Dry Eye Syndrome in Patients with Diabetes Mellitus: Prevalence, Etiology, and Clinical Characteristics

Abstract

There has been substantial progress in our understanding of the ocular surface system/lacrimal function unit in the past 15 years. Keratoconjunctivitis sicca, more commonly referred to as dry eye syndrome (DES), is the most frequently encountered condition and diabetes mellitus (DM) has been identified as one of the leading causes of DES. Poor glycemic control affects both the anterior and the posterior segments of the eye and increasing prevalence of diabetes-associated DES (DMDES) has been reported in recent years. The pathogenesis and specific features of DMDES remain uncertain and interventions are limited to those used in DES. This review outlines the pathogenesis, clinical manifestations, and the current preventive and treatment strategies for diabetes-related DES.

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“…Recently Ozawa et al in the years 2012 and 2015 strongly suggested that the severity of DR in males of T2D were attributed to abnormalities in neuroretinal function 16,18 . In our study frequency of DED was higher in T2D with DR, which was not noticed in previous studies [2][3][4][5] . 5 and strongly suggested that surveillance of diabetic patients and good control over blood glucose are necessary key factors for prevention of dry eye syndrome and retinopathy.…”

“…This increase may be due to association between hormonal status and pre and postmenopausal period Our study suggests that hormones may influence the prevalence of DED in pre and post menopausal women. In our study the number of severity of DR significantly increased with respect to age and we also found relationship between sex and grades of DR. As compared to females, males are more prevalent to DR such a relation was found in Zhang et al, 2016 andOzawa et al, 2015 2, 16 .…”

“…In consistent with this, a high incidence of dry eye among females as compared to males was reported 17 . Also many studies reported the significant correlation between DED and stages of DR [2][3][4][5] . From findings we inferred that DED is more prevalent among females with DR while the severity of DR was found high in males with less prevalence of DED when compared to females.…”

Retrospective analysis of ocular neuropathies in diabetic dogs following cataract surgery

“…Similarly, in dogs, 27.8% (5 of 18) of diabetics were diagnosed with KCS and the overall average tear production among the diabetic dogs tested was low at 12.3 mm/min . Both the afferent and efferent pathways for the tearing reflex could be affected, leading to the clinical manifestation of dry eye . Poor tear film quality has also been documented in diabetic people and dogs, perhaps due to dysfunction of the parasympathetic and sympathetic innervation of the meibomian glands .…”

Transforming growth factor‐β blocks glucose‐induced inflammation and apoptosis in corneal epithelial cells

“…Previous studies have confirmed that dry eye symptoms in diabetes are correlated with the severity of the diabetic retinopathy [14,15]. In relation to this, several investigators have suggested that dry eye symptoms in diabetes are associated with peripheral polyneuropathy caused by reduced corneal sensitivity, altered homeostasis of the cornea, or ocular surface dysfunction caused by tear film instability and reduced tear secretion [16][17][18].…”