Impact of Diabetes on Vision in Children

Diabetes is a condition characterized by insufficient or inefficient insulin production. Insulin is a hormone that allows cells in the body to take in glucose (sugar) from the bloodstream and use it as a source of energy. It helps keep blood sugar levels stable and prevents them from becoming too high (hyperglycemia) or too low (hypoglycemia). Though commonly associated with adults, children as well as adolescents can also develop diabetes. Since diabetes is a chronic metabolic disorder characterized by high blood sugar levels, it can affect many systems in the body and have significant implications on a child’s overall health.

Children can be affected by two types of diabetes
• Type 1 Diabetes – also known as juvenile diabetes or insulin-dependent diabetes is a chronic autoimmune condition where the body’s immune system mistakenly attacks the insulin-producing cells in the pancreas. This results in little to no insulin production, leading to problems with glucose control and high blood sugar levels. Although it can occur at any age, type 1 diabetes is typically diagnosed in childhood or early adolescence between the ages of 4 and 14. Symptoms of juvenile diabetes include unusual thirst, frequent urination (particularly at night), extreme hunger, fatigue, weight loss, slow wound healing, mood changes, and blurry vision.

• Type 2 Diabetes – In this type, the body becomes resistant to the effects of insulin, or there is insufficient insulin production. While type 2 diabetes was traditionally associated with adults, in recent years, the prevalence of type 2 diabetes in children has increased due to changes in lifestyle and unhealthy dietary habits. It has become more common in overweight or obese children who have a family history of the condition and lead a sedentary lifestyle. Symptoms of type-2 diabetes include increased thirst, frequent urination, persistent hunger, fatigue or sleepiness, unexplained weight loss or weight gain, slow healing of wounds, darkened skin patches (in the neck, armpits, or other body folds), and blurred vision or difficulty focusing.
If you suspect your child may have diabetes, it is crucial to consult a healthcare professional for proper diagnosis and management.

Young diabetics are at greater risk of vision problems
If your child has been diagnosed with diabetes, it is important to know that diabetes can affect your child’s eyes and his or her vision, particularly if the condition is poorly controlled and blood sugar levels are consistently high over an extended period. High blood sugar levels can significantly affect the delicate structures of the eye and lead to several eye conditions and vision complications. An earlier onset of diabetes such as juvenile diabetes (Type-1 diabetes) among children is of major concern as their body is exposed to insulin resistance and hyperglycemia for a longer time.
Children with diabetes may have an increased risk of developing the following eye problems:
• Diabetic Retinopathy – a serious complication of diabetes, where high blood sugar levels damage the tiny blood vessels inside the retina, causing them to bleed or leak fluid. This can lead to vision complications such as blurred vision, floaters, and trouble perceiving colour. In severe cases, abnormal blood vessel growth can occur, potentially leading to retinal detachment and vision loss. In children with diabetes, this condition can progress more rapidly compared to adults. Studies have shown that the prevalence of diabetes-related vision problems such as diabetic retinopathy is higher and more severe in young diabetics with a longer duration of diabetes (over 10 years).

• Blurred Vision – Fluctuating blood sugar levels or rapid changes in blood glucose can cause temporary changes in the lens of the eye, leading to changes in its focusing ability. This can cause temporary blurry vision in children with diabetes. Balancing the blood sugar level with proper diabetes management can restore normal vision.

• Cataracts – Children with diabetes may be at a higher risk of developing cataracts compared to their peers without diabetes. Cataracts refer to the clouding of the eye’s natural lens, leading to blurry or hazy vision, sensitivity to light, and decreased night vision. Diabetes-related cataracts can occur at a younger age and progress more rapidly in children.

• Glaucoma – Diabetes can increase the risk of developing glaucoma in both children and adults. Glaucoma is a condition characterized by damage to the optic nerve, often due to increased pressure within the eye. It can lead to permanent and irreversible vision loss if left untreated. Children with diabetes should be regularly screened for glaucoma to ensure early detection and appropriate management.

• Optic Nerve Abnormalities – Diabetes can also affect the optic nerve, which is responsible for transmitting visual information from the retina to the brain. Optic nerve abnormalities can result in vision problems such as reduced visual acuity, poor colour vision, or visual field defects. Regular eye examinations are essential to monitor the health of the optic nerve in children with diabetes.
Early detection and timely intervention are vital in managing diabetes-related eye complications and preventing long-term vision loss. Treatment is directed toward managing the amount of sugar in the blood using insulin (injections or tablets), along with diet and lifestyle modifications to prevent complications.

Conclusion – Since children with diabetes are at increased risk of eye and vision problems, parents should work closely with healthcare professionals to ensure proper diabetes management and prioritize their child’s eye health. Maintaining good blood sugar control and regular eye examinations by an ophthalmologist experienced in paediatric eye care can safeguard the long-term vision of children living with diabetes.

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