7% overall prevalence shown in this study is closely similar to the results from another study in a similar age group done ten years ago by one of the participants in the present study - thank you, Dr Ichino!

But I find it very worrying thing is that we actually have nothing to compare these numbers to on this side of the water. We noted this back when the TFOS DEWS II epidemiology team started reviewing existing research way back in 2015 in preparation for the epidemiology report published last year. They can't report on studies that haven't been done!

There are two findings here in the abstracts which, to me, were startling and interesting points that may have relevance for other populations:

  • The older girls had worse clinical signs than the boys, but reported fewer symptoms than the boys

  • Dry eye prevalence and severity among late adolescent girls was comparable to adults

Int J Ophthalmol. 2018 Feb 18;11(2):301-307. doi: 10.18240/ijo.2018.02.20. eCollection 2018.

Gender differences in adolescent dry eye disease: a health problem in girls.

Ayaki M1, Kawashima M1, Uchino M1, Tsubota K1, Negishi K1.



To evaluate the signs and symptoms of dry eye disease (DED) in adolescents.


This was a cross-sectional, case-control study and outpatients aged 10 to 19y were recruited from six eye clinics of various practices and locations in Japan, and 253 non-DED subjects and 70 DED patients were enrolled. Participants were examined for DED-related signs. Patients were also interviewed to ascertain the presence or absence of six common DED-related symptoms: dryness, irritation, pain, eye fatigue, blurring, and photophobia. Main outcome measures were differences in signs and symptoms of dry eye disease between boys and girls.


Of the 323 adolescents recruited, 70 (21.7%) were diagnosed with DED. Significant differences between the non-DED and DED groups were found for short tear break-up time (BUT; ≤5s; P=0.000) and superficial punctate keratopathy (SPK; staining score ≥3; P=0.000). Late adolescent girls reported fewer symptoms than late adolescent boys, although their DED-related signs were worse compared to other groups. The prevalence and severity of DED were similar in the Tokyo area compared with suburban and local areas but myopic errors were worse.


We find that adolescents reported symptoms of DED similar to those found in adults, and the majority have short BUT-type DED. The prevalence and severity of DED in late adolescent girls is comparable with adults. Adolescents with DED are underserved and we believe that DED is a hidden but potentially serious health problem for this age group.