Article Text
PDF
Abstract
Purpose Baseline ocular surface characteristics in children require investigation. This study characterised blinking and relationships with ocular symptoms, tear film and digital device use.
Methods 45 children aged 6–15 years (56% female) participated in a cross-sectional study. Ocular surface symptoms (Instant Ocular Symptoms Survey, Dry Eye Questionnaire 5, Symptoms Assessment in Dry Eye, Ocular Surface Disease Index, Ocular Comfort Index and Numerical Rating Scale) and clinical indices (lipid layer thickness, tear secretion and stability, meibomian gland) were assessed. Blink rate and interblink interval were measured in situ using a wearable eye-tracking headset (Pupil Labs GmbH, Germany). Associations between blinking, ocular surface, age, and digital device use (bivariate and partial correlations) and between automated and manually counted blink rate (Bland & Altman) were examined.
Results Mean blink rate and interblink interval were 20.5±10.5 blinks/min and 2.9±1.9 s during conversation. There was no difference between automated and manual blink rate (p=0.78) and no relationship between blinking and digital device use, age or sex. Mean group symptoms were within normal range and not associated with clinical measurements including blinking. Greater tear volume was associated with a faster blink rate (r=0.46, p=0.001) and shorter interblink interval (r=−0.36, p=0.02). Older age was associated with improved tear volume (r=0.37, p=0.01) and stability (r=0.38, p=0.01).
Conclusions Blinking characterised in situ was not impacted by age or habitual digital device use. A faster blink rate was associated with greater tear volume but not symptoms. Improved tear function was found with age suggesting that the ocular surface continues to develop through childhood.
- ocular surface
- cornea
- tears
- child health (paediatrics)
Data availability statement
Data are available in a public, open access repository. The research data for this article is available at https://data.mendeley.com/datasets/vyb5fv6ppp/1.
Statistics from Altmetric.com
Data availability statement
Data are available in a public, open access repository. The research data for this article is available at https://data.mendeley.com/datasets/vyb5fv6ppp/1.
Footnotes
Contributors NCC-E contributed substantially to the conception and design of this work, she was responsible for; data acquisition, data analysis and interpretation, drafting the work and revising it critically for important and intellectual content, final approval of the version of this work submitted to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. IJ is responsible for the overall content as guarantor. The guarantor accepts full responsibility for the finished work and/or the conduct of the study, had access to the data, and controlled the decision to publish. She contributed substantially to the conception and design of this work, the interpretation of data for the work, revising the work critically for important and intellectual content, final approval of the version of this work submitted to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. PW contributed substantially to the design of this work, he was responsible for; the software support during data collection using the wearable eye-tracking headset, the revising the work critically for important and intellectual content, final approval of the version of this work submitted to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. BG contributed substantially to the conception and design of this work, she was responsible for; the interpretation of data for the work, revising the work critically for important and intellectual content, final approval of the version of this work submitted to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding The first author, NCC-E, was supported by Tuition Fee Remission Postgraduate Research Scholarship, UNSW Sydney and the Cornea and Contact Lens Society of Australia (CCLSA). The funding sources have no involvement in the study design, conduct of the research, collection, analysis and interpretation of data, writing of the report, preparation of the article or in the decision to submit the article for publication.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.