Effect of obesity on tear film and ocular health among diabetic patients

Abstract

Purpose: To evaluate the effect of obesity on tear film and ocular health in diabetic patients.

Methodology: This was a cross-sectional observational study conducted over six months at Alvi Hospital & Maternity Home Hospital, Lahore. A total of 120 diabetic patients aged 18 to 70 years were selected using purposive sampling. The contestantswere divided into three BMI groups: normal (18.5-24.9kg/m2), overweight (25-29.9 kg/m2), and obese (≥30 kg/m2). Only individuals with confirmed type 1 or type 2 diabetes and stable glycemic control (HbA1c recorded) were included. Tear film quality was examined through Schirmer's test for tear production and TBUT using fluorescein dye and slit-lamp biomicroscopy. Ocular sensitivity was measured using the OSDI questionnaire. P-value <0.05 was considered significant.

Results: Among 120 diabetic participants, 38.33% were males, 61.67% females; 20% had type 1, 80% had type 2 diabetes.  27.5% had normal weight, 36.67% were overweight, and 35.83% were obese. The most frequently reported ocular symptoms were dry eyes (40.8% sometimes), gritty sensation (40.8% sometimes), and blurred vision (48.3% sometimes). A significant negative correlation was found between BMI and TBUT (r=-0.992, p<0.001), BMI and Schirmer test (r=-0.990, p<0.001), indicating reduced tear stability and production with higher BMI. Kruskal-Wallis test showed significantly lower mean ranks of TBUT and Schirmer scores in obese participants compared to normal BMI, p< 0.001.

Conclusion: Diabetes patients with higher BMI had considerably worse tear film characteristics, which emphasizes how crucial weight control is to maintaining the health of the ocular surface.