Main Article Content
Abstract
BACKGROUND
Dry eye is a condition of tear film which occurs either due to tear deficiency or excessive evaporation of tears which causes damage to the interpalpebral ocular surface and is associated with ocular discomfort symptoms. This ocular disorder is common among general population with a prevalence of 28% among adults. Although diabetic retinopathy and diabetic cataracts are commonly known complications of diabetes, dry eye syndrome or keratoconjunctivitis sicca is also prevalent in diabetic individuals. The prevalence of dry eye in patients with type 2 diabetes mellitus has been reported to be 54%. The diagnosis of dry eye can be determined by decreased tear film stability, assessed by the tear film break up time (TBUT), and reduced tear secretion evaluated by Schirmer’s test.
Aims and Objectives
- To assess the tear film parameters in patients with type 2 diabetes mellitus.
- To assess the co-relation of tear film parameters with duration of diabetes and HbA1c levels.
METHODS
A total of 100 eyes of patients with type 2 diabetes mellitus subjects and 100 eyes of non-diabetic age group and gender matched controls, were included in the study. The study was conducted from October 2021 to August 2022. Duration of diabetes mellitus and HbA1c values were documented on all subjects.
RESULTS
The mean age of the study group and the control group was 60.24 years and 58.32 years respectively. There were more males enrolled than females in both the study group and the control group. Among the study group, the mean values of Schirmer’s test-1 and Schirmer’s test-2 were 20.81±7.2 mm and 12.88±6.01 mm respectively. The values of both Schirmer’s test-1 and Schirmer’s test-2 were lower in the diabetics as compared to the controls. The mean value of TBUT (8.7±3.1 sec) was significantly reduced in diabetic patients as compared to the controls. There was a strong negative correlation of Schirmer’s test-1, Schirmer’s test-2 and TBUT with the duration of diabetes mellitus and with the levels of HbA1c.
CONCLUSIONS
The incidence of diabetes and dry eye syndrome as separate disease entities is on the rise at present. Dry eye syndrome in diabetes further compromises the quality of life of the patients and thus, should be diagnosed and treated early.
Keywords
Article Details
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References
- Asbell PA. Increasing importance of dry eye syndrome and the ideal artificial tear: consensus views from a roundtable discussion. Current Medical Research and Opinion 2006;22(11):2149-57.
- Kanski JJ. Clinical ophthalmology: a systemic approach. 6th edn. Edinburgh: Elsevier Butterworth-Heinemann 2006:205-14.
- Dogru M, Stern ME, Smith JA, et al. Changing trends in the definition and diagnosis of dry eyes. Am J Ophthalmol 2005;140(3):507-8.
- Caffery B. Uncomfortable Eyes" might be an indication of Dry Eye Syndrome. Am J Ophthalmol 2005;140:507-8.
- Rahman A, Yahya K, Ahmed T, et al. Diagnostic value of tear films tests in type 2 diabetes. J Pak Med Assoc 2007;57(12):577-81.
- Sicree R, Shaw J, Zimmet P. Diabetes and impaired glucose tolerance. Diabetes Atlas. International Diabetes Federation. 3rd edn. Belgium: IDF 2006:51-3.
- Manaviat MR, Rashidi M, Afkhami-Ardekani M, et al. Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients. BMC Ophthalmol 2008;8(1):1-5.
- Bal C, Mukherjee S, Dan S. Effect of long term glycemic control on precorneal tear film in diabetic patients. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2014;1(13):51-3.
- Eissa IM, Khalil NM, El-Gendy HA. A controlled study on the correlation between tear film volume and tear film stability in diabetic patients. J Ophthalmol 2016;2016:5465272.
- American Diabetes Association. Diagnosis and Classification of diabetes mellitus. Diabetes Care 2014;37(Suppl 1):S81-90.
- Yoon KC, Im SK, Seo MS. Changes of tear film and ocular surface in diabetes mellitus. Korean J Ophthalmol 2004;18(2):168-74.
- Kamel SS, Mohammed TH, El Zankalony YA, et al. Prevalence of dry eye in diabetics. J Egypt Ophthalmol Soc 2017;110(3):77-82.
- Dogru M, Katakami C, Inoue M. Tear function and ocular surface changes in noninsulin - dependent diabetes mellitus. Ophthalmology 2001;108(3):586-92.
- Ozdemir M, Buyukbese MA, Cetinkaya A, et al. Risk factors for ocular surface disorders in patients with diabetes mellitus. Diabetes Res Clin Pract 2003;59(3):195-9.
- Goebbels M. Tear secretion and tear film function in insulin dependent diabetics. Br J Ophthalmol 2000;84(1):19-21.
- Rashmi S, Adappa P, Hegde V, et al. Impact of duration of diabetes on Schirmer’s test and tear film break up time. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2016;1(15):72-4.
References
Asbell PA. Increasing importance of dry eye syndrome and the ideal artificial tear: consensus views from a roundtable discussion. Current Medical Research and Opinion 2006;22(11):2149-57.
Kanski JJ. Clinical ophthalmology: a systemic approach. 6th edn. Edinburgh: Elsevier Butterworth-Heinemann 2006:205-14.
Dogru M, Stern ME, Smith JA, et al. Changing trends in the definition and diagnosis of dry eyes. Am J Ophthalmol 2005;140(3):507-8.
Caffery B. Uncomfortable Eyes" might be an indication of Dry Eye Syndrome. Am J Ophthalmol 2005;140:507-8.
Rahman A, Yahya K, Ahmed T, et al. Diagnostic value of tear films tests in type 2 diabetes. J Pak Med Assoc 2007;57(12):577-81.
Sicree R, Shaw J, Zimmet P. Diabetes and impaired glucose tolerance. Diabetes Atlas. International Diabetes Federation. 3rd edn. Belgium: IDF 2006:51-3.
Manaviat MR, Rashidi M, Afkhami-Ardekani M, et al. Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients. BMC Ophthalmol 2008;8(1):1-5.
Bal C, Mukherjee S, Dan S. Effect of long term glycemic control on precorneal tear film in diabetic patients. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2014;1(13):51-3.
Eissa IM, Khalil NM, El-Gendy HA. A controlled study on the correlation between tear film volume and tear film stability in diabetic patients. J Ophthalmol 2016;2016:5465272.
American Diabetes Association. Diagnosis and Classification of diabetes mellitus. Diabetes Care 2014;37(Suppl 1):S81-90.
Yoon KC, Im SK, Seo MS. Changes of tear film and ocular surface in diabetes mellitus. Korean J Ophthalmol 2004;18(2):168-74.
Kamel SS, Mohammed TH, El Zankalony YA, et al. Prevalence of dry eye in diabetics. J Egypt Ophthalmol Soc 2017;110(3):77-82.
Dogru M, Katakami C, Inoue M. Tear function and ocular surface changes in noninsulin - dependent diabetes mellitus. Ophthalmology 2001;108(3):586-92.
Ozdemir M, Buyukbese MA, Cetinkaya A, et al. Risk factors for ocular surface disorders in patients with diabetes mellitus. Diabetes Res Clin Pract 2003;59(3):195-9.
Goebbels M. Tear secretion and tear film function in insulin dependent diabetics. Br J Ophthalmol 2000;84(1):19-21.
Rashmi S, Adappa P, Hegde V, et al. Impact of duration of diabetes on Schirmer’s test and tear film break up time. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2016;1(15):72-4.