AIM: To investigate the etiopathogenesis and clinical features of dry eye syndrome in children, methods for diagnosing the disease, and the treatment algorithm. MATERIAL AND METHODS: One hundred eighty-seven children with dry eye syndrome aged 3 to 17 yr were examined. To diagnose dry eye syndrome in children, the following research methods were used: biomicroscopy of the anterior part of the eye under diffuse illumination and with a cobalt filter after instillation of vital dyes; examination of the height of the lacrimal meniscus; identification of a characteristic discharge in the conjunctival sac, xerosis of the ocular surface; and evaluation of tear production (Schirmer I test) and stability of the tear film. RESULTS: We found that the links in the pathogenesis of dry eye syndrome in children were as follows: diseases of the ocular surface and appendage of the eye, contact correction of ametropia, and surgical operations on the conjunctiva and oculomotor muscles; otogenic neuritis of the facial nerve; rheumatoid arthritis; endocrine ophthalmopathy; lagophthalmos; and thermal and chemical burns. It is now always possible to evaluate tear production and tear film stability in preschool and primary school-aged children. In this case, the main diagnostic method is biomicroscopy. We identified objective clinical symptoms of dry eye syndrome in children using biomicroscopy. Dry eye syndrome was classified into four degrees of severity: mild, moderate, severe, and extremely severe. The subjective and objective clinical signs of each disease severity are described. An individual approach and personalized therapy are required to treat dry eye syndrome in children, focusing on the individual tolerability and effectiveness of the drug. Maximum medical alertness and early and accurate clinical differential diagnosis between dry eye syndrome and infectious inflammatory pathology of the anterior part of the eye are required. CONCLUSION: The features of the etiopathogenesis of dry eye syndrome in children with various nosologies are examined, and the characteristic clinical symptoms and severity of dry eye syndrome, diagnostic methods, and algorithm for treating dry eye syndrome in children are described. The clinical and diagnostic features of dry eye syndrome in children described by us contribute to its early diagnosis, allowing for the initiation of personalized tear replacement and reparative therapy on time, preventing the development of a chronic course of the disease, the occurrence of complications, and the preservation and/or restoration of visual acuity.

Non-infectious uveitis is one of the main and insufficiently studied causes of disability and blindness in patients with immuno-inflammatory diseases. Uveitis associated with spondyloarthritis, Behcet’s disease, juvenile idiopathic arthritis, systemic sarcoidosis and Vogt-Koyanagi-Harada syndrome are described more often and better than others, but the pathogenesis of different variants of their course is not well understood. Also, there remains a need to study the clinical and pathogenetic features of uveitis in rare autoimmune inflammatory diseases. Despite the currently existing diagnostic and therapeutic schemes, further study of the pathogenesis of uveitis associated with immune-inflammatory diseases is required, the research of a personalized approach and an algorithm for joint multidisciplinary diagnosis by specialists in various fields. A deeper understanding of the specific pathogenetic mechanisms will reveal new possibilities in the treatment of patients with autoimmune uveitis. This article is devoted to the current clinical and differential diagnostic aspects, common features and distinctive features associated with various variants of the course of non-infectious uveitis in patients with immuno-inflammatory diseases.

In the previous part of the review clinical and diagnostic aspects of some non-infectious uveitis in patients with immunoinflammatory diseases were discussed. In this part we proceed the discussion of ocular manifestations of a number of other immunoinflammatory conditions. In addition to uveitis associated with spondyloarthropathies, rheumatoid arthritis, Still’s disease, juvenile idiopathic arthritis and systemic sarcoidosis described in the previous part, ocular manifestations are also common in systemic vasculitis, systemic lupus erythematosus, Vogt—Koyanagi—Harada syndrome. Despite the numerous diagnostic schemes and therapy algorithms developed to date, much in the pathogenesis of uveitis associated with immuno-inflammatory diseases remains unclear. The need to develop personalized and multidisciplinary approaches for the treatment and diagnosis of non-infectious uveitis in numerous systemic immunoinflammatory diseases remains relevant. In-depth understanding of etiopathogenetic mechanisms of immunoinflammatory processes will allow to develop new approaches in the treatment of patients with uveitis.