Ocular Complications in Children with Type 1 Diabetes Mellitus in Al-Diwaniyah Province: Case Control Study

Abstract

Background: Ocular manifestations are common complications seen in children with type 1 diabetes several years after the onset of diabetes mellitus. Disturbed visual acuity, visual field defects, corneal dryness, raised intraocular pressure, cataract and retinal complications have been recognized in patients with type 1 diabetes; however, the exact frequency of these complications in Al-Diwaniyah province is still not very well established.

Aim of the study: To assess the ocular manifestation in patient with type 1 diabetes mellitus in Al-Diwaniyah province, in comparison with non-diabetic children.

Patients and methods: Data used in this study was collected using a case control study on 75 patients with type 1 DM who attended the diabetes specialist center. They were examined by an ophthalmologist in the Ophthalmology clinic department in Al-Diwaniyah teaching hospital. Those are compared with 75 apparently healthy children who attended the consultation clinic and emergency unit of Maternity and Children Teaching Hospital. The study has started from the 1st of September 2018 till the end of September 2019.

Results: Assessment visual acuity in patients with type 1 diabetes mellitus and control subjects revealed that 58 (77.3 %) of patients had normal visual acuity and that 59 (78.7 %) of control subjects had normal visual acuity. Abnormal visual acuity were identified in 17 (22.7 %) of patients and in 16 (21.3 %) of control subjects and the difference was statistically insignificant (P = 0.844). Abnormal Schirmer’s test with dry eye was seen in 11 (14.7 %) of patients and in 3 (4.0 %) of control subjects (P = 0.025). Abnormal findings upon fundoscopic examination were identified in 2 (2.7 %) of patients in comparison with none of control subjects (P = 0.499). Intraocular pressure (IOP) was abnormally high in 8 (10.7 %) of patients in comparison with 1 (1.3 %) of control subjects; the difference was significant (P = 0.034). Visual field defect were identified in 2(2.7) of patients in comparison with 1 (1.3 %) of control subjects with no statistical significant difference (P = 1.000).

Conclusion: eye dryness and raised intraocular pressure were the main ocular complications in type 1 diabetes mellitus and long standing diabetes with poor control are the main risk factors for development of retinopathy in diabetic children.