The prevalence of dry eye disease among patients with diabetes in Malawi: A hospital based study

Background: The prevalence of dry eye disease (DED) recorded among patients with diabetes varies with no information in Malawi. 

Objective: To assess the prevalence of DED among patients with diabetes in Malawi. 

Methods: Type 2 diabetes mellitus (DM) patients visiting the diabetic clinic in the outpatient department of Mzuzu Central Hospital between November 2020 and February 2021 were subject to a descriptive hospital-based cross-sectional survey. Two clinical tests—Tear break-up time (TBUT) and “Schirmer’s test 1”—were used in dry eye test. 

Results: A total of 87 DM patients with a mean duration of DM as 5.75 ± 5.04 and ranging from 1 to 19 years were involved in this study. All the participants were known diabetic patients, with the majority (66.7%) of the patients having poorly controlled sugar levels within the past 3 months, whilst 36.8% had good glycosylated haemoglobin levels. The mainstay of treatment was metformin and glibenclamide. The prevalence of DED was 65.5% (95% CI: 54.6 – 75.4). There was a significant association between glycosylated haemoglobin, the Schirmer test, and the TBUT (p < 0.05), as determined by a Chi-square test. DED was found to be significantly associated with age and the duration of diabetes (p < 0.05); however, after adjusting for significant confounders, neither variable remained associated with DED. There was no significant association between DED and sex or medication use (p > 0.05). 

Conclusion: This study observed a high prevalence of dry eye disease among the study participants. Although age and duration of diabetes showed significant crude associations with DED, these relationships were not sustained after adjusting for confounding variables. These findings emphasize the importance of routine DED screening in patients with diabetes.