While prior studies have focused on tear cytokines in diabetic retinopathy (29, 30), our study identified elevated tear cytokines (IL-6, CXCL8, IL-15, CCL5, and VEGF) in diabetic patients without diagnosed retinopathy, persisting after controlling for age, hypertension, and dyslipidemia. This evidence concerns the gene CCL5 and hypertensive disorder.