Dry Eye Syndrome and Diabetes: What to Know

This content originally appeared on Diatribe. It was reissued with permission.

by Amelia Harnish

It is estimated that over half of diabetics have dry eyes. Here are some reasons why it is important to recognize the symptoms of dry eye and receive appropriate treatment:

Do your eyes bother you? 54% of diabetics struggle with what is known as dry eye. Dryness, redness, pricks, or sensitive eye symptoms can appear less than a major deal compared to other types of diabetes-related eye diseases, such as glaucoma and retinopathy.

However, it is important to take dry eyes seriously, as chronic dry eyes can damage your vision without treatment.

“Chronic dryness and inflammation can increase the risk of eye infections, corneal damage and vision problems,” said Dr. William Hoag, an ophthalmologist at VRMNY in New York. “Long-term dry eyes can also affect quality of life, causing discomfort and difficulty in carrying out daily activities that rely on clear vision.”

What is Dry Eye Syndrome?

Healthy eyes are wet eyes. The human eye constantly produces tears from the duct in the corner of the eye. These tears are made of water, oil and mucus that cover your eyes, so you can see clearly. Not only that, tears also contain enzymes, signaling molecules, and metabolites that are essential for maintaining the health of the eye surface.

Dry eye syndrome is exactly how it sounds. These important liquid shortages. Dry eyes means your eyes aren’t properly tearing. Essentially, if there is a malfunction somewhere in a complicated mechanism and the eyes continue to function – even if it’s just a blink rate, you can get dry eye.

Why diabetes puts you at risk of dry eye

“One of the main reasons why diabetes leads to dry eye is that high blood sugar levels can damage small blood vessels that nourish the nerves and tissues of the eye,” Hogue said. “This can lead to neurological dysfunction, including those that cause tear production. This can reduce tear production and lead to imbalances in tear composition.”

Diabetes also affect what is called the Maybomb glands of the eyelids. This produces an oily layer that helps prevent tear evaporation. If your glands can’t keep up, your eyes will feel dry. Diabetes can also cause inflammation of the eyes, which can cause further destruction and further evaporation of this protective oily membrane.

It is important to note that not all people with diabetes develop dry eyes, as they do not develop other diabetic complications. Other factors can increase the risk of dry eye, such as:

• Environmental factors (living in a dry climate, etc.)
• Wearing contact lenses
• There is another condition (for example, rheumatoid arthritis)
• Take certain medications, such as antidepressants and blood pressure medications

Symptoms of dry eye

It is important to know the symptoms of dry eye. This will allow you to talk to a healthcare professional about your treatment. Symptoms of dry eye include:

• Red eyes
• Burning or stab wounds
• The rough feeling in my eyes
• Increased mucus around the eyes
• Blurred vision or difficult to read
• Increased or abnormal stimulation from wind or smoke
• Discomfort or pain from using contact lenses
• Overwatering the eyes (this may be caused by the eyes trying to compensate for poor quality tears)

Prevention and treatment

The good news is that there are so many things you can do to protect your eyes. If you notice symptoms of dry eye, it is important to mention an endocrinologist or ophthalmologist. Early treatment can help reduce the long-term outcome of dry eye.

The best thing diabetics can do to reduce the risk of eye complications is to keep blood glucose levels within the target range. For some, this may completely resolve the symptoms and complications of dry eye without further treatment.

In general, treatment for dry eyes can include artificial tears or anti-inflammatory eye drops that encourage glands to produce tear components, Hogue said. Warm compression and keeping eyelids away from debris can also help to improve symptoms.

“Applying warm compression to the eyes can interfere with and improve the function of the Maybomb gland,” added Hogue.

Treatment of dry eye syndrome depends not only on severity but also on other risk factors. Ophthalmologists can help develop treatment plans that protect your eyes while navigating other risk factors (for example, if you are taking blood pressure medication).

Why it’s important to take dry eyes seriously

For mild or moderate dry eyes, symptoms are irritating, but are unlikely to cause harm to your vision. However, if it is severe and untreated, dry eyes can lead to corneal scars and ulcers. Damage to the cornea can easily restore your vision. Early diagnosis and treatment to prevent these complications is important.

Furthermore, dry eyes in diabetic patients are associated with diabetic retinopathy (DR). DR is caused by damage to blood vessels that provide nutrition to specialized cells in the retina.

In one study, the researchers observed that approximately 45% of participants with diabetes and dry eye had early stage DR signs, and 25% had late stage DR signs. This suggests that these two diabetic complications may be linked.

Getting your eye test every year is important to everyone, but it is especially important for people with diabetes.

“If dry eye symptoms persist or worsen, it is essential to consult an eye care professional for proper assessment and treatment,” Hogue said.