Abstract : This study analyzes how Type 2 Diabetes Mellitus (T2DM) affects Meibomian Gland Dysfunction (MGD) and its relationship to an ocular surface disease index (OSDI), Tear Film Break-Up Time (TBUT), and Schirmer I test which are common indicators of dry eye syndrome. A prospective, case-control study was carried out at Lattakia University Hospital, Syria, from February 2024 to February 2025. 200 participants were recruited in total: 100 T2DM patients and 100 matched controls. All participants underwent a complete ophthalmologic assessment which comprised OSDI, TBUT, Schirmer I test, and infrared meibography with Sirius Topographer. For analysis, data were processed statistically with SPSS v20 and p < 0.05 was set as the significance threshold. The TBUT scored lower for diabetic patients (mean 8.45 ± 3.2 seconds) compared to healthy controls (mean 13.4 ± 4.6 seconds; p < 0.05). Schirmer I test was abnormal in 160 eyes (84 patients) with diabetes. There was greater Meibomian gland dropout in the diabetic group as noted on infrared meibography (Figure 1, Table 4). While OSDI scores did not exhibit significant differences (p > 0.05), diabetics did show more marked structural and functional changes. T2DM appears to be a considerable risk for the development of MGD which leads to evaporative dry eye. The application of infrared meibography will allow for the non-invasive assessment of diabetic patients for early pathological changes within the Meibomian glands.