Effect Of Diabetes Mellitus On Ocular Surface

Objective: To investigate the correlation of the duration, severity and grade of diabetic retinopathy (DR) with the changes of ocular surface in diabetic patients. Methods: One hundred and two eyes of fifty one patients with non insulin - dependent diabetes mellitus as well as forty eyes of twenty healthy subjects underwent examinations including tear film break-up time(BUT) and Schirmer -I test , fluorescein vital staining( FL) , and conjunctival impression cytologic analysis (CIC) . The grades of DR in patients were also evaluated with fluorescein angiography. Results: The mean BUT and Schirmer - I test in the diabeticpatients was ignificantly lower than that in the control subjects ( P<0.01) . The average grade of squamous metaplasia and the average score of FL were significantly higher and the mean goblet cell density was significantly lower in diabetic patients than that of control subjects ( P < 0. 01) . The BUT value , Schirmer - I test value , the grade of conjunctival squamous metaplasia , the conjunctival goblet cell density and the score of FL were significantly related to the control condition of diabetes (P <0.05), and no significant correlation with duration of diabetes mellitus and the grade of DR(P>0.05). Conclusions: Diabetes mellitus would damage ocular suface, including tear filmfunction and keratoconjunctival epithelium, and the extent of damage is closely related to the control condition of diabetes. Non-insulin dependent diabetics are susceptible persons of the dry eye.