An Evaluation of Tear Film and Ocular Surface Changes in Type 2 Diabetes Mellitus

Abstract

Aim

To compare tear film changes and ocular surface abnormalities in diabetics with that in non-diabetics.

Materials & methods

In this prospective case control study 100 eyes of 50 patients with Type 2 diabetes and 100 eyes of 50 normal patients were compared. All the patients were subjected to tear assessment tests- Schimers tests, Tear break up time tests in addition to Corneal sensitivity tests, CCT and CIS.

Conclusion

Our study showed that In Diabetics CCT was 560.14(SD 15.65) and Non diabetics was 534.14(SD 44.50) p value < 0.005.Corneal sensitivity measured by Cochet-Bonnet esthesiometer in diabetics was 26.08+/- 5.14mm and in Non diabetics was 53.58+/-2.06mm(p value <0.001).Tear break up time in diabetics was 6.8 +/-7.01 sec and in non-diabetics was 12.8+/-5.71sec(p value< 0.001).Total secretion by Schimers test was 7.77+/-3.9mm and basal secretion was 13.4+/-5.7mm(p value<0.001) . Conjunctival impression cytology revealed squamous metaplasia in diabetics as 1.25+/-0.63mm and in non-diabetics 0.65+/-0.57mm .Goblet cell density in diabetics was 429.68+/-108.35 cells/mmsq and in non-diabetics was 545.17+/-77.56cells/mmsq. Therefore diabetic patients with poor metabolic control and diabetic retinopathy should be assessed for tear film and ocular surface changes.