Type 2 Diabetes and Chronic Dry Eye

Reviewed by: HU Medical Review Board

Diabetes has been identified as a risk factor for dry eye syndrome (DES). In fact, it has been reported that more than half of those with type 2 diabetes may have symptoms of chronic dry eye. Dry eye symptoms can significantly impact overall quality of life due to pain and vision changes.1

What is type 2 diabetes?

Type 2 diabetes is a condition that is caused by high blood glucose (sugar). Blood glucose comes from the foods you eat, and it is your main source of energy. Your body makes insulin, a hormone created in the pancreas, to help move glucose from the bloodstream into your cells so it can be used for energy.2

In people with type 2 diabetes, the body works hard to release enough insulin to keep blood glucose levels down. Eventually, the body cannot make enough insulin to keep up. Since there is not enough insulin to move glucose into your cells, as well as the inability of cells to respond to insulin, it stays in the blood instead. Over time, this extra glucose in your blood causes a variety of health problems.2

Who gets chronic dry eye?

Chronic dry eye is especially common in those with type 2 diabetes who have peripheral neuropathy. Peripheral neuropathy occurs as a result of damage to the nerves outside the brain and spinal cord. These nerves are known as the peripheral nerves. Peripheral neuropathy is a common complication of diabetes.3

Peripheral neuropathy may decrease the sensations felt on the surface of the eye. This decreases the dry eye symptoms a person feels. Even though a person may not feel the symptoms, the damage on the surface of the eye is still happening. This can be devastating to the overall health of the eye and may lead to infection or vision loss.1-3

High blood sugar levels from type 2 diabetes may also lead to a decrease in tear production, too many tears lost from the eyes, abnormalities in blinking, and changes in the overall make-up of the tears.1


Treatment for dry eye disease from type 2 diabetes is not much different than treatment in those without diabetes. The first step of treatment is to identify the cause of dry eye. Control and management of blood sugar levels is the main treatment goal. Early screening and treatment may help to prevent long-term complications and vision loss.4

Successful management of dry eye disease means slowing the progression of the disease and improving comfort. This is not always easy, since dry eye disease can have multiple causes and can be hard to manage.4

The overall goal of treatment for chronic dry eye is to improve or maintain the normal amount and quality of tears on the surface of the eye. This decreases dryness and the overall discomfort related to chronic dry eyes.4

Artificial tears, regenerative or steroid eye drops, diet, and nutrition may all be used to treat symptoms of dry eye in those with type 2 diabetes.4

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