Prevalence of dry disease in patients of type 2 diabetes mellitus: A cross-sectional study

Abstract

Background and Aim: Dry eye disease has a significant impact including physical, social, psychological, negatively affecting daily activities and workplace productivity. This study is conducted to find the prevalence of dry disease in patients of type 2 diabetes mellitus and to find the correlation between glycemic control and prevalence of dry eye. Material and Methods: A total of 130 patients fulfilled the criteria and total 200 eyes are included in the study. Type II diabetic patients diagnosed by the American Diabetes Associations criteria. The duration of diabetes, fasting and post-prandial blood sugar and Hb1Ac values were recorded. A complete ocular examination of the lid margins, conjunctiva, cornea and tear film was done. Examination of fundus was done to access the grade of diabetic retinopathy in the patients. Relevant examination of other important ocular structures was done. Following this, tests to diagnose dry eye were performed. These are tear break up time (TBUT), ocular surface staining by Rose Bengal and fluorescein staining, Schirmer’s tests and conjunctival impression cytology. Diagnosis of dry eye was made if OSDI Score was more than 12 with one of the positive specific tests for dry eye. Results: Prevalence of dry eye in diabetes in males and females were comparable to each other that are 44.99% and 54.01%. A statistically significant co-relation was found on comparing between Schirmer score of that eye and HbA1c level of that individual. All the patient with severe NPDR and PDR had Schirmer score of below 5 mm. Our study found that with increased duration of diabetes, the chance of developing dry eye increases, and poor glycemic control increases the severity of dry eye. The severity of diabetes has a positive correlation with goblet cell loss and morphological changes in conjunctival impression cytology. Conclusion: Significant correlation between the prevalence of dry eye in the diabetic patient which shows poor glycemic control is directly related to dry eye. This study reveals that attention should also be paid on dry eye, particularly among patients suffering from DM when they are concerned about diabetic retinopathy.