Comparative study of tear film evaluation among healthy pregnant women and gestational diabetes: a cross-sectional study

Jayakumar Antony Cruse, Samuel Livingstone Kumaran, Tamilselvan Pachiyappan


Background: Diabetes mellitus (DM) is one of the risk factors for dry eye. This study aimed to estimate the characteristics of tear film by measuring the tear secretion, tear evaporation rate, conjunctival impression cytology and also ocular surface disease index (OSDI) scoring through a questionnaire for gestational diabetes mellitus (GDM) and healthy pregnant women (HPW).

Methods: Total of 40 subjects which included 20 subjects who were HPW in group-1 and 20 subjects who were GDM in group-2. After examining their ocular status, the subjects were initially administered with OSDI questionnaire followed by dry eye evaluation procedures such as non-invasive tear breakup time (NIBUT), Schirmer’s 1 and 2, tear film break up time (TBUT) and conjunctival impression cytology (CIC).

Results: The gathered data was checked for normality. Mean and standard deviation was compiled for each parameter for their respective groups. A statistical comparison with independent t test was performed between the groups which compared OSDI scores, NIBUT, Schirmer’s 1 and 2, TBUT and CIC for both HPW and GDM group women. Statistically significant difference (p<0.01) was observed with OSDI scores, Schirmer's test 2, TBUT and NIBUT whereas Schirmer's test 1 and CIC were not statistically significant (p>0.01). OSDI scores represented mild symptoms for GDM women.

Conclusions: Tear film of GDM women was affected more than HPW suggesting evaporative dry eye. Assessing tear film as a part of routine eye examination for women with GDM is essential to avoid the occurrence of complications due to tear film abnormalities.


Gestational diabetes mellitus, Pregnant women, Dry eye, Tear film

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