Abstract
Purpose: The objective was to quantitate the loss of corneal sensitivity in patients with diabetic peripheral neuropathy and to determine if it correlates with the stage of DM.
Materials and Methods: This is a cross sectional analytical study of all diabetic patients attending the Indian Institute of Diabetes, Trivandrum, outpatient clinic (Jan 2011-‐Jun 2012). After detailed medical history and general examination FBS, PPBS and HBA1c were done. Patients underwent a slit lamp examination after which corneal sensitivity was measured using Cochet-Bonnet esthesiometer. The readings were taken at five different points on the cornea (at centre, 12o'clock, 3o'clock, 6o'clock and 9o'clock) and was repeated three times. The average of all the readings in mm was noted. DPN was assessed by a neurologist using Modified Neuropathy Disability Score. A dilated fundus examination was done to assess the grade of retinopathy. All statistical analysis was performed using SPSS for windows. Pearson’s correlation was estimated to explore the functional measures of neuropathy, age, duration of diabetes and HbA1c.
Results: Corneal sensitivity was absent, mild, moderate and severe in 26.9%, 20.9%, 31.3% and 20.9% of diabetic patients. Neuropathy was absent in 10.4%. There was a significant correlation between duration of diabetes and the decrease in corneal sensation. A strong negative correlation existed between the severity of peripheral neuropathy and reduction in corneal sensation.
Conclusion: Loss of corneal sensation occurring in diabetic patients is easily quantifiable and correlates with neuropathy and progresses with the severity of neuropathy. These findings have important clinical implications regarding the development of corneal abnormalities in diabetic patients and also raise the possibility that corneal sensation could be used to screen for diabetic neuropathy.
Keywords: Corneal sensitivity, Diabetic peripheral neuropathy, Cochet-Bonnet esthesiometer.
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Corresponding Author
Dr V. Sahasranamam
Director, Regional Institute of Ophthalmology, Thiruvananthapuram, 695035, India
Phone Number: +91-9846020421, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.70
