Abstract
Objective: To determine prevalence and ocular findings of dry eye syndrome in adult diabetic patients at Kenyatta National Hospital (KNH) in Kenya.
Methods: A descriptive cross sectional study that was carried out among diabetic patients attending diabetic outpatient clinic and diabetic eye clinic at the KNH during October 2013-May 2014. All diabetic patients aged 18 years and over were requested to participate. Data on demographic profile, symptomatology, duration of diabetes and medication use of participants was documented. They were subsequently examined and underwent non-invasive tests to determine presence of dry eye syndrome (DES). Data collected was analyzed using the Statistical Package for Social Scientists (SPSS) version 21.0. Descriptive statistics such as frequencies, tables, mode, median and mean were used to summarize the data. Relationship between frequency, presence of dry eye syndrome and age, sex, duration of diabetes was assessed.
Results: Prevalence of DES was 49.8% (CI 0.001-0.568), was more common among females (M:F 1:2.2) and increased with age (p=0.001, peak age 56-65 years) and duration of diabetes (p=0.000454, peak duration after 15-19 years). There was significant association between DES and symptomatology (p<0.00001) , but not between DES and ocular signs (p=0.81) nor DES and TBUT (P=0.082) nor DES and Schirmer test (p=0.454).
Conclusion and recommendation: There is high prevalence of DES among diabetics. Greater emphasis should be placed on symptoms when making a diagnosis of DES.
References
Herrero-Vanrell R, Peral A. [International Dry Eye Workshop (DEWS). Update of the disease]. Archivos de la Sociedad Espanola de Oftalmologia. 2007; 82(12):733-734.
Sahai A, Malik P. Dry eye: Prevalence and attributable risk factors in a hospital-based population. Indian J Ophthalmol. 2005; 53(2):87-91.
De Roeth AF. Low flow of tears--the dry eye. Amer J Ophthalmol. 1952; 35(6):782-7.
Wenderlein M, Mattes S. The “dry eye” phenomenon and ovarian function. Study of 700 women pre- and postmenopausal. Zentralblatt fur Gynakologie. 1996;118(12):643-649.
Kumar PJ, Clark ML. Kumar & Clark clinical medicine. 6th ed. Edinburgh; New York: W.B. Saunders; 2005. xviii, pp 1508.
Johnson GJ, Minassian DC, Weale RA, West SK. The epidemiology of eye disease. 3rd edition 2012.
Seifart U, Strempel I. The dry eye and diabetes mellitus. Der Ophthalmologe. Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 1994; 91(2):235-9.
Moss SE, Klein R, Klein BE. Prevalence of and risk factors for dry eye syndrome. Arch Ophthalmol. 2000; 118(9):1264-8.
Alves Mde C, Carvalheira JB, Modulo CM, Rocha EM. Tear film and ocular surface changes in diabetes mellitus. Arquivos brasileiros de oftalmologia. 2008; 71(6 Suppl):96-103.
Miljanovic B, Dana R, Sullivan DA, Schaumberg DA. Impact of dry eye syndrome on vision-related quality of life. Amer J Ophthalmol. 2007; 143(3):409-15.
Labbé A, Wang YX, Jie Y, Baudouin C, Jonas JB, Xu L. Dry eye disease, dry eye symptoms and depression: The Beijing Eye Study. Brit J Ophthalmol. 2013; 97(11):1399-403.
Lee AJ, Lee J, Saw SM, Gazzard G, Koh D, Widjaja D, et al. Prevalence and risk factors associated with dry eye symptoms: a population based study in Indonesia. Brit J Ophthalmol. 2002; 86(12):1347-51.
Bandeen-Roche K, Munoz B, Tielsch JM, West SK, Schein OD. Self-reported assessment of dry eye in a population-based setting. Invest Ophthalmol Visual Sci. 1997; 38(12):2469-75.
Manaviat MR, Rashidi M, Afkhami-Ardekani M, Shoja MR. Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients. BMC Ophthalmol. 2008; 8:10.
Kaiserman I, Kaiserman N, Nakar S, Vinker S. Dry eye in diabetic patients. Amer J Ophthalmol. 2005; 139(3):498-503.
Journal of Ophthalmology of Eastern Central and Southern Africa December 2015 68 Journal of Ophthalmology of Eastern Central and Southern Africa December 2015 December 16. Najafi L, Malek M, Valojerdi AE, Aghili R, Khamseh ME, Fallah AE, et al. Dry eye and its correlation to diabetes microvascular complications in people with type 2 diabetes mellitus. J Diabetes Complications. 2013; 27(5):459-462.
McCarty CA, Bansal AK, Livingston PM, Stanislavsky YL, Taylor HR. The epidemiology of dry eye in Melbourne, Australia. Ophthalmology. 1998; 105(6):1114-9.
Parkar A. The prevalence of dry eye syndrome among Kenyan African patients aged forty years and above in Nairobi, Kenya: MMed thesis, University of Nairobi; 1998.
American Academy of Ophthalmology. External disease and cornea. San Francisco, Calif.: American Academy of Ophthalmology; 2011. xvi, pp. 512.
Schaumberg DA, Dana R, Buring JE, Sullivan DA. Prevalence of dry eye disease among us men: Estimates from the physicians; health studies. Archives Ophthalmol. 2009;127(6):763-768.
Chia E-M, Mitchell P, Rochtchina E, Lee AJ, Maroun R, Wang JJ. Prevalence and associations of dry eye syndrome in an older population: the Blue Mountains Eye Study. Clin Exper Ophthalmol. 2003; 31(3):229-232.
Begley CG, Chalmers RL, Abetz L, Venkataraman K, Mertzanis P, Caffery BA, et al. The relationship between habitual patient-reported symptoms and clinical signs among patients with dry eye of varying severity. Invest Ophthalmol Visual Sci. 2003; 44(11):4753-61.
Schein OD, Muñoz B, Tielsch JM, Bandeen-Roche K, West S. Prevalence of dry eye among the elderly. Amer J Ophthalmol. 1997; 124(6):723-728.
Schein OD, Tielsch JM, Muñoz B, Bandeen-Roche K, West S. Relation between signs and symptoms of dry eye in the elderly: A population-based perspective. Ophthalmology. 1997; 104(9):1395-401.
Nichols KK, Nichols JJ, MPH M, Mitchell GL. The lack of association between signs and symptoms in patients with dry eye disease. Cornea. 2004; 23(8):762-770.