{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:21:23Z","timestamp":1790803283503,"version":"4.1.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate dry eyes in children with vernal kerato-conjunctivitis (VKC) and correlate it with symptoms, clinical findings, and ocular surface analysis (OSA) parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Children with clinically diagnosed VKC underwent complete ophthalmological examination, Schirmer\u2019s testing, modified ocular surface disease index (OSDI) scoring, Bonini grading, fluorescein tear-film break-up time (TBUT), VKC \u2013 Collaborative Longitudinal Evaluation of Keratoconus (CLEK) scoring, and OSA. Children with a TBUT of &lt; 10 s were defined to have dry eyes. The above-mentioned parameters were compared between dry eye and non-dry eye VKC children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean age of the 87 children included in the study was 9.1 \u00b1 2.9 years. Dry eyes were seen in 60.9% [95% confidence interval (CI); 51% to 71%]. The mean TBUT was 13.4 \u00b1 3.8 and 5.9 \u00b1 1.9 s in non-dry and dry eye groups, respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The mean value of Schirmer\u2019s test was 25.9 \u00b1 9.8 and 20.8 \u00b1 8.6 mm in the non-dry and dry eye groups, respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01). The two groups did not differ in their OSDI scores, Bonini grading, and CLEK scores. The OSA parameter of non-invasive break-up time (NIBUT) was 8.3 \u00b1 3.2 s in non-dry eye group and 6.4 \u00b1 2.9 s in dry eye group,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.008. The lower lid Meibomian gland (MG) loss was 7.4% in non-dry eye group and 12.2% in dry eye group,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.028. Other OSA parameters did not differ significantly among the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Dry eyes are seen in two-thirds of pediatric VKC. Evaluation of dry eyes should be incorporated in their clinical evaluation. Among OSA parameters, NIBUT and lower lid MG loss are associated with dry eyes in pediatric VKC patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2836_22","type":"journal-article","created":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T11:10:52Z","timestamp":1680952252000},"page":"1488-1494","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Evaluation of dry eyes in children with vernal kerato-conjunctivitis using clinical tests and ocular surface analysis"],"prefix":"10.4103","volume":"71","author":[{"given":"Shalini","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Paediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff\u2019s Charity Eye Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmooda","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Paediatric Ophthalmology, OSB Eye Hospital and Institute, Dhaka, Bangladesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailja","family":"Tibrewal","sequence":"additional","affiliation":[{"name":"Department of Paediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff\u2019s Charity Eye Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abha","family":"Gaur","sequence":"additional","affiliation":[{"name":"Department of Cornea and Anterior Segment Services, Dr. Shroff\u2019s Charity Eye Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suma","family":"Ganesh","sequence":"additional","affiliation":[{"name":"Department of Paediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff\u2019s Charity Eye Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virender Singh","family":"Sangwan","sequence":"additional","affiliation":[{"name":"Department of Cornea and Anterior Segment Services, Dr. Shroff\u2019s Charity Eye Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,4,5]]},"reference":[{"key":"R1-20240828","doi-asserted-by":"crossref","first-page":"27683","DOI":"10.1016\/j.jtos.2017.05.008","article-title":"TFOSDEWS II definition and classification report","volume":"15","author":"Craig","year":"2017","journal-title":"Ocul Surf"},{"key":"R2-20240828","doi-asserted-by":"crossref","first-page":"124","DOI":"10.3928\/01913913-20130108-01","article-title":"Clinical correlations of dry eye syndrome and allergic conjunctivitis in Korean children","volume":"50","author":"Kim","year":"2013","journal-title":"J Pediatr Ophthalmol Strabismus"},{"key":"R3-20240828","doi-asserted-by":"crossref","first-page":"e727","DOI":"10.1111\/aos.13093","article-title":"High incidence of dry eye in young children with allergic conjunctivitis in Southwest China","volume":"94","author":"Chen","year":"2016","journal-title":"Acta Ophthalmol"},{"key":"R4-20240828","doi-asserted-by":"crossref","first-page":"467","DOI":"10.4103\/0974-9233.167814","article-title":"Dry eye syndrome and allergic conjunctivitis in the pediatric population","volume":"22","author":"Akil","year":"2015","journal-title":"Middle East Afr J Ophthalmol"},{"key":"R5-20240828","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1097\/ACI.0000000000000471","article-title":"Ocular allergy as a risk factor for dry eye in adults and children","volume":"18","author":"Villani","year":"2018","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"R6-20240828","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/S1542-0124(12)70104-0","article-title":"Dry eye in childhood: Epidemiological and clinical aspects","volume":"6","author":"Alves","year":"2008","journal-title":"Ocul Surf"},{"key":"R7-20240828","doi-asserted-by":"crossref","first-page":"e1648","DOI":"10.1097\/MD.0000000000001648","article-title":"Dry eye in vernal keratoconjunctivitis: A cross-sectional comparative study","volume":"94","author":"Villani","year":"2015","journal-title":"Medicine"},{"key":"R8-20240828","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3109\/15569527.2015.1010727","article-title":"Evaluation of the tear film instability in children with allergic diseases","volume":"35","author":"Dogru","year":"2016","journal-title":"Cutan Ocul Toxicol"},{"key":"R9-20240828","doi-asserted-by":"crossref","first-page":"240.e1","DOI":"10.1016\/j.jaapos.2022.05.015","article-title":"Ocular surface characteristics in pediatric vernal keratoconjunctivitis: A clinico-cytological study","volume":"26","author":"Sabu","year":"2022","journal-title":"J AAPOS"},{"key":"R10-20240828","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/00004397-200343010-00007","article-title":"Vernal keratoconjunctivitis","volume":"43","author":"Leonardi","year":"2003","journal-title":"Int Ophthalmol Clin"},{"key":"R11-20240828","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1186\/s12886-016-0364-4","article-title":"Smartphone use is a risk factor for pediatric dry eye disease according to region and age: A case control study","volume":"16","author":"Moon","year":"2016","journal-title":"BMC Ophthalmol"},{"key":"R12-20240828","doi-asserted-by":"crossref","first-page":"2983","DOI":"10.3892\/etm.2017.4364","article-title":"A novel noninvasive ocular surface analyzer for the assessment of dry eye with Meibomian gland dysfunction","volume":"13","author":"Qi","year":"2017","journal-title":"Exp Ther Med"},{"key":"R13-20240828","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/S1542-0124(12)70083-6","article-title":"Methodologies to diagnose and monitor dry eye disease: Report of the diagnostic methodology subcommittee of the International Dry Eye WorkShop","volume":"5","year":"2007","journal-title":"Ocul Surf"},{"key":"R14-20240828","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1136\/bjophthalmol-2017-311171","article-title":"Corneal staining patterns in vernal keratoconjunctivitis: the new VKC-CLEK scoring scale","volume":"102","author":"Leonardi","year":"2018","journal-title":"Br J Ophthalmology"},{"key":"R15-20240828","doi-asserted-by":"crossref","first-page":"4364","DOI":"10.1097\/ACI.0b013e3282efb726","article-title":"Clinical grading of vernal keratoconjunctivitis","volume":"7","author":"Bonini","year":"2007","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"R16-20240828","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.jtos.2017.05.001","article-title":"TFOS DEWS II diagnostic methodology report","volume":"15","author":"Wolffsohn","year":"2017","journal-title":"Ocul Surf"},{"key":"R17-20240828","first-page":"237","article-title":"Allergic conjunctivitis","volume":"19","author":"Kosrirukvongs","year":"2001","journal-title":"Asian Pac J Allergy Immunol"},{"key":"R18-20240828","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1111\/pai.12197","article-title":"Vernal keratoconjunctivitis: A severe allergic eye disease with remodeling changes","volume":"25","author":"Vichyanond","year":"2014","journal-title":"Pediatr Allergy Immunol"},{"key":"R19-20240828","doi-asserted-by":"crossref","first-page":"408","DOI":"10.2500\/aap.2013.34.3695","article-title":"An algorithm for the management of allergic conjunctivitis","volume":"34","author":"Bielory","year":"2013","journal-title":"Allergy Asthma Proc"},{"key":"R20-20240828","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1016\/j.ophtha.2012.03.041","article-title":"Vernal keratoconjunctivitis in school children in Rwanda: Clinical presentation, impact on school attendance, and access to medical care","volume":"119","author":"De Smedt","year":"2012","journal-title":"Ophthalmology"},{"issue":"8 Suppl","key":"R21-20240828","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.1097\/01.ico.0000178741.14212.53","article-title":"Atopic ocular surface disease: Implications on tear function and ocular surface mucins","volume":"24","author":"Dogru","year":"2005","journal-title":"Cornea"},{"key":"R22-20240828","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1076\/ceyr.19.3.201.5309","article-title":"Altered cytokine balance in the tear fluid and conjunctiva of patients with Sj\u00f6gren's syndrome keratoconjunctivitis sicca","volume":"19","author":"Pflugfelder","year":"1999","journal-title":"Curr Eye Res"},{"key":"R23-20240828","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/S0161-6420(95)31024-X","article-title":"Dry eye with only decreased tear break-up time is sometimes associated with allergic conjunctivitis","volume":"102","author":"Toda","year":"1995","journal-title":"Ophthalmology"},{"key":"R24-20240828","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.anai.2012.01.006","article-title":"Allergic conjunctivitis and dry eye syndrome","volume":"108","author":"Hom","year":"2012","journal-title":"Ann Allergy Asthma Immunol"},{"key":"R25-20240828","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.ophtha.2011.09.018","article-title":"Corneal confocal microscopy in patients with vernal keratoconjunctivitis","volume":"119","author":"Leonardi","year":"2012","journal-title":"Ophthalmology"},{"key":"R26-20240828","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.clae.2020.02.018","article-title":"Agreement and repeatability of four different devices to measure non-invasive tear breakup time (NIBUT)","volume":"43","author":"Bandlitz","year":"2020","journal-title":"Cont Lens Anterior Eye"},{"key":"R27-20240828","doi-asserted-by":"crossref","first-page":"938484","DOI":"10.3389\/fmed.2022.938484","article-title":"Dry eye disease and tear film assessment through a novel non-invasive ocular surface analyzer: The OSA protocol","volume":"9","author":"S\u00e1nchez-Gonz\u00e1lez","year":"2022","journal-title":"Front Med"},{"key":"R28-20240828","doi-asserted-by":"crossref","first-page":"72","DOI":"10.4103\/kjo.kjo_26_19","article-title":"Ocular surface analyzer","volume":"31","author":"George","year":"2019","journal-title":"Kerala J Ophthalmol"},{"key":"R29-20240828","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1097\/01.ico.0000133997.07144.9e","article-title":"The lack of association between signs and symptoms in patients with dry eye disease","volume":"23","author":"Nichols","year":"2004","journal-title":"Cornea"},{"key":"R30-20240828","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1007\/s00417-012-2097-2","article-title":"Children with dry eye type conditions may report less severe symptoms than adult patients","volume":"251","author":"Han","year":"2013","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"R31-20240828","doi-asserted-by":"crossref","first-page":"106312","DOI":"10.1016\/j.chb.2020.106312","article-title":"Associations between duration and type of electronic screen use and cognition in US children","volume":"108","author":"Walsh","year":"2020","journal-title":"Comput Human Behav"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2836_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:13:30Z","timestamp":1787166810000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2836_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":31,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2836_22","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]},"assertion":[{"value":"2022-10-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-08","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}