A COMPARATIVE STUDY OF TEAR FILM FUNCTION AND TEAR SECRETION AMONG DIABETICS

Author(s): Pai Shobha G, Pai Sheila R, Kini Jyoti, Nayak Madhurima K and Pai G Ajay

Abstract

The present work aims to study the changes in tear film function by studying tear film stability, amount of tear secretion and conjunctival impression cytology among diabetics and to compare with that in non-diabetics. In this prospective case control study, 100 eyes of 50 patients with type II Diabetes Mellitus and 100 eyes of 50 normal patients coming to OPD of a tertiary hospital were chosen. The tests done included Tear film Break Up Time, Rose Bengal staining, Schirmer’s test and Conjunctival Impression Cytology (CIP). For CIP, samples were taken from nasal and temporal conjunctiva and smeared on slides and stained with Papanicolau stain and observed under light microscope of 400x magnification. The mean age among diabetics was 53.4±11.2 years and non-diabetics was 48.8±15.3years. The TBUT was significantly reduced in diabetics with a mean of 9.8±7.01 seconds and 12.8±5.71 seconds in non-diabetics (p<0.005). 30% patients had values less than 10 seconds. The Rose Bengal test did not show a statistically significant difference. Schirmer’s test was positive in 26% in diabetics and 10% in non- diabetics. The mean was 7.7±3.9 in diabetics and 13.4±5.7 in non-diabetics (p=0.003). The mean grade of squamous metaplasia in diabetics was 1.58±0.62 and 0.52±0.57 in non-diabetics (p=0.001). Corneal sensitivity was found to be significantly lower in diabetics (29.17mm) when compared to controls (54.58mm). Dry eye is a significant ocular surface disorder in diabetes. The tear film parameters were significantly reduced in diabetics but Rose Bengal test did not show much difference.

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