Diabetic corneal alterations are frequent but underdiagnosed complications of both type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes. Corneal alterations include:
- Delayed wound healing of the surface cell layer (epithelial cell layer)
- Edema (swelling)
- Recurrent erosions (wearing away) of the corneal layers
- Neuropathy/loss of sensitivity of the corneal surface
- Tear film changes
The disease affects corneal epithelium (surface layer cells) and corneal nerves. Clinically observed corneal diabetic alterations include increased corneal thickness, epithelial defects ( surface layer cells that do not function properly), epithelial fragility and recurrent erosions, ulcers, edema, superficial punctate keratitis (small areas of cell death on the surface of the cornea, this can cause the eyes to become red, watering, and sensitive to light), delayed and incomplete wound repair, endothelial changes, and neuropathy exemplified by reduced corneal sensitivity 2.