Risk factors for ocular surface disorders in patients with diabetes mellitus

Abstract 

Objective: To evaluate risk factors for ocular surface disorders and tear dysfunction in patients with type 2 diabetes. Study design and methods: This prospective case controlled study included 41 patients with type 2 diabetes and 20 healthy subjects as the control group. All subjects underwent routine ophthalmic examination, tear film break-up time (BUT) test, Schirmer test, fluorescein dye test, rose bengal staining test, and a questionnaire for subjective complaints. The relationship of metabolic control of diabetes mellitus, duration of diabetes, severity of diabetic retinopathy, and argon laser photocoagulation (ALP) to tear dysfunction was evaluated. Results: Tear film BUT and Schirmer test values were significantly lower in diabetic patients compared with control subjects (P<0.001). In the diabetic group, significantly more subjects had abnormal fluorescein and rose bengal staining than in the control group (P<0.001). Abnormal tear function tests were associated with poorer metabolic glucose control, panretinal ALP, and proliferative diabetic retinopathy (P<0.05), but not with duration of diabetes (P>0.05). Conclusions: The results of the study indicate that poor metabolic control, panretinal ALP, and proliferative diabetic retinopathy are high risk factors for ocular surface disorders in type 2 diabetes. These patients should be followed more carefully, and should be referred to an ophthalmologist when required.

Keywords:  Diabetes mellitus, Ocular surface disorders, Tear function tests