Abstract:AIM:To establish a transtheoretical model(TTM)-based health management protocol for pediatric dry eye disease, and explore its practical application value in the clinical management of pediatric dry eye disease.
METHODS: This was a prospective study. Children diagnosed with dry eye disease in the ophthalmology outpatient department from January to June 2025 were enrolled and randomly assigned to a control group and a management group. The control group received routine symptomatic treatment for dry eye, whereas the management group received TTM-based health management interventions in addition to conventional treatment, with a total intervention duration of 6 mo. Subjective symptoms were assessed using the ocular surface disease index(OSDI)and Dry Eyerelated Quality of Life Score(DEQS)at baseline, 1-month, 3-month and 6-month follow-up visits. Slitlamp biomicroscopy, tear film break-up time(BUT), Schirmer's I test(SIt), corneal fluorescein staining(FL), and doublepass optical quality measurement were conducted. Modulation transfer function cutoff frequency(MTF cutoff), Strehl ratio(SR), and objective scattering index(OSI)were recorded. All outcome indicators were compared between the two groups.
RESULTS: A total of 235 children completed the follow-up, including 118 in the management group(64 males, 54 females; mean age 11.31±1.92 y)and 117 in the control group(60 males, 57 females; mean age 11.08±1.85 y). There was no significant difference in the indexes between the two groups before treatment(all P>0.05). At 1, 3, and 6 mo after intervention, BUT, SIt, MTF cutoff, and SR values were significantly increased in both groups compared with baseline, whereas OSDI, DEQS, FL, and OSI were significantly decreased(all P<0.05). At 1 mo posttreatment, there was no significant difference in the indexes between the two groups(all P>0.05). At 3 and 6 mo, the management group exhibited significantly higher BUT, SIt, MTF cutoff, and SR, as well as significantly lower OSDI, DEQS, FL, and OSI than the control group(all P<0.05).
CONCLUSION: The TTM-centered health management model can effectively improve the ocular surface status and visual function of pediatric dry eyedisease and relieve dry eye symptoms, which exerts a remarkable effect on consolidating the long-term therapeutic efficacy of pediatric dry eye.