The Clinical Observation Of Ocular Surface In Diabetic Patients

Background and Purpose:The normal ocular surface structure and function are the prerequisite for the clarity of vision.The health of ocular surface depends on the stability of the tear film and the integrity of the ocular surface epithelium.Any disorders of tear quality and quantity can result in tear film instability with potential damage to the ocular surface,and cause symptoms of ocular discomfort such as foreign body sensation,dryness,blurred vision and other eye discomfort.As we all know,diabetes can cause many ocular surface disorders such as eyelid,conjunctiva,cornea and so on.The present study was designed to observe the ocular surface of diabetic patients through comparing the results between the diabetic patients and healthy volunteers.Methods:Thirty patients with diabetes mellitus,diagnosed according to the World Health Organization diabetes diagnostic criteria,were enrolled to the diabetes group.Thirty healthy volunteers were enrolled to the control group.The eyelid,conjunctiva,cornea and other ocular surface organization were checked by the slit lamp microscope.Ocular surface disease index(OSDI)questionnaire,recognized as the evaluation index for the severity of ocular surface disease internationally,were used to evaluate the ocular symptoms.The tear meniscus height,tear break-up time(TBUT),corneal fluorescein staining(CFS)and the meibomian glands were assessed by the Keratograph Ocular surface analyzer.Corneal surface regular index(SRI)under the natural opening state and 10 seconds after the continuous eye opening were detected by the corneal topography instrument.Schirmer I test(SIt)was conducted to express the amount of tear.The results were recorded and analyzed statistically.All subjects accepted the examinations and signed the informed consent form voluntarily,and the same examination was performed by the same inspector in the same conditions.Results:Some diabetic patients had different degrees of eye burning,foreign body sensation,dryness,irritation,asthenopia,blurred vision or other discomfort symptoms.Less cases had above symptoms in the control group,and the degree of discomfort was much lower.OSDI was higher in diabetes group,and the difference between the control and diabetes group was statistically significant(P<0.01).Both the quality and quantity of tear were abnormal in diabetic patients.The results of tear meniscus height,TBUT and SIt were less in the diabetes group,and the differences between the two groups were statistically significant(P<0.01).Compared with the control group,diabetic patients had obvious corneal epithelium defect and fluorescein staining.The CFS score and corneal SRI(natural opening state and 10 seconds after the continuous eye opening)were higher than the results of healthy volunteers,and the differences were statistically significant(P<0.05).There was no statistically significant difference in meibomian gland deficiency between the diabetes and the control group(P>0.05).Conclusion:Diabetes could decrease the tear film stability,which caused damage to the ocular surface and was associated with symptoms of ocular discomfort.