Assessment of Tear Film Parameters in Patients with Type 2 Diabetes Mellitus

BACKGROUND Dry eye is a condition of tear film which occurs either due to tear deficiency or excessive evaporation of tears which causes damage to the interpalpebral ocular surface and is associated with ocular discomfort symptoms. This ocular disorder is common among general population with a prevalence of 28% among adults. Although diabetic retinopathy and diabetic cataracts are commonly known complications of diabetes, dry eye syndrome or keratoconjunctivitis sicca is also prevalent in diabetic individuals. The prevalence of dry eye in patients with type 2 diabetes mellitus has been reported to be 54%. The diagnosis of dry eye can be determined by decreased tear film stability, assessed by the tear film break up time (TBUT), and reduced tear secretion evaluated by Schirmer’s test. Aims and Objectives To assess the tear film parameters in patients with type 2 diabetes mellitus. To assess the co-relation of tear film parameters with duration of diabetes and HbA1c levels. METHODS A total of 100 eyes of patients with type 2 diabetes mellitus subjects and 100 eyes of non-diabetic age group and gender matched controls, were included in the study. The study was conducted from October 2021 to August 2022. Duration of diabetes mellitus and HbA1c values were documented on all subjects. RESULTS The mean age of the study group and the control group was 60.24 years and 58.32 years respectively. There were more males enrolled than females in both the study group and the control group. Among the study group, the mean values of Schirmer’s test-1 and Schirmer’s test-2 were 20.81±7.2 mm and 12.88±6.01 mm respectively. The values of both Schirmer’s test-1 and Schirmer’s test-2 were lower in the diabetics as compared to the controls. The mean value of TBUT (8.7±3.1 sec) was significantly reduced in diabetic patients as compared to the controls. There was a strong negative correlation of Schirmer’s test-1, Schirmer’s test-2 and TBUT with the duration of diabetes mellitus and with the levels of HbA1c. CONCLUSIONS The incidence of diabetes and dry eye syndrome as separate disease entities is on the rise at present. Dry eye syndrome in diabetes further compromises the quality of life of the patients and thus, should be diagnosed and treated early.