Ocular Allergy as a Risk Factor for Dry Eye in Adults and Children

Edoardo Villani; Giovanni Rabbiolo; Paolo Nucci


Curr Opin Allergy Clin Immunol. 2018;18(5):398-403. 

In This Article

Dry eye in Adults and Children

'Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological role'.[9] The newly revised definition of DED, proposed by the TFOS DEWS II, highlights the etio-pathogenetic role of five key mechanisms, providing a useful trace to investigate how ocular allergy could impact on DED pathogenesis (Figure 1).

Figure 1.

Scheme of the main pathways of impact of ocular allergy on dry eye disease vicious cycle. Seasonal allergic conjunctivitis and perennial allergic conjunctivitis subset is under-represented in the ocular allergy set because of the lower impact of these forms on the dry eye disease pathogenic mechanisms.

Pediatric dry eye has been historically considered as a rare condition, mainly associated with congenital, autoimmune, and inflammatory disorders, but it has not been investigated as well as in adults, and its diagnosis is often overlooked.[10,11] Recent evidences suggest that the peculiar, not yet fully understood, anatomo-physio-pathology of the pediatric ocular surface, the specific difficulties related to symptoms assessment and interpretation, and the lack of standardized and validated diagnostic strategies, have limited a lot our comprehension of this more neglected than rare disease.[6,11–14]