According to the charity Diabetes UK there are an estimated 5.6 million people with diabetes in the UK, this includes those with a formal diagnosis and over a million more who are yet to be diagnosed. The data shows that incident levels are on the increase and predicted to continue rising.
Put simply diabetes is a disease which affects your ability to metabolise sugar in the body. The blood sugar level is controlled by the hormone insulin, produced in your pancreas insulin allows sugar to move from your blood into your cells where it is needed. Diabetes sufferers are either not able to produce insulin, do not produce enough insulin or their cells do not react to the insulin that is being made.
In all cases, if left untreated you will end up with a higher-than-normal blood sugar level. This can be the cause of damage to vital body organs such as the nerves, kidneys, heart – and your eyes. Diabetes has been identified as a leading causes of dry eye disease with studies indicating up to 50% of those with diabetes being affected by dry eye too.
Your health care professional will help make sure that your diabetes symptoms are effectively managed and it is vital this care routine is followed correctly. If you are also experiencing dry eye Dry Eye Zone has information about the condition and its’ management, most importantly you need to seek the advice of an eye care professional.
How are your eyes affected by diabetes?
Blurred vision can be an early sign of diabetes. This is one of the reasons regular eye examinations are so important for your general health as your eye care professional can be the first one to pick-up on signs that not all is well.
The higher sugar levels in the blood can result in damage to the nerves associated with tear production and also alter the fluid concentrations in the eye – both these are linked with impaired tear and meibomian gland function which are causes of dry eye disease.
Common dry eye symptoms reported by those with diabetes
Dry eye symptoms are wide ranging with people describing their symptoms in different ways but essentially they are feelings of irritation. Reported symptoms include loss of visual quality, sensitivity to light, gritty sensations, soreness and itchiness. One study reported grittiness as the most common symptom.
In more severe cases damage to the cornea, conjunctiva, and inflammation have been reported.
How do you manage diabetes associated dry eye?
There is no difference in the treatment of dry eye caused by diabetes compared to dry eye resulting from other underlying causes – your eye care professionals’ recommendations will be the same.
For immediate symptom relief dry eye drops will be recommended. Not all eye drops are suitable for dry eye and information on what to look for is provided by Dry Eye Zone. Dry eye drops are formulated to rebalance the concentration of your tears to help stop dry eye inflammatory responses.
Because diabetes is linked with a loss of meibomian gland function heat therapy may be a longer-term solution, along with a thorough eyelid cleansing routine. If left untreated the meibomian glands will start to waste away (atrophy) and be permanently lost. Without these tiny glands dry eye symptoms will become far more severe. A leading ophthalmology journal published the results of a 2023 study that compared the loss of meibomian glands in groups with dry eye alone and those with dry eye and diabetes. The combination of both conditions produced the most significant loss in function, which indicated the impact diabetes makes on the health of these glands.
Getting expert advice from an eye care professional is essential for the best outcomes for the management of any dry eye symptoms.
Diabetic medications
Diabetes compromises the ocular environment in several ways. Firstly, the condition itself and secondly some of the medications prescribed may also contribute to the level of dry eye. Add to this the correlation between both dry eye, diabetes and aging and you can see it can be a challenge to manage the dry eye symptoms experienced by diabetic patients.
Metformin is a commonly used drug to help manage blood sugar levels. Dry eye symptoms were reported by diabetic patients using this drug – the symptoms were more prevalent than in diabetics who were not using metformin.
Other eye problems caused by diabetes
Dry eye is not the only ocular problem associated with diabetes. Diabetic retinopathy and glaucoma, both of which can result in permanent loss of vision, occur as a result of high blood sugar levels damaging the nerves and blood vessels in the eye.
To prevent dry eye progressing and other ocular problems it is essential the advice from your health care providers is followed to keep blood sugar levels under control.
You can find more information about dry eye and its management at Dry Eye Zone.
And don’t forget to visit Dry Eye Zone and subscribe to the regular free information updates.
If you are experiencing dry eye symptoms then you should ask the advice of your eye care professional. Do not leave things untreated as symptoms may progress. Why not book your next eye examination with an independent optician today.
Sources:
Diabetes UK. How many people in the UK have diabetes? https://www.diabetes.org.uk/about-us/about-the-charity/our-strategy/statistics
Zhang X, Zhao L, Deng S, Sun X, Wang N. Dry Eye Syndrome in Patients with Diabetes Mellitus: Prevalence, Etiology, and Clinical Characteristics. J Ophthalmol. 2016;2016:8201053. doi: 10.1155/2016/8201053. Epub 2016 Apr 26. PMID: 27213053; PMCID: PMC4861815.
Medical News Today. How do dry eyes relate to diabetes. Medically reviewed by DWilliam C Lloyd III, MD, FACS — Written by Mathieu Rees — Updated on September 20, 2023. https://www.medicalnewstoday.com/articles/diabetes-and-dry-eyes
Guo Y, Zhang H, Zhao Z, Luo X, Zhang M, Bu J, Liang M, Wu H, Yu J, He H, Zong R, Chen Y, Liu Z, Li W. Hyperglycemia Induces Meibomian Gland Dysfunction. Invest Ophthalmol Vis Sci. 2022 Jan 3;63(1):30. doi: 10.1167/iovs.63.1.30. PMID: 35072689; PMCID: PMC8802017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8802017/
Yang Q, Liu L, Li J, Yan H, Cai H, Sheng M, Li B. Evaluation of meibomian gland dysfunction in type 2 diabetes with dry eye disease: a non-randomized controlled trial. BMC Ophthalmol. 2023 Jan 31;23(1):44. doi: 10.1186/s12886-023-02795-7. PMID: 36721131; PMCID: PMC9887780.
Sandra Johanna GP, et al. Correlation between type 2 diabetes, dry eye and Meibomian gland dysfunction. J Optom. (2019), https://doi.org/10.1016/j.optom.2019.02.003
Gabriela Roncholeta De Freitas, Giovana Aparecida Moura Ferraz, Marcelo Gehlen, Thelma L. Skare,
Dry eyes in patients with diabetes mellitus, Primary Care Diabetes, Volume 15, Issue 1, 2021, Pages 184-186, ISSN 1751-9918, https://doi.org/10.1016/j.pcd.2020.01.011.
Igor Kaiserman, Nadia Kaiserman, Sasson Nakar, Shlomo Vinker, Dry eye in diabetic patients, American Journal of Ophthalmology, Volume 139, Issue 3, 2005, Pages 498-503, ISSN 0002-9394, https://doi.org/10.1016/j.ajo.2004.10.022.
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