Dry Eye and Diabetes: Connection, Causes, and Treatments
If you live with diabetes, you may well have experienced the painful, irritating, and lifestyle-affecting eye symptoms that can accompany this chronic condition.
It’s well-known that diabetes can contribute to retinal damage and cataracts. But did you know that more than half of all diabetes sufferers may also experience dry eye? And that this can lead to other eye problems?
Join us as we explain the links between the symptoms of diabetes and dry eye disease. We’ll also provide guidance on how to manage the effects of dry eye. You’ll learn these and other dry eye and diabetes facts and tips below.
Can diabetes cause dry eye disease?
According to a study from the American Diabetes Association, around 54% of people with diabetes experience symptoms of dry eye.
If you have diabetes and don’t take steps to control your blood sugar, your dry eye symptoms are likely to be severe.
Diabetes may contribute to two different types of dry eye:
- Evaporative: The tears evaporate from the surface of the eye before properly cleaning it.
- Tear-deficient: The ducts do not produce enough tears.
How does diabetes cause dry eye disease?
A 2016 review outlined that the mechanisms of diabetes leading to dry eye syndrome are still not totally clear. However, there are several ways the effects of chronically raised blood sugar levels can reduce tear production, creating a tight dry eye and diabetes link.
Dry eye disease is recognized as an issue with the lacrimal function unit (LFU). The LFU consists of several components in your eye that work together to preserve the surface of the eye and produce tears.
Diabetes can cause your blood to reach a state called hyperosmolarity. This means that blood glucose levels are too high, and the blood draws water from organs to dilute the glucose to normal levels.
If you have diabetes, your tear film and the surface of your eye may fall victim to hyperosmolarity, drying them out and contributing to the uncomfortable symptoms of dry eye.
Consistently raised blood glucose can cause nerve damage across the body. And with as many nerves as the eyes have, doctors think that damage to this area might have something to do with tear duct malfunction. This creates yet another link between dry eyes and diabetes.
The nerves in your eyes recognize and respond to irritation by triggering the tear ducts. If the nerves aren’t communicating with your tear ducts properly due to glucose-induced damage, you might start to notice that your eyes show signs of dry eye syndrome.
Abnormal enzyme and protein production
Different proteins and enzymes play a role in tear production and protecting the surface of the eye.
Enzymes like aldose reductase can interfere with how your tear ducts function, and the high glucose levels present in those with type 2 diabetes can trigger aldose reductase production. This can damage the structure of your tear-producing lacrimal glands.
As well as potentially spiking the levels of aldose reductase in your eye, chronically high blood sugar can also bring down the numbers of mucins. Those are proteins that cover the surface of your eye and provide protection from pathogens and irritants.
Can diabetes affect eyesight? Diabetes and dry eye disease in women
Diabetes and eyesight are closely linked.
While both males and females with diabetes may experience dry eye syndrome, women are 50% more likely to experience dry eyes during diabetes than men, according to a 2016 review. The risk of dry eye as a diabetes symptom also increases as you age.
When it comes to other diabetes eye problems, however, males and females with diabetes face similar risks.
Other diabetes vision problems include:
- Diabetic retinopathy: High blood sugar damages the nerves in the layer at the back of the eye a.k.a. the retina.
- Diabetic macular edema: Raised blood glucose causes swelling of the macula, an important part of the retina.
- Glaucoma: Diabetes can lead to glaucoma, which damages the optic nerve — a vital nerve that feeds all visual information to the brain.
- Cataracts: These cause clouding of the lens in the eye. While cataracts are often a byproduct of aging, diabetes can lead to an earlier age of onset.
- Blepharitis: There’s an association between inflammation of the eyelids (blepharitis) and diabetes, though most patients recover quickly with good blood sugar control.
- Blurred vision: Poor diabetes management or changing treatments can cause blurred vision from diabetes.
Common causes of dry eye syndrome
Diabetes and chronically raised blood sugar levels are far from the only causes of dry eye syndrome. Beyond dry eyes and diabetes, other causes include:
- Drops you may take for other eye conditions
- Living in excessively dry, smoky, or windy environments
- Spending too much time looking at a screen
- Wearing contact lenses
- Receiving LASIK eye surgery
- Changes in hormonal balance, especially around, during, and after menopause
- Eyelid conditions like entropion and ectropion
- Several medications that list dry eyes as a side effect, including those related to high blood pressure, allergies, sleeping, anxiety, depression, and heartburn
- Some other lifelong illnesses, including rheumatoid arthritis, thyroid disease, and lupus
Whatever the cause, specialized eye drops can help you improve your well-being by reducing dry eye’s irritating impact.
The best treatments for dry eye syndrome if you have diabetes
Type 2 diabetes is a chronic condition, meaning that ongoing treatment is necessary. Reversal is possible but unlikely with the current treatments available. You’ll have to manage symptoms as they arise while monitoring blood glucose after each meal.
If you have dry eyes and diabetes, it’s vital to have simple, accessible solutions on hand to keep your life comfortable as you help your body defend itself against diabetes’ more severe effects.
If you’re one of the many people who experience dry eye syndrome as a result of diabetes, Visionology’s powerful Klarity-C dry-eye drops can help you regain some level of comfort due to their moisturizing and anti-inflammatory effects.
Plus, you can have them delivered right to your door. They’re one of the best eye drops for diabetics, as they allow you to effectively reduce inflammation and soothe symptoms.
Other options include:
- Adding tears. You can use artificial tear solutions as often as you like to relieve mild presentations of dry eye. Some options are available over the counter, while other, stronger solutions are available via prescription.
- Conserving tears. The tear ducts aren’t only for producing tears — your tears also drain the same way. Sometimes, you may need to use small, removable, silicon or gel-based plugs to prevent tears from draining too quickly. Surgical interventions may also be used to permanently close the tear ducts and keep moisture in the eye.
- Increasing tear production. Your doctor might prescribe eye drops that improve tear production. Supplementing certain nutrients, like omega-3 fatty acids, might also help reduce discomfort from dry eyes with diabetes.
- Treating inflammation of the eyelid or surface of the eye. Dry eye increases the risk of inflammation in the eye and can also occur as a result. Your optometrist might prescribe anti-inflammatory eye drops like Klarity-C or other ointments, warm compresses, and eyelid cleaners.
Diabetes triggers a range of unwelcome effects across the body. Diabetes and vision changes are related, and over half of all people with the chronic condition may find that dry eye numbers among these effects.
Constantly raised blood sugar and nerve damage in the eye can affect how your tear ducts produce lubrication. This creates a strong dry eyes and diabetes link.
If dry eye regularly disrupts your quality of life as a result of diabetes, Visionology’s eye drops are a powerful, cost-effective, and accessible solution.
- Achtsidis, V., et al. (2014). Dry eye syndrome in subjects with diabetes and association with neuropathy https://care.diabetesjournals.org/content/37/10/e210
- Diabetic eye disease. (2017). https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-eye-disease#who
- Diabetic hyperglycemic hyperosmolar syndrome. (n.d.). https://medlineplus.gov/ency/article/000304.htm
- Dry eye. (n.d.). https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/dry-eye?sso=y
- Golden M., et al. (2021). Dry eye syndrome. https://www.ncbi.nlm.nih.gov/books/NBK470411/
- Hallberg, S., et al. (2019). Reversing type 2 diabetes: A narrative review of the evidence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520897/
- Vieira, G. (n.d.). All about “dry eye” with diabetes. https://beyondtype1.org/dry-eye-with-diabetes/
- Zhang, X., et al. (2016). Dry eye syndrome in patients with diabetes mellitus: Prevalence, etiology, and clinical characteristics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861815/