Diabetic Eye Diseases: Glaucoma

Retinopathy -- Glaucoma -- Cataract --

Glaucoma is one of the diabetic eye diseases that leads to visual impairment in children suffering from diabetes. It steals the vision gradually, often without any preceding symptoms. In absence of regular eye checkups of diabetic children, its detection can therefore be unduly delayed. Delayed sub-optimal management of diabetic eye disease poses potential risk for blindness in teenagers and youths. On the other hand, early detection and optimal treatment can prevent its progression, and thereby blindness.

Development of glaucoma in diabetics

Abnormal growth of retinal blood vessels, as seen in proliferative diabetic retinopathy, can also encroach over the anterior portion of the eye, where lies the drainage channels of aqueous humor.

Aqueous humor is the thin watery clear fluid.
It is constantly produced by the ciliary body of the eye. It fills the space around the lens, and provides essential nutrition to cornea and the lens. To make space for fresh nutrient rich aqueous fluid, the fluid is constantly circulated out of the eye through the trabecular mesh-work lying in the angles of anterior chamber of the eye.

Blockage of the trabecular mesh-work by growth of abnormal blood vessels leads to excessive accumulation of aqueous humor in the eye ball. Trapped fluid generates high pressure within the eye: Glaucoma, yet one more form of diabetic eye diseases.

High intra-ocular pressure further compromises retinal blood flow, damages the nerve fibers that run through retina, compresses the head of the optic nerve and causes vision impairment.

Besides the congenital variety, glaucoma is considered to be rare among children, teenagers and youths. But childhood diabetes increases the risk by many folds; about 1 in 5 diabetic children show early signs of glaucoma on regular eye checkups. Prompt efficient management can stop its progression and prevent visual impairment.

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Can appropriate blood sugar maintenance prevent diabetic eye diseases?

Optimal insulin supplementation is the key for optimal glucose utilization and prevention of metabolic imbalance. Glucose utilization in the body fluctuates with intensity of physical activity incurred.
In diabetics, because of deficient endogenous insulin, blood sugar fluctuation is a common feature. Nevertheless, its rise and dips should be diligently avoided.
Swift swings in blood sugar levels can alter the lens curvatures and cause blurring of vision. This does get rectified over about 3 months period if the fasting blood sugar is brought back to target range of 80 to 130 mg/dl and is maintained there.
Diligent blood sugar maintenance does not substitute evaluation by an ophthalmologist, but only compliments prevention of diabetes associated complications.
Closer the blood sugar levels are maintained to normal more are the chances of minimizing diabetic eye diseases and other child health complications.
Yet all variants of diabetic eye diseases are known to occur in spite of maintaining appropriate blood sugar levels.

Therefore, regular eye check ups including dilated eye examination are crucial for prevention of visual impairment in diabetic children.

Signs that indicate prompt ophthalmologic evaluation

The signs that indicate immediate evaluation by an ophthalmologist are usually mistaken for children's excuses for being non compliant: An insect is troubling me or I can't see clearly. - These are not teenage pranks, but the warning signs that children do not know to express adequately.

Do not ignore the signs of vision defects: