Dry eye disease in diabetics versus non-diabetics: Associating dry eye severity with diabetic retinopathy and corneal nerve sensitivity

PURPOSE: To compare the prevalence of dry eye disease (DED) and assess corneal nerve sensitivity (CNS) in diabetic and non-diabetic patients. To study the association of severity of DED in patients with diabetic retinopathy (DR) and CNS in DED. METHODS: A cross-sectional prospective comparative study was conducted on 400 patients attending the ophthalmology OPD. The patients above 18 years of age were divided into two groups—diabetic (T2DM) and non-diabetic. All patients were subjectively assessed for DED based on Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and objectively, using Schirmer’s II test and Tear Film Break-Up Time (TBUT). Visual acuity assessment, anterior segment, and posterior segment evaluation were done. RESULTS: Considering the SPEED score, Schirmer II values, TBUT values, and Dry Eye Work Shop (DEWS) II diagnostic criteria, mild DED was seen in 23% diabetic and 22.25% non-diabetic groups, moderate DED in 45.75% diabetic and 9.75% non-diabetic groups, and severe DED in 2% diabetic and 1.75% non-diabetic groups. Moderate DED was more common within all grades of DR. CNS was reduced more in diabetic group and also in patients with higher degree of DED. CONCLUSION: Prevalence of DED is more in the patients with T2DM. CNS was reduced more in patients with T2DM and in patients with moderate DED. Our study also correlated that severity of DR affects the severity of DED.