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Transient refractive changes during glycemic control in a newly-diagnosed diabetic patient

Poster Details

First Author: T.Lalias GREECE

Co Author(s):    E. Kanonidou              

Abstract Details

Purpose:

In some patients with diabetes mellitus and elevated glucose levels, a transient change in their refraction during the glycemic control is observed. We present a case of a newly diagnosed diabetic patient who developed temporarily hyperopia and evaluate the course and characteristics of the refractive change.

Setting:

Department of Ophthalmology, 212 Military Hospital of Xanthi, Xanthi, Greece.

Methods:

A 48 year old male was newly diagnosed with diabetes mellitus type 2. The glucose values were 400-450mg/dl in successive measurements and glycosylated hemoglobin (HbA1c) was 9.2%. Immediate treatment with anti-diabetic medication per os was initiated in order to restore normal glucose levels. His ophthalmological history was clear.

Results:

The ophthalmological findings five days after treatment initiation were: Distance visual acuity 10/10 (unaided)/near visual acuity J1 (+1,50sph) bilaterally. Anterior segment and intraocular pressure were normal. Fundoscopy revealved no abnormal findings. The patient returned complaining of sudden reduction of his visual acuity on the sixth day of the anti-diabetic treatment. The examination revealed hyperopia. Distance visual acuity was 10/10 (+1,50sph) and near visual acuity J1 (+3,00sph) bilaterally. Anterior/posterior segment and intraocular pressure were normal. Glucose levels had fallen to 130-150mg/dl. The refraction began to return to normal after the third week, with complete recovery and stabilization in the initial measurements.

Conclusions:

Some patients with diabetes mellitus develop a transient hyperopic shift in refraction during the acute phase of glycemic control. Several studies suggest that the degree of the refraction change is proportional to the initial glucose level in the blood plasma and the rate of its decline during the first week of treatment. The mechanism of this change is not fully elucidated. However, it is important to inform the patient about the disease and its management and possibly prescribe him a refractive correction until the refraction status is stabilized.

Financial Disclosure:

NONE

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