EVALUATION OF DRY EYE STATUS IN DIABETES AND ITS RELATION WITH DIABETIC RETINOPATHY IN SOUTH INDIA
Introduction: Diabetic mellitus is a clinical syndrome characterized by hyperglycemia caused by absolute or relative deficiency of insulin. The term diabetes was 1st coined by Arashes Cappodocia (81-133 AD). Later, the word mellitus was added by Thomas Willis in 1675. Clinical features similar to diabetes mellitus (DM) were described 3000 years ago by the ancient Egyptians. Diabetes is one of the leading cause of blindness in age group of 40-70-year Materials and Methods: It is a prospective study consisting of 180 diabetic patients who attended Ophthalmology Department of SLIMS Hospital Pondicherry. Type I and Type II DM of either sex were screened for dry eye and diabetic retinopathy over a period of 18 months. Detailed ocular and diabetic history was recorded and clinical examination with slit-lamp for anterior and posterior segment of eye was done. For assessment of dry eye status Schirmer's test (SchT), tearlm breakup time (TBUT), and tear meniscus height (TMH) test were performed, and results noted. The stage of diabetic retinopathy was determined using direct and indirect ophthalmoscopy. Results: In this study, 90 diabetic patients participated, of which 25 were Type I and 65 were Type II DM. Dry eye prevalence was maximum in patients aged 50 years and above (53.6%) . It was more common in females (60.9%) compared to males (39.1%). SchT showed 15% and 72.5% of Type I and Type II diabetics respectively had dry eye. The TBUT was found to be ?10 s in 65% of Type II DM. 49% of Type II diabetics had low TMH. Moderate non-proliferative diabetic retinopathy (NPDR) (33%) was significantly more common in diabetic patients with dry eyes compared to diabetic patients without dry eyes. There were no patients with very severe NPDR. Statistically significant (P ? 0.001) association was found between diabetic retinopathy and dry eye. Conclusion: DM and dry eyes appear to have common association. Statistically significant correlation was found between dry eye and diabetic retinopathy. Hence, examination of dry eye should be integral part of assessment of diabetic disease as early detection will help to prevent further progression. Early treatment of dry eye should be initiated in dry eye positive individuals in order to prevent potential corneal complications.