Abstract
M.Phil. (Optometry)
Keratoconjunctivitis Sicca is a common disorder usually characterised by
disturbances to the tear film which affects a significant percentage of the population. Dry eye
disease develops when there is a dysfunction of one or more components of the integrated
lacrimal system and this system can no longer maintain a stable tear film. This disruption of
the tear film affects the ocular surface of the eye and as a result affects the quality of life of
dry eye disease sufferers.
Research has revealed that individuals with Diabetes Mellitus (DM) experience
greater, or more severe, symptoms of dry eye disease and a positive correlation has been
evident between higher blood sugar levels and dry eye disease. The presence of dry eye
disease symptoms in DM subjects has been documented, however, there has not been
sufficient research performed on both subtypes of DM namely: Type 1 and Type 2 DM.
There is also a lack of extensive investigation on the osmolarity of the tears in diabetic
individuals. Tear osmolarity measurements are characterised as being a reliable and objective
measurement in the diagnosis of dry eye disease as well as a diagnostic tool used to evaluate
the severity of dry eye.
The aim of this study was to determine if there was a significantly greater correlation
present between Keratoconjuncitivis Sicca signs and symptoms in DM subjects compared to
controls. A secondary aim was to evaluate if there was a significant difference between Type
1 and Type 2 diabetics and their correlation to Keratoconjuncitivis Sicca. The third objective
was to determine if there was any correlation between the various tests used to assess the
signs of Keratoconjunctivitis Sicca and the symptoms reported. This study made use of a
subjective test, the Ocular Surface Disease Index (OSDI) questionnaire, to evaluate the
symptoms of dry eye disease experienced by individuals. The Keratograph was utilised to
measure tear break-up times non-invasively (NITBUT), tear osmolarity was measured using
the TearLab System and a slitlamp was used to measure tear-break up times subjectively
(TBUT).
The study comprised of 38 subjects, of which 20 were control subjects and 18 were
diabetic subjects. The diabetic subjects were further divided into 6 Type 1 diabetics and 12
Type 2 diabetics. This study compared diabetics to controls as well as Type 1 diabetics to
Type 2 diabetics. The results of this study can be summarised as follows:..