Dry Eye in Children and Teenagers

Key overview

  • Children rarely say their eyes are dry. They rub, blink hard, avoid reading or complain of tiredness.
  • Blepharitis and chalazions are relatively common in children and often recurrent.
  • A red eye, an eyelid lump, or light sensitivity in a child warrants a clinician rather than home treatment.
  • Our masks are not specified for children. Any heat treatment for a child should be directed by their optometrist.

Dry eye in children is under-recognised largely because children do not report it in the terms adults use. Knowing what it looks like from the outside is most of the problem.

How it actually presents

Children rarely say their eyes feel dry or gritty. What you see instead:

  • Persistent eye rubbing
  • Hard or exaggerated blinking, sometimes mistaken for a tic
  • Avoiding reading, or losing their place and tiring quickly at close work
  • Complaining of headaches or tiredness after screens
  • Sitting very close to screens or holding books close
  • Redness at the lid margins, or crusting on waking
  • Light sensitivity

Several of these overlap with uncorrected refractive error, allergy and other conditions, which is exactly why they need assessing rather than interpreting from home.

What is common at this age

Blepharitis. More common in children than most parents expect, and often recurrent. It tends to present as crusting, redness and recurrent lumps rather than as dryness.

Chalazions and styes. Frequent in children, and frequently recurrent, which usually reflects an underlying lid margin problem rather than hygiene failure. Our guide to styes and chalazions covers the difference, though a lid lump in a child should be seen rather than managed from a webpage.

Allergic eye disease. Very common, overlaps symptomatically with dry eye, and is treated differently. Itch is the discriminating symptom.

Screen-related symptoms in teenagers. The same mechanism as adults — reduced and incomplete blinking — arriving earlier than it used to. The screen guide applies, and the practical measures are the same.

Contact lens wear in teenagers. Frequently combined with long screen hours, imperfect hygiene and over-wear. Discomfort has usually got a findable cause.

When a child needs to be seen

Lower your threshold considerably compared with an adult. Book, or seek urgent care, for:

  • A red eye that is not clearly settling, particularly with discharge
  • Any eyelid lump or swelling
  • Light sensitivity
  • Pain, or an eye held closed
  • Any change in vision, or a new squint
  • Symptoms interfering with reading or school

Redness spreading onto the cheek, fever, or a lid swelling shut needs same-day care.

What is reasonable at home

Screen breaks, sensible screen distance and height, adequate sleep, and gentle lid cleaning with warm water if a clinician has advised it for blepharitis. That is about the extent of it.

Our heated masks are not specified for children, and heat applied to a child's eyelids should be directed and supervised by their optometrist rather than started on the basis of adult guidance. Children's skin tolerates less heat, they report discomfort less reliably, and the conditions producing a lid lump in a child are not identical to those in an adult.

The one thing worth doing

If a child is rubbing their eyes persistently or avoiding close work, book an eye examination. It is inexpensive, it catches refractive error and lid disease equally well, and the alternative — interpreting a child's symptoms from the outside — is not something this page can help you do.

Part of our guide to Dry Eye Through Life.