Why is dry eye common in diabetes patients?
Some studies report dry eye in more than 50% of diabetic patients. People with dry experience discomfort, grittiness, sensitivity to light, redness and a foreign body sensation of the eyes. Sometimes vision becomes blurry. One of the most common causes of dry eye disease is blepharitis (infection and/or inflammation of the eyelids). This is very common in diabetic patients.
Causes of dry eye in people living with diabetes
Hyperglycaemia and insulin resistance can result in neuropathy. The corneal nerves can be affected by long-term diabetes and this may, via the trigeminal nerve and facial nerves, affect the way the lacrimal gland produces tears. This may result in dry eye.
Neurotrophic (insensitive) corneas often result from diabetes. This nerve damage interrupts normal tear development pathways.
Insulin also has a role in tear production.
Inflammation releases certain chemicals, called cytokines, in the body. These chemicals can also damage tear producing cells in the conjunctiva and lacrimal gland.
Sequelae of dry eye
Apart from the frustration of suffering from dry eye, people living with diabetes have a higher incidence of corneal ulceration. This is due to the lack of protection to the eye by a normal tear film, increased blepharitis incidence (a source of bacteria) and insensitivity of the cornea.
Treating your dry eye
- Eyelid hygiene to clear blepharitis. A good eyelid cleanser, preferably with tea tree is advisable.
- Topical lubricant eye drops and lubricant ointments at night.
- Visit your eye doctor annually.
- The inflammation of your eyes may require additional treatment and extra measures with cortisone eye drops or ointments.
- You may even require lacrimal plugs to be inserted.
- Check your HbA1c and blood pressure regularly via your doctor.
- Follow a good diet consisting of protein, vegetables, especially leafy greens, and oily fish like salmon and mackerel.
- Exercise regularly. Walk 20 minutes daily.
- Take Omega 3 supplements.
Article published in Diabetes South Africa