Evaluation of Tear Film Stability and Ocular Surface Alterations in Obese Individuals

Abstract

 To evaluate the tear film stability and ocular health in obese patients. This was a cross-sectional
observational study conducted over six months at Farooq Hospital, Lahore. A total of 120
diabetic patients aged 18 to 70 years were selected using purposive sampling. Participants were
categorized into three BMI groups: normal (18.5-24.9kg/m2), overweight (25-29.9 kg/m2), and
obese (≥30 kg/m2). Tear film quality was assessed through Schirmer’s test for tear production
and TBUT using fluorescein dye and slit-lamp biomicroscopy. Ocular discomfort was
evaluated using the OSDI questionnaire. All procedures were standardized and conducted by
trained personnel. P-value <0.05 was considered significant. Out of 120 diabetic participants,
38.33% were males and 61.67% females; 20% had type 1 and 80% had type 2 diabetes. Based
on BMI, 38% had normal weight, 41% were overweight, 41% were obese. Tear film stability
(TBUT) mean ranks: 94.39, 64.90, 24.68) and tear production (Schirmer’s mean rank 94.50,
65.61, 23.88) declined with increasing BMI. However, the Kruskal-Wallis test showed no
statistically significant difference in overall symptom score across BMI categories *H=0.211,
df=2, p=0.900) The differences between BMI groups were not statistically significant, tear film
function revealed a decreasing trend with increasing BMI indicating that overweight and obese
people may have lower tear stability and production.