Determination of Risk Factors and Treatment of Dry Eye Disease in Type 1 Diabetes Before Corneal Complications at Sindh Institute of Ophthalmology And Visual Sciences

Abstract

Objective:The objective of this study was to assess and determine the risk factors and treatment of dry eye disease in type 1 diabetes before any ocular surface or corneal complication occurs. This study was conducted at Sindh Institute of Ophthalmology And Visual Sciences, Hyderabad, Pakistan.Methodology:Subjects and methods for observational study were undertaken at the Department of Ophthalmology Sindh Institute Of Ophthalmology And Visual Sciences, Hyderabad, Pakistan. Hundred confirmed cases of type 1 diabetes were included in the study by non probability convenience sampling. Tear film breakup time and schrimer test were carried out to determine dry eye disease. Data was collected by self-prepared questionnaire and entered and analyzed by using Statistical Program for Social Sciences (SPSS, version 20.0). The frequencies and percentage were recorded and any associations with predisposing factors were statistically analyzed by t test.Results:Out of hundred patients, 71 (71%) were found to have dry eyes (P<0.001). The mean age of the subject in this study was 50.97 years (range 30-70 years). Old age was related to high risk of dry eye disease (P<0.001). There was no big difference in the incidence of dry eyes in males and females. Long duration was found to be related with increased occurrence of dry eyes (P<0.001). We found higher values for abnormal tear film break up time than schirmer test values leading to increased occurrence of evaporative dry eyes.Conclusion:There is marked increase in frequency/ risk of developing dry eye disease in type 1 diabetes patients. Therefore, it is recommended to have periodic ophthalmic examination for type 1 diabetic patients.

Tear film layers and meibomian gland assessment in patients with type 1 diabetes mellitus using a noninvasive ocular surface analyzer: a cross-sectional case–control study

“…Participants with T1DM had a reduced tear volume compared to controls in the SIT. These results are consistent with other research in adults with T1DM [ 43 , 44 ], children and adolescents [ 42 , 45 ], and subjects with T2DM [ 33 , 46 – 49 ] but disagree with Ferdousi et al [ 50 ]. Shujaat et al [ 45 ] suggested that diabetes may cause damage to the microvasculature and innervation of the main lacrimal gland, affecting tearing.…”

“…Regarding TFBUT, patients with T1DM had lower TFBUT values than controls, corroborating the results of other authors [45,50] and supporting the results obtained in the NIBUT, although there are also some authors who disagree with this result.…”

Dry eye disease in patients with type II diabetes mellitus: A retrospective, population-based cohort study in Taiwan

“…An intriguing finding is that longer DM duration appeared to be a protective factor for the development of DED in our study. In previous studies, DM duration either did not have a significant effect or is a contributing factor for DED (32,33). However, studies had discovered that, in patients with longer DM duration, self-reported symptoms and decreased corneal sensitivity along with inferior whorl length destruction were noted with high underdiagnosis rate for DED (8,34).…”

“…We further identified patients with DED using ICD-9-CM 370. 33 (x = 1, 2, 3, 9), H04.12x (x = 1, 2, 3, 9), and for diagnostic accuracy, we excluded those who did not receive either lubricant and/or topical anti-inflammation agent after the diagnosis was established. Those with DED were classified as the DED group, and those without DED were classified as the non-DED group.…”

Contact lens wear and the diabetic corneal epithelium: A happy or disastrous marriage?

“…58 One could speculate that in diabetes, where there is an increase in dry eye, cellular desquamation is escalated. [59][60][61][62][63][64][65][66] In a diabetic rat model, terminal deoxynucleotidyl transferase dUTP nick end (TUNEL) labeling was used to measure the number of apoptotic cells in the corneal epithelium. 67 Importantly, the authors found a five-fold increase in apoptotic cells compared to the non-diabetic control.…”