DRY EYE DISEASE AMONG DIABETES MELLITUS PATIENTS SEEN IN UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY, NIGERIA
To determine the incidence of dry eye disease and possible risk factors associated with dry eye disease among diabetes mellitus patients seen in the University of Benin Teaching Hospital Benin City Nigeria.
Material and Method
This is a hospital- based descriptive cross sectional study conducted at the Endocrinology and Eye clinic of the University of Benin Teaching Hospital, Benin City from 1st September to 31stDecember, 2015. One hundred and ninety (190) diabetics were enrolled into the study having met the inclusion criteria. These were both old and newly diagnosed patients attending the Endocrinology and Eye clinics.
Clinical data from each participant in the study was obtained using interviewer administered structured questionnaire and the Ocular Surface Disease Index questionnaire All the studypopulation had their visual acuity recorded using the Snellen’s chart. Slit lamp examination wasperformed with particular attention to the lid margin, bulbar, tarsal conjunctiva and cornea. Tear film break up time and Schirmer’s test were also done. Fundus examination was carried out in each patient to asses for diabetic retinopathy. This was statistically collated and analyzed with Statistical Package for Social Science (SPSS) 20. Descriptive statistics such as frequencies and proportions, tables, bar charts, pie charts and mean were used to summarize the data. Relationship between frequency, presence of dry eye disease and age, sex, fasting hyperglycaemia, duration of diabetes were assessed.
A total of 190 diabetic patients were recruited into the study. There were fifty three (53) males and 137 females with a male to female ratio of 1:3. The peak age group was 51-60 years age group. The mean age was 61.3 (± 10.3) years and range was 28-88 years.
Of the 190 diabetic subjects, 106 patients (55.8%) had dry eye disease. Grittiness was the most common ocular symptom, while discomfort when reading was the most common vision-related symptom. Windy condition was the most common environmental trigger.
Dry eye disease was more common in older patients. This association was significant (P=0.021). Dry eye disease was seen more among females compared to males. This association was not significant (P=0.425). Dry eye disease was also common among diabetics with longer duration of disease and elevated fasting blood sugar though this was not statistically significant (P =0.123) and (P=0.332) respectively.
Based on the Receiver Operating Characteristic curve, tear film break up time seems to be better in screening for dry eye disease using the Ocular Surface Disease Index Questionnaire as a comparator for the screening test.
Dry eye disease occurs in patients with diabetes mellitus with an increase in frequency as they get older. Tear film break up time was the better objective test in confirming the diagnosis of dry eye disease.