Diabetes and dry eye
Monday, March 24, 2014
In a multi-specialty practice like BayCare’s Green Bay Eye Clinic, we see more than our share of diabetic eye disease. We are all too aware of the threat of diabetic retinopathy and how it affects small blood vessels in the eye, contributing to swelling and bleeding in the back of the eyes, glaucoma, and cataract formation and, in some cases, permanent blindness.
A less spoken complication of diabetic eye disease is how it contributes to dry eye disease. According to the American Diabetic Association, diabetics have a higher incidence of dry eyes. One theory for increased dry eye in diabetics may be that fluctuations in insulin levels cause inflammation of the blood vessels that supply the glands producing the tear film.
Your tear film is comprised of three layers. The outer layer is an “oily layer” to help prevent evaporation. The middle “water layer” supplies oxygen, moisture and nutrients to nourish the cornea. The inner layer is comprised of a sticky, mucinous layer, which promotes the even spread of the tear film over the cornea. Inflammation of any of the glands or cells producing one of these three layers can result in a deficit in production of that layer. Consequently, loss of the upper oily layer allows for faster evaporation; loss of the watery layer merely allows “smearing,” just as your windshield wipers would smear the dirt if there wasn’t enough washer fluid; and loss of the mucinous layer prevents tears from being distributed evenly, causing “dry patches”.
Dry eye disease can cause burning, red and sore eyes along with excessive “reflex” tearing. Treatment of dry eye disease starts with a thorough evaluation by your eye care professional, regular use of quality artificial tear supplements and, in some cases, a prescription for Cyclosporine Ophthalmic Emulsion (i.e. Restasis), which can help increase your eyes’ natural ability to produce tears.