Analysis of corneal biomechanical characteristics and clinical correlations in children with dust mite-allergic conjunctivitis

Investigating the corneal biomechanical characteristics and clinical correlations in children with dust mite-induced perennial allergic conjunctivitis (PAC). This study is a prospective cross-sectional study that enrolled 260 children (aged 6 to 12), divided into the PAC group and the healthy control group (NAC).Corneal biomechanical parameters were measured using the OCULUS Corvis ST, and the Ocular Surface Disease Index (OSDI), Visual Analogue Scale (VAS), typical symptom and sign scores, corneal fluorescein staining(CFS), tear break-up time (TBUT), and tear meniscus height (TMH) were recorded. The PAC group showed higher symptom/sign scores and poorer tear-film function (all p < 0.001). First applanation time (A1) and first applanation length (AL1) were shorter, and first applanation velocity (A1V) and second applanation time (A2) were higher (all p < 0.05). After covariate adjustment/weighting, second applanation time (A2), deformation amplitude ratio (DA ratio), and integrated radius (IR) also increased (all p < 0.05). Symptoms and signs showed weak to moderate correlations with multiple biomechanical parameters. CFS acted as a mediator for differences in some parameters. Cluster analysis revealed a “soft subtype”, and trend analysis suggested that the corneal biomechanical differences in normal children are primarily driven by corneal thickness, with limited age effects. PAC children show reduced corneal stability and biomechanical susceptibility, warranting regular follow-up for early risk stratification.