Prevalence of Dry Eye in Diabetic Patients in Rural Population

Abstract

B. L. Sujatha Rathod1 , Anupriya A.2 , Bharathi Narasimhamurthy3 , Vidyadevi M.4 , Ranjitha Chowkahally Sadananda5 , Divya N. Raj6

BACKGROUND Diabetes mellitus has been diagnosed as a risk factor for dry eye in several studies including large population studies. It has been suggested that the association may be due to diabetic sensory or autonomic neuropathy or due to the occurrence of microvascular changes in lacrimal gland. The main aim of this study was to study the prevalence of dry eye in diabetics and its association with duration of diabetes, Meibomian Gland Disease (MGD), and HbA1c levels in rural population. METHODS This is a hospital-based comparative cross-sectional study conducted in a rural area. 80 (40 diabetics + 40 non-diabetics) patients were enrolled in the study. All patients underwent complete ophthalmic examination including OSDI score, TBUT, Schirmer´s test, ocular surface staining and blood tests like RBS, HbA1c. RESULTS 80 patients satisfied the inclusion criteria and were enrolled in the study. As the age increased, the occurrence of dry eye also increased significantly with p value of 0.784 in our study. Among 66 female patients, 29 patients (80.6%) and among 14 male patients, 7 patients (19.4%) had dry eye symptoms. 60% of diabetic and 30% of non-diabetic patients had symptomatic dry eye. We also found significant association between the HbA1c levels and dry eye (p<0.001). Significant reduction in TBUT and Schirmer´s test values in diabetic patients with poor metabolic control was found. CONCLUSIONS Dry eye is a very common condition with high prevalence among elderly diabetics of rural population in our study. Significant association was noted between dry eye disease and the duration of diabetes, RBS level, HbA1c level, and MGD in diabetes patients of rural population. Hence, we advocate OSDI (Ocular Surface Disease Index) scoring, Schirmer´s test and tear film break up time, ocular surface staining, examination of lid for MGD to be routinely done for diabetic patients and especially those with symptoms.

image