Background: Diabetes mellitus being one of the systemic diseases which affects almost every system of our body and may cause multiple complications.

Objectives: To estimate prevalence and clinical characteristics of DED among diabetic patients.

Methods: All the diabetic patients attending the out-patient unit of Postgraduate department of Ophthalmology, Government Medical College & Associated SMHS Hospital who gave written informed consent and willingly participated in the study were included in the study. Socio-demographic data, clinical data pertaining to diabetes symptoms, duration of disease, presenting illness and other co-morbid conditions was collected using a pre-designed, pre-tested structured questionnaire. All the study participants were subjected to visual acuity test and slit-lamp examination. DED was confirmed by tear film break up time (TBUT) and Schirmer’s I test. Diagnosis was established by positivity of one or both the tests (TBUT or Schirmer’s test).

Results: The studied individuals were between the age ranges of 40-79 years with mean age of 56 ± 13.6 years. Among the studied sample, 49 (54.4%) were females, 36(40%) were doing elementary jobs while the educational status of most of the patients, 42(46.6%) was intermediate/diploma holders. Majority of the studied patients 34 (37.8%) belonged to Upper middle (II) class. Among the patients 31 (34.4%) were having moderate type retinopathy on fundoscopy examination, majority 45(50%) had thin tear meniscus height. In our study, a total of 47(52.2%) patients had dry eyes which was further classified into mild 21(23.3%), moderate 16(17.8%) and severe 10(11.1).

Conclusion: Dry eye disease is a common entity among individuals with diabetes mellitus and the estimated prevalence of DED at our hospital is about 52%.

1. Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus–present and future perspectives.Nat Rev Endocrinol.2012; 8:228–36.
2. Zou, L. Lu, Y. Xu, J. Zhu, J. He, B. Zhang, H. Zou, Prevalence and clinical characteristics of dry eye disease in community-based type 2 diabetic patients : the Beixinjing eye study, BMC Ophthalmol. 18 (2018) 1–7.
3. Lemp MA, Foulks GN. The definition and classification of dry eye disease:Report of the definition and classification subcommittee of the international dry eye workshop (2007). Ocul Surf. 2007;5:75–92.
4. Devi RSU, Gowda MSS. Dry Eye in Diabetes Mellitus Patients and its Relationship with Diabetic Retinopathy. Int J Sci Stud 2016;4(8):67-72.
5. Dogru M, Katakami C, Inoue M. Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus. Ophthalmology. 2001;108:586–92.
6. Jin J, Chen LH, Liu XL, Jin GS, Lou SX, Fang FN. Tear film function in non-insulin dependent diabetics [in Chinese]. Zhong Hua Yan KeZaZhi. 2003;39:10–3.
7. Manaviat MR, Rashidi M, Afkhami-Ardekani M, Shoja MR. Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients. BMC Ophthalmol. 2008;8:10.
8. Najafi L, Malek M, Valojerdi AE, Aghili R, Khamseh ME, Fallah AE, et al. Dry eye and its correlation to diabetes microvascular complications in people with type 2 diabetes mellitus. J Diabetes Complicat. 2013;27:459–62
9. Mohd Saleem, Modified Kuppuswamy socioeconomic scale updated for the year 2019, Indian J. Forensic Community Med. 6 (2019) 1–3. doi:10.18231/2394-6776.2019.0001.
10. Ayaki M, Kawashima M, Negishi K, Kishimoto T, Mimura M, Tsubota K. Sleep and mood disorders in women with dry eye disease. Sci Rep. 2016;6:35276.
11. Wilkinson CP, Ferris FL 3rd, Klein RE, Lee PP, Agardh CD, Davis M, etal. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003;110:1677–82.
12. Li J, Zheng K, Deng Z, Zheng J, Ma H, Sun L, et al. Prevalence and risk factors of dry eye disease among a hospital-based population in Southeast China. Eye Contact Lens. 2015;41:44–50.
13. Jie Y, Xu L, Wu YY, Jonas JB. Prevalence of dry eye among adult Chinese in the Beijing eye study. Eye. 2009;23:688–93.
14. Le Q, Zhou X, Ge L, Wu L, Hong J, Xu J. Impact of dry eye syndrome on vision-related quality of life in a non-clinic-based general population. BMC Ophthalmol. 2012;12:22.
15. Cousen P, Cackett P, Bennett H, Swa K, Dhillon B. Tear production and corneal sensitivity in diabetes.JDiab Complications.2007;21:371–3.
16. Figueroa-Ortiz LC, Jime´ nezRodrı´guez E, Garcı´a-Ben A,García-Campos J.Study of tear function and the conjunctival surface in diabetic patients. Arch Soc Esp Oftalmol 2011;86:107–112.
17. Song XJ, Li DQ, Farley W, Luo LH, Heuckeroth RO, Milbrandt J, et al. Neurturin-deficient mice develop dry eye and keratoconjunctivitissicca. Invest Ophthalmol Vis Sci. 2003;44:4223–9.
18. Nepp J, Abela C, Polzer I, Derbolav A, Wedrich A. Is there a correlation between the severity of diabetic retinopathy and keratoconjunctivitissicca? Cornea 2000;19:487-91.
19. Yoon, S. Im, M. Seo, Changes of Tear Film and Ocular Surface in Diabetes Mellitus, Korean J Ophthalmol. 18 (2004) 168–174.
20. Whitcher JP. Clinical diagnosis of the dry eye. IntOphthalmol Clin 1987;27:7-24.20.
21. Lin PY, Tsai SY, Cheng CY, Liu JH, Chou P, Hsu WM. Prevalence of dry eye among an elderly Chinese population in Taiwan: The shihpai eye study.

Shiraz Ahmad Bhat

Mohanlal Memorial Gandhi Eye Hospital Aligarh