A Controlled Study on the Correlation between Tear Film Volume and Tear Film Stability in Diabetic Patients

Abstract

Purpose. To assess the tear film quantity and correlate it with the quality and stability of the tear film in diabetics and compare them to age matched controls. Introduction. Diabetes affects tear film parameters in multiple ways. Poor metabolic control and neuropathy are postulated factors. To further understand how diabetes affects tear film parameters this study was conducted. Subjects and Methods. Tear meniscus height was measured by anterior segment OCT, along with tear thinning time, a subtype of noninvasive tear break-up time, and blinking rate per minute which were all recorded for 22 diabetic patients. Correlations between these tear film parameters were studied and then compared to 16 age matched controls. Results. A statistically significant difference was found in blinking rate between the diabetic and the control group (P = 0.002), with higher blinking rate among diabetics. All tear film parameters were negatively correlated with duration of diabetes. A positive correlation was found between tear film volume and stability. Conclusion. Diabetes affects the tear film in various ways. Diabetics should be examined for dry eye signs even in absence of symptoms which may be masked by associated neuropathy. Duration of diabetes has an impact on tear film status.

The Effects of Diabetic Duration on Lacrimal Functional Unit in Patients with Type II Diabetes

“…Blinking plays an important role in maintaining the stability of tear film and is related to psychological and/or several systemic diseases [4, 20, 42]. In this study, we observed the increased blinking frequencies in all diabetes groups, but only the subgroup with diabetic duration of 10 to 20 y reached statistical significance as compared to the healthy controls (Figure 2(i)).…”

“…For instance, keratoepitheliopathy was evident [3–7]; corneal sensitivity [7–11], quantity, and quality of tear secretion [3, 7, 11–14] were reduced in diabetic patients; moreover, the alterations in tear composition [15–18] were also detected in the diabetics. However, the factors contributing to the LFU dysfunction are not clear, and they might include the patient's general condition such as age and gender [5, 19–21], metabolic control [3, 12, 22, 23], duration of diabetes [20, 21], and occurrence of diabetic microvascular complications [5, 8, 22, 23].…”

“…The diabetic duration is considered one of the most important risk factors for retinopathy [21, 24, 25], yet its role in the LFU dysfunction remains controversial. Several studies reported no relationship between duration of diabetes and tear functions [3, 12, 13, 22, 23]; whereas others indicated higher prevalence of dry eye syndrome in the patients with longer duration of diabetes [21]; further, a correlation was found between diabetic duration and deterioration of ocular surface clinical parameters [20].…”

External eye symptoms in indoor environments

“…Lacrimal production is regulated by androgens; thus, age‐regulated production of androgens and estrogen in women impacts ocular surface homeostasis and the PTF stability. Diseases, in general, may also influence the PTF stability, for example, diabetes …”

A case–control study of the ocular surface and tear film parameters in gestational diabetes mellitus

“…DM affects basal tear production more than total tear production and is reflected in our results where Schirmer’s II is significantly reduced in the GDM group. [ 20 ] The reduced values of Schirmer’s I and TBUT in the GDM group although not statistically significant can be explained by involvement of the LFU by DM. [ 8 ] Hyperglycemia via the neural mechanism results in either reduced tear production or an increase in tear evaporation; blink-related abnormalities and alterations in tear film composition also result in DES.…”