The Hidden Burden of Diabetes: Investigating the Link between Dry Eye Disease and Diabetic Retinopathy with its Severity

BACKGROUND: To determine the prevalence of dry eye disease (DED) in diabetic patients and its association with the duration and severity of diabetic retinopathy (DR). METHODS: A tertiary care hospital-based study was conducted on both eyes of 200 diabetic patients attending the Ophthalmology Outpatient Department from December 2019 to July 2021. Detailed ocular examination along with tear function tests (Schirmer's test, tear break-up time), ocular surface staining with fluorescein for DED grading was performed. DR was graded using the early treatment DR study classification, and its associated factors were analyzed. RESULTS: The prevalence of DED was 23% among diabetic patients. The duration of diabetes mellitus was found to have a significant association with DED (P < 0.05). Patients with disease duration of more than 10 years had 14.33 times the risk of having DED. The presence of proliferative DR (PDR) was also found to be significantly associated with DED (P < 0.05). Severe non-PDR (NPDR) and PDR were found to be a significantly higher prevalence of DED than mild-to-moderate NPDR. CONCLUSION: DED is a prevalent ocular complication in diabetic patients, particularly those with longer disease duration and with DR. Regular ocular examinations, including DED assessment, are crucial for early detection and management of this ocular complication in diabetic patients, to provide better quality of vision.