Abstract
Aim
To evaluate blinking patterns in patients with diabetes mellitus and whether blinking contributes to the formation of superficial punctate keratopathy in diabetic patients.
Methods
We examined 163 patients with type II diabetes mellitus and 76 without diabetes. Blinks were recorded, analysed using six parameters, and compared between patients with and without diabetes. Multivariate regression analysis was performed to assess the influence of other ocular factors, such as status of tear lipid layer, tear breakup time, corneal sensitivity, the result of cotton thread test, or blinking rate related to superficial punctate keratopathy.
Results
In patients with diabetes, the average mean and maximum interblinking times were longer, the average coefficient of variation of interblinking time was higher, and the average blinking rates were lower than those in patients without diabetes. Multivariate regression analysis revealed that the status of tear lipid layer and tear breakup time were significantly relevant to superficial punctate keratopathy (P<0.01).
Conclusion
Interblinking time was longer in diabetic patients, resulting in a decreased blinking rate. The prevalence of superficial punctate keratopathy cannot be predicted from blinking patterns in patients with diabetes.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Herse PR . A review of manifestations of diabetes mellitus in the anterior eye and cornea. Am J Optom & Physiol Optics 1988; 65: 224–230.
Saini JS, Khandalavla B . Corneal epithelial fragility in diabetes mellitus. Can J Ophthalmol 1995; 30: 142–146.
Hatchell DL, Magolan JJ Jr, Besson MJ, Goldman AI, Pederson HJ, Schultz KJ . Damage to the epithelial basement membrane in the corneas of diabetic rabbits. Arch Ophthalmol 1983; 101: 469–471.
Schultz RO, Van Horn PL, Peters MA, Klewin KM, Schutten WH . Diabetic keratopathy. Trans Am Ophthalmol Soc 1981; 79: 180–199.
Inoue K, Kato S, Ohara C, Numaga J, Amano S, Oshika T . Ocular and systemic factors relevant to diabetic keratoepitheliopathy. Cornea 2001; 20: 798–801.
Miyata K, Sawa M, Nishida T, Mishima H, Miyamoto Y, Otori T . Classification of severity of superficial punctate keratitis. Jpn J Clin Ophthalmol (in Japanese) 1994; 48: 183–188.
Yokoi N, Takehisa Y, Kinoshita S . Correlation of tear lipid layer interference patterns with the diagnosis and severity of dry eye. Am J Ophthalmol 1996; 122: 818–824.
Tsubota K, Hata S, Okusawa Y, Egami F, Ohtsuki T, Nakamori K . Quantitative videographic analysis of blinking in normal subjects and patients with dry eye. Arch Ophthalmol 1996; 114: 715–720.
Sakamoto R, Bennett ES, Henry VA, Paragina S, Narumi T, Izumi Y et al. The phenol red thread tear test: A cross-cultural study. Invest Ophthalmol Vis Sci 1993; 34: 3510–3514.
Paschides CA, Kitsios G . Evaluation of tear break-up time, Schirmer's 1 test and rose bengal staining as confirmatory tests for keratoconjunctivitis sicca. Clin Exp Rheumatol 1989; 7: 155–157.
Cochet P, Bonnet R . L'esthesiometrie corneenne: realisation et interet pratique. Bull Soc Ophthalmol Fr 1961; 61: 541–550.
Al-Abdulmunem M . Relation between tear break-up time and spontaneous blink rate. Int Contact Lens Clin 1999; 26: 117–120.
Karson CN, Burns RS, LeWitt PA, Calne DB, Wyatt RJ . Blink rates and disorders of movement. Neurology 1984; 34: 677–678.
Kleinman JE, Karson CN, Weinberger DR, Freed WJ, Berman KF, Wyatt RJ . Eye-blinking and cerebral ventricular size in chronic schizophrenic patients. Am J Psychiatry 1984; 141: 1430–1432.
Kojima M, Shioiri T, Hosoki T, Sakai M, Bando T, Someya T . Blink rate variability in patients with panic disorder: new trial using audiovisual stimulation. Psychiatry Clin Neurosci 2002; 56: 545–549.
Dogru M, Katakami C, Inoue M . Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus. Ophthalmology 2001; 108: 586–592.
Collins M, Seeto R, Campbell L, Ross M . Blinking and corneal sensitivity. Acta Ophthalmol 1989; 67: 525–531.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Inoue, K., Okugawa, K., Amano, S. et al. Blinking and superficial punctate keratopathy in patients with diabetes mellitus. Eye 19, 418–421 (2005). https://doi.org/10.1038/sj.eye.6701497
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.eye.6701497
Keywords
This article is cited by
-
Analysis of risk factors for dry eye disease and effect of diquafosol sodium ophthalmic solution on the tear film after vitrectomy in patients with type 2 diabetes mellitus: a preliminary study
International Ophthalmology (2022)
-
Prevalence and clinical characteristics of dry eye disease in community-based type 2 diabetic patients: the Beixinjing eye study
BMC Ophthalmology (2018)
