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Prevalence and risk factors for dry eye disease in Chinese type II diabetes

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Session Details

Session Title: Cornea: Medical

Session Date/Time: Tuesday 10/10/2017 | 08:00-10:30

Paper Time: 09:24

Venue: Room 3.6

First Author: : A.Ma HONG KONG

Co Author(s): :    S. Mak   A. Ng   K. Shih              

Abstract Details


Diabetes mellitus has been found to be associated with dry eye syndrome (DES), which leads to significant ocular morbidities especially if its diagnosis and treatment are delayed. Studies have reported the prevalence of DES in diabetes to be up to 54.3%. However, the prevalence of DES amongst Chinese diabetic patients in Hong Kong is currently unknown. This observational study aims to estimate the prevalence of DES in the Chinese diabetic population. Secondary objectives involve examining the association(s) between dry eye status and diabetes-related clinical parameters.


A cross-sectional observational study was conducted in Hong Kong, at the Lo Fong Siu Po Eye Centre (Grantham Hospital), in close collaboration with the K.K. Leung Diabetes Centre (Queen Mary Hospital), and The University of Hong Kong from January to March 2017.


80 Chinese type 2 diabetes mellitus patients were recruited. Dry eye assessment was done with the Oculus Keratograph 5M to evaluate tear meniscus height (TMH), non-invasive tear break-up time (NITBUT), and bulbar redness (BR). Ocular symptoms were evaluated via the Ocular Surface Disease Index (OSDI), Symptom Assessment iN Dry Eye (SANDE), and Standard Patient Evaluation of Eye Dryness (SPEED). We adopted the Asia Dry Eye Society’s definition of DES: having an OSDI ≥ 13 and NITBUT ≤ 5 seconds. Diabetes-related parameters were obtained from questionnaires or retrieved from electronic patient records. All statistical analyses were performed using SPSS Statistics software.


The prevalence of DES was 20% (95% CI: 11-30%) among 80 Chinese diabetic subjects (mean age 64.95 ± 10.97 years, female 44%). Ocular surface evaluation revealed significant negative Pearson correlations between HbA1c and NITBUT (P = 0.007), duration of diabetes and NITBUT (P = 0.047), and positive correlations between HbA1c and OSDI score (P = 0.038). There was no significant correlations between OSDI and SPEED or SANDE scores.


In our study, the prevalence of DES amongst Chinese diabetic patients in Hong Kong was estimated to be 20%. Both increased serum HbA1c and a longer duration of diabetes were associated with reduced NITBUT. Higher serum HbA1c was also associated with a higher OSDI score. From this, we conclude that DES is a prevalent diabetic complication in the Hong Kong Chinese population. As DES causes significant ocular morbidities, it should be identified and managed promptly, especially in patients with poorly controlled diabetes mellitus.

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