Authors : Rishita Bhatt; Niranjan Kumar

Volume/Issue : Volume 9 - 2024, Issue 10 - October

Google Scholar : https://tinyurl.com/mrx6s7dh

Scribd : https://tinyurl.com/y89w4j9y

DOI : https://doi.org/10.38124/ijisrt/IJISRT24OCT472

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Millions of people worldwide suffer from diabetes mellitus (DM), which can lead to systemic issues in a number of organs. Ocular problems, such as dry eye syndrome (DES), are among its less well-known side effects. This review delves into the interactions between diabetes and the composition of tear films, emphasizing alterations in the mucin, aqueous and lipid layer. Dry eye symptoms are exacerbated by induced changes in the components of the tear film in diabetes DM, which lead in decrement in tear production, increment in tear evaporation and tear film instability. Lipid layer is a lubricant, that reduces friction between the ocular surface and the eyelids which promotes high-quality, smooth refractive surface. The lacrimal function unit shields the tear film, preserves the normal function of the ocular surface. The mucin layer is secreted by the conjunctival goblet cells, in hyperglycemia the functionality of the cells are reduced thus, the mucin secretion is also altered which causes instability of the tear film. Diabetic patients can have their tear film integrity assessed with the help of diagnostic methods like Schirmer's Test and Tear Break- Up Time (TBUT). In order to relieve symptoms and maintain ocular health, there should be a complete management of diabetes and the induced tear film disorders.

Keywords : Diabetes Mellitus (DM), Dry Eye Syndrome (DES), Dry Eye (DE) Tear Film (TF), Meibomian Gland Dysfunction (MGD), Lacrimal Function Unit (LFU).

References :

1. Geberemeskel, G. A., Debebe, Y. G., & Nguse, N. A. (2019). Antidiabetic Effect of Fenugreek Seed Powder Solution (Trigonella foenum-graecum L.) on Hyperlipidemia in Diabetic Patients. Journal of diabetes research, 2019, 8507453. https://doi.org/10.1155/2019/8507453
2. Akbarzadeh, A., Norouzian, D., Mehrabi, M. R., Jamshidi, S.h, Farhangi, A., Verdi, A. A., Mofidian, S. M., & Rad, B. L. (2007). Induction of diabetes by Streptozotocin in rats. Indian journal of clinical biochemistry: IJCB, 22(2), 60–64. https://doi.org/10.1007/BF02913315
3. Kesarwani D, Rizvi SW, Khan AA, Amitava AK, Vasenwala SM, Siddiqui Z. Tear film and ocular surface dysfunction in diabetes mellitus in an Indian population. Indian J Ophthalmol 2017;65:301-4.
4. Dahal, Manish & Kaiti, Raju & Nepal, Sabina & Shyangbo, Ranjila & Dahal, Grishma & Ghimire, Rekha. (2020). Dry Eye Disease: A Comprehensive Review. Integrative Journal of Conference Proceedings. 2. 1-12. 10.31031/ICP.2020.02.000537.
5. L. Yu, X. Chen, G. Qin, H. Xie, and P. Lv, “Tear film function in type 2 diabetic patients with retinopathy,” Ophthalmologica, vol. 222, no. 4, pp. 284–291, 2008.
6. Eissa, Iman & Khalil, Noha & El-Gendy, Heba. (2016). A Controlled Study on the Correlation between Tear Film Volume and Tear Film Stability in Diabetic Patients. Journal of Ophthalmology. 2016. 1-5. 10.1155/2016/5465272.
7. Arya, Sudesh & Raj, Amit & Deswal, Jyoti. (2020). Tear film and corneal morphological changes in patients with Type II Diabetes Mellitus. International Journal of Medical Science and Innovative Research. 5. 394-402.
8. Javadi, Mohammad-Ali & Feizi, Sepehr. (2011). Dry Eye Syndrome. Journal of ophthalmic & vision research. 6. 192-8.
9. Andleeb, Ansa & Fatima, Alishba & Farrukh, Ayesha & Manzoor, Maryam. (2024). Tear Film Insbility in type 1 diabetics. Ophthalmology Pakistan. 14. 8-12. 10.62276/OphthalmolPak.14.01.127.
10. Chetty, Elizabeth & Gillan, W.. (2008). Reviewing the tear film’s lipid layer. African Vision and Eye Health. 68. 10.4102/aveh.v68i4.194.
11. Kopacz, Dorota & Niezgoda, Łucja & Sikorska, Ewa & Nowak, Anna & Maciejewicz, Piotr. (2020). Tear Film – Physiology and Disturbances in Various Diseases and Disorders. 10.5772/intechopen.94142
12. Lin, Xiaolei, Xu, Binbin, Zheng, Yuxi, Coursey, Terry G., Zhao, Yinying, Li, Junhua, Fu, Yana, Chen, Xuewen, Zhao, Yun-e, Meibomian Gland Dysfunction in Type 2 Diabetic Patients, Journal of Ophthalmology, 2017, 3047867, 7 pages, 2017. https://doi.org/10.1155/2017/3047867
13. Dogru, M., & Tsubota, K. (2012). Diabetes mellitus and dry eye syndrome: Overview and epidemiology. Experimental Diabetes Research, 2012, 1–7. https://doi.org/10.1155/2012/761302
14. Zeng, Xiaoyu & Lv, Ying & Gu, Zhongxiu & Jia, Zhe & Zhang, Chen & Lu, Xiaoxiao & Chu, Chenchen & Gao, Yichen & Nie, Yu & Wang, Yanxia & Zhang, Yan & Zhao, Shaozhen. (2019). The Effects of Diabetic Duration on Lacrimal Functional Unit in Patients with Type II Diabetes. Journal of Ophthalmology. 2019. 1-11. 10.1155/2019/8127515.
15. Torrent-Burgués, J.. (2023). Tear Film Constituents and Medicines for Eyes Investigated as Langmuir Films. BioNanoScience. 13. 1-15. 10.1007/s12668-023-01112-2.
16. Suryawanshi, A., et al. "Inflammation and dry eye disease: A paradigm shift in treatment approach." Eye and Vision, vol. 2, 2015, pp. 1-12.
17. Pflugfelder, S. C., et al. "Corneal epithelial barrier disruption in dry eye." The Ocular Surface, vol. 4, no. 3, 2006, pp. 207-212.
18. Martinez-Carrasco, R., Argüeso, P., & Fini, M. E. (2021). Membrane-associated mucins of the human ocular surface in health and disease. The ocular surface, 21, 313–330. https://doi.org/10.1016/j.jtos.2021.03.003
19. Yu, T., Shi, W. Y., Song, A. P., Gao, Y., Dang, G. F., & Ding, G. (2016). Changes of meibomian glands in patients with type 2 diabetes mellitus. International journal of ophthalmology, 9(12), 1740–1744. https://doi.org/10.18240/ijo.2016.12.06
20. 20.Sawy, Nada & Mahmoud, Doaa & Madbouly, Wafaa. (2019). Evaluation of Meibomian Glands Dysfunction in Type Two Diabetic Patients. The Egyptian Journal of Hospital Medicine. 77. 10.21608/ejhm.2019.47986.
21. Alanazi, Saud & Alomran, Abdullah & Abusharha, Ali & Fagehi, Raied & Al-Johani, Naji & El-Hiti, Gamal & Masmali, Ali. (2019). An assessment of the ocular tear film in patients with thyroid disorders. Clinical Ophthalmology. Volume 13. 1019-1026. 10.2147/OPTH.S210044.
22. Brott, Nathan & Zeppieri, Marco & Ronquillo, Yasmyne. (2024). Schirmer Test.
23. Naik, Kunj & Magdum, Renu & Ahuja, Amod & Kaul, Sucheta & S, Johnson & Mishra, Ashish & Dhore, Dr & Alapati, Aparna. (2022). Ocular Surface Diseases in Patients With Diabetes. Cureus. 14. 10.7759/cureus.23401.
24. Wu, Huping & Fang, Xie & Luo, Shunrong & Shang, Xumin & Xie, Zhiwen & Dong, Nuo & Xiao, Xianwen & Lin, Zhirong & Liu, Zuguo. (2022). Meibomian Glands and Tear Film Findings in Type 2 Diabetic Patients: A Cross-Sectional Study. Frontiers in Medicine. 9. 762493. 10.3389/fmed.2022.762493.
25. Abusharha, Ali & Alsaqr, Ali & Fagehi, Raied & Alobaid, Mohammad & Almayouf, Ali & Alajlan, Sulaiman & Omair, Mossab & Alahmad, Essa & Masmali, Ali. (2021). Evaluation of Tear Film Osmolarity Among Diabetic Patients Using a TearLab Osmometer. Clinical Optometry. Volume 13. 257-261. 10.2147/OPTO.S325768.
26. Viswanathan, Vrinda & Shetgar, Anupama & Patil, Brijesh & Kulkarni, K & S, Hamsa. (2020). Tear film changes in diabetic retinopathy: A hospital based case control study. Indian Journal of Clinical and Experimental Ophthalmology. 6. 252-255. 10.18231/j.ijceo.2020.054.
27. Goud, Rakesh & Aggarwal, Manvi & Radhakrishnan, O & Mantri, Priyanka & Shah, Arpit. (2020). Prevalence of dry eyes in patients with Type-2 diabetes mellitus. Indian Journal of Clinical and Experimental Ophthalmology. 6. 286-290. 10.18231/j.ijceo.2020.062.
28. Abusharha, Ali & El-Hiti, Gamal & Alsubaie, Mushawwat & Munshi, Abdulaziz & Alnasif, Ahmed & Fagehi, Raied & Alanazi, Mana & Masmali, Ali. (2022). Evaluation of Tear Evaporation Rate in Patients with Diabetes Using a Hand-Held Evaporimeter. Healthcare. 10. 104. 10.3390/healthcare10010104.
29. Vieira-Potter, Vicki & Karamichos, Dimitrios & Lee, Darren. (2016). Ocular Complications of Diabetes and Therapeutic Approaches. BioMed Research International. 2016. 1-14. 10.1155/2016/3801570.
30. Management and Therapy of Dry Eye Disease: Report of the Management and Therapy Subcommittee of the International Dry Eye WorkShop (2007). The Ocular Surface, 5(2), 163-178.
31. Rolando, M., & Barabino, S. (2005). Dry Eye and Inflammation: Role of the Ocular Surface and Lacrimal Gland. Eye and Contact Lens, 31(4), 133-139
32. Taj, Zafar & Zaidi, Kashaf & Ahmad, Farah. (2023). DRY EYES AND ASSOCIATED RISK FACTORS. 19. 974-83.
33. Cao, Xia & Yu, Huixin & Quan, Yu & Qin, Jing & Zhao, Yuhong & Yang, Xiaochun & Gao, Shanyan. (2024). An overview of environmental risk factors for type 2 diabetes research using network science tools. DIGITAL HEALTH. 10. 10.1177/20552076241271722.
34. Bhargava, R., Kumar, P., Phogat, H., Kaur, A., & Kumar, M. (2016). Oral Omega-3 Fatty Acids Treatment in Computer Vision Syndrome Related Dry Eye. Contact Lens and Anterior Eye, 39(1), 5-6.