Health, diabetes and dry eye: campaign highlights low awareness of the problem

The experience gathered during the campaign ‘If you have diabetes, open your eyes to dry eyes’, conceived by Alcon in collaboration with Fand, the Italian Diabetics Association Odv – which took place between February and April 2024 in the cities of Milan, Rome and Bari – highlights not only what has been recorded by other research on the possible relationship between diabetes and dry eyes, but also the low awareness of the complication.

Diabetes mellitus – we read in a note – is one of the most widespread chronic diseases in the world, which leads to various complications, including eye problems. Among these, dry eye disease is one of the most common conditions, characterized by symptoms such as dryness, irritation, foreign body sensation and visual disturbances that can significantly affect the quality of life. A recent meta-analysis that collected data from several scientific publications between 2000 and 2018 – 4 studies for a total of 2,504,794 people – suggests a possible relationship between diabetes and the risk of developing dry eye, with an increase in 30% risk in diabetic patients compared to non-diabetic ones. This would be due to several factors, including diabetic corneal neuropathy, a damage caused by diabetes to the peripheral nerve fibers, which leads to the release of neuromediators, i.e. mediators of inflammation, and which produces chronic inflammation of the ocular surface.

In detail, the campaign involved the ophthalmologist at the Fand centers with the aim of raising awareness among patients about the importance of eye health and the risk of developing dry eye disease due to diabetes. 46 patients were involved over the course of three days in Milan, Rome and Bari. Most had type 1 and type 2 diabetes and presented symptoms of dry eye. Furthermore, a lack of knowledge about this pathology emerged, despite periodic eye examinations. The campaign therefore underlines the importance of comprehensively evaluating diabetic patients, considering the possibility of secondary pathologies that can affect their quality of life such as eye health. “Speaking about eye health in a more general sense, prevention for diabetic patients is fundamental – says Emilio Augusto Benini, president of Fand – Unfortunately, despite the fact that the impact that diabetes can have on eyesight is well-known, to date there is still little awareness among patients. Only 30-40% of diabetics go to one of the 600 specialized diabetes centers in our country, meaning that a significant number of people are not followed in a specialized way. This creates information gaps that, if properly managed, could make the difference, as this campaign has highlighted”.

A multidisciplinary approach is essential in the management of patients with diabetes, the note continues. The ophthalmologist plays an essential role not only in treating eye conditions associated with diabetes, such as dry eye, but also in the effective monitoring and management of these conditions. This integrated strategy improves the quality of care and helps prevent more serious complications, ensuring that every aspect of the patient’s health is treated appropriately

“Ocular discomfort increases with increasing glycemic imbalance and the number of years of disease – underlines Antonio Di Zazzo, associate professor of Visual System Diseases at the Fondazione Policlinico Universitario Campus Bio-Medico in Rome – It is important not to underestimate ocular discomfort in patients with diabetes, as it could represent an indicator of more significant neuropathic damage. Once the presence of dry eye has been detected, it is essential to intervene with specific eye drops based on hyaluronic acid or Hp-guar (hydroxypropylguar) or carboxymethylcellulose to restore the structure of the tear film, in addition to constantly monitoring and effectively managing glycemic imbalance”.

The ‘If you have diabetes, open your eyes to dry eyes’ campaign responded to a need for information, as demonstrated by the strong appreciation of the population, confirming that supporting awareness initiatives is the right path. It is essential for diabetic patients to keep their eyesight under control to intercept any signals in time and intervene promptly, thus ensuring better management of the pathology and a better quality of life.