Table 1

Ocular surface changes associated with obesity, prediabetes and diabetes

Ocular structureObesityPrediabetesDiabetes
Corneal endotheliumNRNRDecreased cell density
Increased pleomorphism
Increasd polymegathism)
Increase in auto-fluorescence
Corneal stroma (thickness)Increased thicknessNRIncreased thickness
Increased stiffness (hysteresis)
Corneal nerve and DCsNRDecreased subbasal nerve densityDecreased subbasal nerve density
Decreased mechanical, thermal and chemical sensitivity
Increased DC density in the central cornea
Corneal epitheliumNRNRIncreased risk of neurotrophic keratitis and ulceration
Increased number and persistence of defects
Decreased wound healing
Decreased basal and wing cell density
Thickened basement membrane
ConjunctivaIncreased cell metaplasia
Decreased goblet cell density
Increased cell metaplasia
Decreased goblet cell density
Increased cell metaplasia
Decreased goblet cell density
Increased hyperemia
Increased conjunctival microvasculopathy
Eyelids and Meibomian glandsNRNRIncreased Meibomian gland dysfunction
Increased blepharitis
Ocular surface microbiomeNRNRIncreased risk of acute bacterial conjunctivitis
Increased levels of positive bacterial culture
Increased bacterial diversity
Tear function and eye symptomsNRNRDecreased tear volume
Decreased tear break-up time
Increased osmolarity
Increased symptoms of dry eye and discomfort
  • DC, dendritic cells; NR, not reported.