Frequency and risk factors of non-retinopathy ocular conditions in people with diabetes: the Singapore Malay Eye Study

Diabet Med. 2013 Feb;30(2):e32-40. doi: 10.1111/dme.12053.


Aim: To investigate the frequency and risk factors of non-retinopathy ocular conditions in persons with diabetes.

Methods: A population-based cross-sectional study of 3176 Malay persons aged between 40 and 79 years in Singapore was conducted. Cataract, glaucoma, refractive errors, age-related macular degeneration, dry eye, epiretinal membrane, ocular hypertension and retinal conditions were assessed based on standardized interviews, clinical examinations and laboratory investigations.

Results: A total of 768 participants (24.2%) had diabetes. People with diabetes were more likely to have cortical cataract (52.1 vs. 37.3%, P < 0.001), ocular hypertension (10.9 vs. 7.4%, P = 0.002) and epiretinal membrane (17.2 vs. 10.1%, P < 0.001) compared with those without diabetes. The odds of having cortical cataract (odds ratio 1.63, 95% CI 1.20-2.20) and epiretinal membrane (among those with previous cataract surgery: odds ratio 1.63, 95% CI 1.20-2.20) were significantly higher in people with diabetes compared with those without. The population attributable risks for cortical cataract and epiretinal membrane because of diabetes were 8.7 and 9.0%, respectively. In persons with diabetes, hypertension and high cholesterol were the major risk factors associated with non-retinopathy eye complications such as ocular hypertension (odds ratio 1.18, 95% CI 1.04-1.33) and retinal emboli (odds ratio 1.99, 95% CI 1.05-3.80).

Conclusion: Our results allow clinicians to better inform patients with diabetes that they are more likely to have cortical cataract and epiretinal membranes (those with previous cataract surgery) in addition to diabetic retinopathy. Two modifiable risk factors-blood pressure and cholesterol associated with ocular hypertension and retinal emboli, respectively-are also risk factors for non-retinopathy ocular conditions in persons with diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism*
  • Body Mass Index
  • Cataract / blood
  • Cataract / epidemiology*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Dry Eye Syndromes / blood
  • Dry Eye Syndromes / epidemiology*
  • Female
  • Glaucoma / blood
  • Glaucoma / epidemiology*
  • Humans
  • Macular Degeneration / blood
  • Macular Degeneration / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Retinal Diseases / blood
  • Retinal Diseases / epidemiology*
  • Risk Factors
  • Singapore / epidemiology
  • Surveys and Questionnaires


  • Blood Glucose