Abstract: Objective To investigate the risk factors associated with pediatric dry eye disease (DED) and to formulate effective preventive measures. Methods A cross-sectional, stratified, cluster random sampling method was employed between February and October 2024. The study sample comprised 496 students from two primary and two secondary schools in the Yingzhou District of Fuyang City. Three classes were randomly selected from each school, totaling 12 classes. All participants underwent questionnaire surveys and ophthalmic examinations to ascertain the prevalence of pediatric DED and to inform the development of prevention and control strategies. Results A total of 492 participants were included in the final analysis. The prevalence of DED among the pediatric population was 17.89% (88/492). Among the 88 diagnosed cases, a higher proportion was observed in the 13-18 age group, accounting for 62.50% (55/88). The predominant symptoms reported were ocular dryness (81 cases, 92.05%), foreign body sensation (76 cases, 86.36%), eye strain (70 cases, 79.55%), and photophobia (46 cases, 52.27%). Other reported manifestations included a burning sensation in the eyes (35 cases, 39.77%), fatigue (32 cases, 36.36%), fluctuating vision (26 cases, 29.55%), and ocular redness (25 cases, 28.41%). Logistic regression analysis identified several significant risk factors for pediatric DED in this region: age (OR=1.885), passive smoking exposure (OR=2.085), non-academic screen time (OR=2.277), insufficient sleep duration (OR=2.270), meibomian gland dysfunction (MGD, OR=9.492), allergic conjunctivitis (AC, OR=3.534), and refractive error (OR=2.189) (all P<0.05). Conclusions This study establishes that age, passive smoking, extended non-academic screen time, insufficient sleep, MGD, AC, and refractive error are significant contributing factors to the development of DED in children. These findings provide an empirical basis for the formulation of targeted preventive strategies, encompassing behavioral modifications, environmental optimization, and health monitoring, to mitigate the burden of pediatric dry eye disease.

Key words: Pediatric dry eye disease, Risk factors, Epidemiological survey, Behavioral intervention, Environmental exposure, Prevention strategies