Prevalence of dry eye and tear film changes in diabetic population: experience at our tertiary care centre

Abstract

Background: Abnormalities in tear secretion, alteration of epithelial barrier and autonomic neuropathy lead to tear film and ocular surface changes in diabetes, thus causing dry eye. Aim was the evaluation of tear film and ocular surface of diabetic patients and to assess the prevalence of dry eye in diabetic patients presenting to our department.

Methods: It was prospective, observational study. Visual acuity was tested for all the patients and slit lamp evaluation was done followed by staining methods to evaluate dry eye. The parameters included ocular symptoms, Schirmer test, tear meniscus height, tear film breakup time, corneal staining with fluorescein, conjunctival staining, presence of strands/filaments and presence of diabetic retinopathy.

Results: A total of 200 diabetic patients were assessed. Forty percent had the duration of diabetes mellitus ranging between 6-10 years. Majority of patients were having grittiness (54%). Around 32% of the study participants are having dry eye. On Schirmer test majority (43%) were having 6-10 mm. 69% of the study participants were having more than 1 mm of tear meniscus height. Majority (69%) of the study participants had more than 10 sec tear film breakup time. 18% of the study participants were having positive conjunctival staining and 18% of the study participants were having positive corneal staining. 13% of the study participants are having filaments/strands.

Conclusions: The incidence of dry eye was seen to increase with increasing duration of diabetes and increasing age. Careful elicitation of history followed by proper evaluation to diagnose dry eye is emphasized.