Ocular Surface Disease Frequency In Diabetic Patients

PURPOSE: Ocular surface disease(OSD) is a multifactorial tear and ocular surface disease that results in symptoms of discomfort, visual disturbances, unstable tear film and potential damage of the ocular surface. It may be associated with increased tear film osmolarity and inflammation of the ocular surface. Risk factors for Ocular Surface Disease are numerous,systemic or external and among them are changes of some biochemical blood test parameters, such as glucose level in diabetic patients. Diabetes mellitus is a common metabolic disorder with prolonged hyperglycemia due to lack and reduced efficiency of endogenous insulin. In the anterior segment of the eye diabetes is most often associated with Ocular Surface Disease.

Aim of this work is to examine the frequency of OSD findings in patients with confirmed type 2 diabetes (DMT2) examined in Health Center and Eye Clinic in  University Clinical Center Nis during daily ophthtalmologic examination in one year.

METHODS: Using Slit Lamp examination of patients with Diabetes Mellitus Type 2 we checked the OSD occurence. Tear break up time (TBUT) test was performed, and a result shorter than 10 seconds was considered as pathological. Data of patients with type II diabetes was taken (gender, age, duration of diabetes). The results were processed in retrospective analysis, using descriptive statistical methods SPSS.

RESULTS: A total of 547 patients(eyes) with confirmed  Diabetes Mellitus Type 2  were examined. Higher percentage of women had the problem of OSD 63% (362 patients) compared to men 37%.  The highest percentage of tested patients was between 51 and 70 years old (48%). Patients underwent a complete ophthalmological examination, TBUT was performed in all of them. Based on TBUT, OSD was present in 383 patients or 70% of respondents, and TBUT shorter than 5 seconds was found in 82 patients, which makes up to 21.4% of those with a pathological finding of OSD.

CONCLUSION: Complications in the posterior segment of the eye are the cause of vision loss, which can be irreversible, and changes in the anterior segment can be the first indicator of the severity of diabetes. With this work, we wanted to point out that an increasing number of patients suffering from diabetes mellitus and having the OSD problem. Almost two-thirds of DMT2 patients have OSD of this respondents, even one in five patients has a very unstable tear film.