An evaluation of dry eye symptoms and signs in a cohort of children with juvenile idiopathic arthritis

Abstract

Kaisu M Kotaniemi1, Pirjo M Salomaa1, Kristiina Sihto-Kauppi1, Hanna M Säilä2, Markku J Kauppi31Department of Ophthalmology;2Pediatric Rheumatology;3Rheumatology, Rheumatism Foundation Hospital, Heinola, FinlandObjective: To determine the prevalence of dry eye symptoms and signs in children with juvenile idiopathic arthritis (JIA).Patients and methods: A total of 192 children with JIA: 48 oligo-, 39 extended oligo-, 79 polyarthritis, and 26 with other types of arthritis (eight juvenile spondyloarthritis, five juvenile psoriatic arthritis, three mixed connective tissue diseases, two systemic onset arthritis, and eight undetermined arthritis) were interviewed for dry eye symptoms and tested with Schirmer test with anesthetic. Two thirds of the patients were female and the mean age of the patients was 13.1 years (range 10–16) and the mean duration of arthritis was six years (SD 4, 4). Thirty-one percent of the patients had a history of uveitis. Dry eye was defined as Schirmer test score ≤5 mm in five minutes. The type of arthritis, a history of uveitis, and the ocular and systemic medication used were evaluated for their correlation with dry eye symptoms and signs by using chi-square tests and the Mann–Whitney Monte Carlo analysis.Results: Altogether 17% of this cohort had decreased basal tear secretion. The most common symptoms of dry eye were discharge secretion, itching, and watering. The intensity of symptoms and signs did not correlate. The type of arthritis, a history or presence of uveitis, and the medication used did not correlate with the occurrence of dry eyes.Conclusion: Dry eye symptoms and signs are common in JIA, and Schirmer test with anesthetic is a useful tool in evaluating these patients.Keywords: dry eyes, Schirmer test, juvenile idiopathic arthritis