Purpose:　To　investigate　changes　in　cytokine　levels　in　tears　of　type　2　diabetics　with　or　without　retinopathy.　Methods:　Tears　were　collected　from　15　type　2　diabetics　without　retinopathy　(DNR),　15　patients　with　retinopathy　(DR),　and　15　age　and　gender　matched　non-diabetic　controls.　Tear　concentrations　of　27　cytokines　were　measured　by　multiplex　bead　immunoassay.　Cytokine　differences　between　groups,　ratios　of　type-1　T　helper　(Th1)/type-2　T　helper　(Th2)　cytokines　and　anti-angiogenic/pro-angiogenic　cytokines　were　analyzed　statistically.　Results:　The　most　abundant　cytokine　detected　in　tears　was　interferon-induced　protein-10　(IP-10).　In　comparison　with　controls,　IP-10　and　monocyte　chemoattracant　protein-1　(MCP-1)　levels　were　significantly　elevated　in　DR　(p=0.016　and　0.036,　respectively)　and　DNR　groups　(p=0.021　and　0.026,　respectively).　Interleukin-1　(IL-1)　receptor　antagonist　(IL-1ra)　levels　were　significantly　increased　in　DNR　(p=0.016).　Th1/Th2　cytokines　interferon-gamma　(IFN-gamma)/IL-5　and　IL-2/IL-5　ratios　were　significantly　increased　in　DR　compared　to　controls　(p=0.037　and　0.031,　respectively).　Anti-angiogenic/angiogenic　cytokines　IFN-gamma/MCP-1　and　IL-4/MCP-1　ratios　in　DR　and　DNR　were　significantly　decreased　compared　to　controls　(p＜0.05).　IL-4/IL-8　and　IL-12p70/IL-8　ratios　were　also　significantly　decreased　in　DR　compared　to　controls　(p=0.02　and　0.045,　respectively).　No　significant　correlation　was　demonstrated　between　tear　cytokine　concentrations　and　glycosylated　hemoglobin　(HbA1c)　or　fasting　plasma　glucose　(FPG).　Conclusions:　Diabetic　tears　exhibited　elevated　levels　of　IP-10　and　MCP-1.　The　Th1/Th2　cytokine　balance　may　shift　to　a　predominantly　Th1　state　in　DR　patients.　Pro-angiogenic　cytokines　are　more　highly　represented　than　anti-angiogenic　cytokines　in　the　tears　of　diabetic　patients.