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Characterization of Dry Eye Disease in Diabetic Patients Versus Nondiabetic Patients

Beckman, Kenneth A. MD

doi: 10.1097/ICO.0000000000000163
Basic Investigation

Purpose: The purpose of this investigation was to assess the presence and relative severity of dry eye evaluated by a panel of diagnostic methods in diabetic patients as compared with that in nondiabetic patients.

Methods: Patients (≥40 years of age) scheduled for a routine eye examination at the clinical site were recruited for the study. Exclusion criteria included current use of topical medication for glaucoma or prior ocular surgery if the patient was within the postoperative recovery period (3 months). Study endpoints included tear film break-up time, tear film osmolarity, corneal fluorescein and conjunctival lissamine green staining, Schirmer strip testing, Ocular Surface Disease Index questionnaire, and Dry Eye International Task Force severity ranking.

Results: Sixty-three patients were enrolled in this study, 38 in the diabetic group and 25 in the nondiabetic group. All enrolled patients scored at least a 1 on the International Task Force ranking scale. A significantly higher mean tear film osmolarity was observed in the nondiabetic patient group, 312 versus 303 mOsm/L (P = 0.02). The mean conjunctival staining scores were significantly higher in the diabetic patient group, 2.72 versus 2.11 (P = 0.034). No statistically significant differences were observed between patient groups for corneal staining, tear film break-up time, Schirmer strip, or Ocular Surface Disease Index scores.

Conclusions: The overall presence and severity of dry eye was found to be similar in the diabetic and nondiabetic patient groups. However, significant differences were observed between groups with regard to individual diagnostic assessments (lissamine green staining and tear film osmolarity).

Comprehensive Eye Care of Central Ohio, Westerville, OH; and The Ohio State University Department of Ophthalmology, Columbus, OH.

Reprints: Kenneth A. Beckman, MD, Comprehensive Eye Care of Central Ohio, 450 Alkyre Run Drive, #100, Westerville, OH 43082 (e-mail:

K. A. Beckman, Consultant to Allergan, Bausch & Lomb Incorporated, and TearLab.

Supported by Allergan via an independent and unrestricted research grant. Allergan had the opportunity to review the final version of the paper to address any factual inaccuracies or request the redaction of information deemed to be proprietary or confidential and ensure that study support was disclosed.

Received January 07, 2014

Accepted April 22, 2014

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.