Prevalence Of Dry Eye In Type 2 Diabetes Patients Attending Tertiary Hospital In South India

Abstract

BACKGROUND Dry eye is a very common disorder of tear film resulting from either decreased tear production or increased tear evaporation. It is not a common cause of vision loss, but it is still a serious issue for people who have it. The symptoms become progressively troublesome and exert an increasing burden on the patients as the disease progresses or increases in severity. If not detected early it can lead to sight threatening complications. Diabetics often complain of dry eye symptoms such as burning sensation, foreign body sensation, heavy lids, redness etc. Cataract and retinopathy are well known complications of diabetes, recently, problems involving the ocular surface , dry eye in particular have been reported in diabetics. Diabetes patients suffer variety of complications due to dry eye which include superficial punctate keratopathy, trophic ulceration, and persistant epithelial defect. Aim and objective of the study To find the prevalence of dry eye in type 2 diabetes patients and correlate with severity and duration of diabetes in patients attending BLDEU’S Shri. B. M. Patil Medical College, Hospital & Research Centre. Materials and methods Its a prospective observational cross sectional study, consisting of 251 type 2 diabetes mellitus patients. After applying inclusion and exclusion criteria all diabetic patients attending ophthalmology OPD of BLDEU’S Shri. B. M. Patil Medical College, Hospital & Research Centre were studied. XI All patients were given standard dry eye questioner (OSDI scores) and answers were documented. Detailed diabetic history, ocular signs and symptoms were taken. Patients were subjected for complete ocular examination of anterior and posterior segment. Tear film function tests included Schirmer’s test, TBUT, and Lissamine green staining. On basis of these test results and OSDI scores patients were labelled to have presence of absence of dry eye. RESULTS A total of 251 patients included in the study, 130 (41.03%) were found to be positive for dry eye. Hence prevalence of dry eye in type 2 diabetics in this study was found to be 41.03%. Of 251 patients included in study 155 were males and 96 were females. Mean age group of study population was 67.5years. 33.5% of study population was between age group of 51 to 60 years. High OSDI scores were found to correlate significantly with prevalence of dry eye p value < 0.05%. Significant correlation was found between duration of diabetes and dry eye prevalence, with increasing duration of diabetes there was increase in the prevalence of dry eye. With increased severity of diabetic retinopathy there was increase in prevalence of dry eye. And patients with retinopathy changes had increased prevalence of dry eye when compared to those who did not have retinopathy changes. XII Lissamine green stain was found to be very effective alternative to Rose Bengal stain and we were able to detect even pre dry eye cases. Even before the signs and symptoms of dry eye appeared, stain showed the damage to the ocular surface. There was significant correlation between HbA1c levels and prevalence of dry eye. CONCLUSION In this study prevalence of dry eye was 41.03%. Dry eye is significantly more common in diabetes patients. Poor glycemic control correlates with increase prevalence in dry eye in diabetes patients. The declined tear film function is severe in patients with diabetic retinopathy changes than those without retinopathy changes. Examination for dry eye should be integral part of the assessment of diabetic eye disease.