Evaluation of Meibomian Glands Dysfunction in Type Two Diabetic Patients

Abstract

Background: Diabetes Mellitus is one of the most common leading causes of blindness. Cataract and retinopathy are wellknown as ocular complications of diabetes, problems involving the ocular surface; dry eyes in particular, have been reported in diabetic patients. Aim of the Work: to evaluate Meibomian glands function in patients with type 2 diabetes Mellitus. Materials and Methods: this prospective observational study compared changes in Meibomian glands and tear film function in type 2 diabetic patients with non-diabetic patients. It included 20 eyes of 11 patients with type two diabetes mellitus and 20 eyes of 11 healthy non-diabetic controls. Meibomian glands function was evaluated by grading of Meibomian gland loss by meibography. Tear film function was assessed by dry eye questionnaire, measuring tear breakup time (TBUT), the Schirmer I test & corneal and Conjunctival fluorescein staining. Results: dry eye questionnaire results were significantly higher scoring in diabetic group comparing with non-diabetic. TBUT was significantly lower in diabetic, especially with longer diabetic duration, comparing with normal control. Schirmer 1 test, corneal and conjunctival fluorescein staining, was significantly higher in diabetic patients compared with normal control. Meibography showed significant high scoring in diabetic patients that represent significant decrease in Meibomian gland number compared with controls. Conclusion: our data suggest that type 2 diabetes predisposes to various changes on the ocular surface Meibomian gland dysfunction (MGD) in type 2 diabetic patients is more severe compared with nondiabetic patients. It should be noted at an early stage and treated appropriately in order to prevent more severe eye complications. Therefore, close attention should be paid to the ocular surface, especially in long-term diabetes mellitus. Further studies are needed to increase the sample size and include fluctuations in blood sugar as a key factor in studying the ocular surface.