DM is often associated with increased oxidative stress and free radical production,23, 24 which may damage epithelial tissues such as the conjunctiva and the lachrymal glands. As the tear film is rich in several antioxidants such as ascorbic acid (vitamin C), found in high concentrations in the eye, Peponis et al24 demonstrated that orally administered antioxidant supplements for a period of 10 days improved the tear film stability and secretion, and the antioxidant properties of vitamins C and E could protect the ocular surface from the attack of free radicals and preserve the integrity of the epithelium. These proteins were not observed in healthy subjects and could be decisive therefore in the pathogenesis of DM and the development of eye related complications of diabetic disease.26.
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