Analysis Of The Effect Of Lipid Layer On Tear Film In Children With Seasonal Allergic Conjunctivitis

Seasonal allergic conjunctivitis(SAC)is the most common type of ocular allergic disease.It generally does not damage the cornea,but it is prone to repeated attacks affecting quality of life.Studies have shown that decreased tear film stability is one of the causes of eye discomfort caused by allergic conjunctivitis.Allergic conjunctivitis is a risk factor for dry eye in adults.It may be associated with recurrent inflammatory lesions such as goblet cells,decreased mucin production,damage to corneal epithelial nerve fibers,and thickening of the tear film lipid layer.At present,the relationship between children with allergic conjunctivitis and dry eye in children is still controversial,but all agree that it can reduce the tear film stability point of view,which may be related to the reduction of mucin secretion of goblet cells in inflammatory injury,but we are in clinical At work,some children with SAC were found to have lid margin hyperemia,abnormal meibum,and distorted or missing meibomian glands.At the same time,the lipid layer of the tear film in children was thin,and there was no seasonal allergic conjunctivitis in children.The effect of membrane lipid layer was reported in this study.Objective:This study focused on the special population of children with seasonal allergic conjunctivitis and observed changes in the lipid layer thickness of the tear film,and investigated whether SAC-induced changes in meibomian gland function were associated with changes in the lipid layer of the tear film and lipids.The effect of layer change on tear film stability.Methods:This study is a single-center,prospective case-control study.Thirty cases of seasonal allergic children admitted to the Xiamen Eye Center Affiliated to Xiamen University from January 2017 to June 2017 were selected as the observation group and 30 healthy children were collected as the experimental control group.Each child was evaluated and observed as follows:lipid layer thickness(LLT),tear film breakup time(BUT),tear meniscus height,lid margin score,meibum score,meiboscore and gland distortion scores.In order to observe the changes of tear film and meibomian gland before and after treatment of seasonal allergic conjunctivitis,we conducted a 3-month follow-up of children with seasonal allergic conjunctivitis,and recorded relevant data and performed statistical analysis.RESULTS:Before the treatment,the SAC group had higher scores of lid margin,meibum,gland distorting and meiboscore than the control group.The thickness of the lipid layer was thinner than the normal control group,and the tear film breakup time was shorter.The difference was statistically significant(P<0.001).There was no significant difference in tear meniscus height between the two groups.In order to further explore the changes of tear film and meibomian glands in children with SAC before and after treatment,we observed tears and meibomian glands before and after treatment in the SAC group and found that the SAC group had 3 months after treatment.There was no significant change in meiboscore and gland distorting scores,and lid margin and meibum scores were all decreased.Lipid layer thickness and BUT were significantly increased in children.Spearman correlation analysis:1.The parameters of the meibomian glands before treatment in the SAC group and the control group were negatively correlated with the tear film lipid layer thickness and tear film breakup time,and the lipid layer thickness was positively correlated with tear film breakup time.There was no correlation between parameters and tear meniscus height.2.After the treatment,the meibomian gland-related indicators(excluding gland distorting)were negatively correlated with the thickness of the lipid layer,and the meibomian gland indicators were negatively correlated with tear film breakup time,and lipid layer thickness were positive correlation with tear film breakup time.Conclusion:Seasonal allergic conjunctivitis leads to thinning of the tear film lipid layer and decreased tear film stability in children;lipid layer thinning may be associated with abnormal meibomian gland dysfunction;lipid layer thickness is positively correlated with tear film stability.After treatment,the symptom of the child is relieved,the thickness of the lipid layer is increased,and the tear film breakup time is prolonged,which may indicate that the thickness of the lipid layer is one of the indexes of the disease condition change.In the diagnosis and treatment of children with allergic conjunctivitis,we should pay attention to changes in tear film and meibomian gland markers in children.If the signs is abnormal,we should treat it early to avoid eye damage.