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AIM: To investigate the clinical features of dry eye in patients with type 2 diabetes mellitus complicated with peripheral neuropathy.METHOD: Prospective cohort study. A total of 192 patients with type 2 diabetes were enrolled in the Department of Endocrinology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from July 2021 to March 2022. The right eyes of all patients were selected as the observation eye, among which 122 patients were diagnosed with diabetic peripheral neuropathy(DPN)and 70 patients were diagnosed with non-diabetic peripheral neuropathy(NDPN). The score of ocular surface disease index(OSDI), tear meniscus height, tear meniscus width, corneal epithelial thickness, corneal endothelial cell density, tear secretion test(Schirmer Ⅰ test, SⅠt), corneal sensitivity, meibomian gland function status score, tear film breakup time(BUT), corneal fluorescein sodium staining score and Toronto clinical scoring system(TCSS)score were compared between two groups. The correlation between OSDI score and TCSS score in type 2 diabetes patients was analyzed as well.RESULTS: The morbidity of dry eye in the DPN group(55 eyes, 45.1%)was significantly higher than that of NDPN group(20 eyes, 28.6%; χ2=5.094, P=0.024), BUT and corneal sensitivity score of DPN were lower than NDPN group(P<0.001), meanwhile, corneal staining score and meibomian gland function score were higher than NDPN group(P<0.001). OSDI scores of all subjects were negatively correlated with TCSS scores(rs=-0.233, P=0.002), and OSDI scores of DPN group were negatively correlated with TCSS scores(rs=-0.511, P<0.001), but there was no significant correlation between the two scores of NDPN patients(rs=0.007, P=0.957).CONCLUSIONS: DPN patients are more likely to develop dry eye than NDPN patients. OSDI score is not an accurate evaluation index for type 2 diabetes patients, especially for DPN patients.
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Background: Dry eye is recognized as a growing public health problem and one of the most frequent reasons for visiting an ophthalmologist in middle and old age people. Objectives: To the best of our knowledge, very less study has been undertaken in central India on dry eye. The present study was designed to study clinical profile and to evaluate the true prevalence and risk factors of dry eye in central India. Materials and Methods: A total of 1562 participants aged 30 years or more visiting ophthalmology department in a tertiary care rural hospital enrolled in a study. Study duration was 18 months. The study design was a prospective, cross-sectional, and observational study. An ocular surface disease index (OSDI) questionnaire was administered to all participants and individuals with OSDI score greater than 12 were further evaluated with dry eye tests in sequence of tear break-up time, lissamine green staining, Schirmer-1 test, and slit-lamp examination for meibomian gland dysfunction. The participants with OSDI Score ≥13 were diagnosed to be having dry eye. The data were compiled and subjected to statistical analysis using SPSS v.17.0 software (SPSS Inc., Chicago, Illinois, USA). P < 0.05 was considered to be statistically significant. Results: Prevalence of dry eye in our study was 24.7%. Prevalence of lipid layer, aqueous layer, and mucin layer deficiency dry eye was 13.8%, 5.2%, and 7.8%, respectively. Increasing age, illiteracy, and menopause were the significant risk factors and female sex, urban habitat, and laborer and factory worker were insignificant risk factors for dry eye. Conclusion: Prevalence of dry eye in our study is higher than reported in literature in central India. Lipid anomaly dry eye was the most prevalent, followed by mucin layer deficiency and lastly aqueous tear deficiency.
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Background: Ocular surface disease is the most common, underdiagnosed comorbidity of glaucoma. Ocular surface diseaseaffects the quality of life of glaucoma patients apart from causing visual disturbances. Evaluation of ocular surface disease isimportant for complete management of glaucoma.Aims and Objectives: This study aims to evaluate the subjective and objective measures of ocular surface disease in patientswith glaucoma.Materials and Methods: A cross-sectional study was carried out on 108 eyes of 54 glaucoma patients on topical antiglaucomamedications for >6 months at the department of ophthalmology from January 2018 to January 2019. Subjective evaluation withocular surface disease index (OSDI) score and objective evaluation with tear breakup time (TBUT) and Schirmer test werecarried in all patients.Results: The subjective measure with OSDI score >12 was observed in 55.6% of glaucoma patients. The objective measures withTBUT <10 s and Schirmer test <10 mm in 5 min were observed, respectively, in 64.8% and 53.7% of glaucoma patients. Patientson longer duration (>15 months) of topical antiglaucoma medications and patients on multiple topical antiglaucoma drugs had higherOSDI score, lesser TBUT, and lesser Schirmer test values. OSDI score had strong positive correlation with TBUT and Schirmer test.Conclusion: Prompt evaluation of ocular surface disease, use of fixed-drug combinations, use of preservative-free antiglaucomaeye drops, and supplementation with lubricants will improve the compliance of patients and outcome of glaucoma management.