Kids with diabetes may be more likely to develop dry eye as well.
Kids with diabetes may be more likely to develop dry eye as well. Click image to enlarge.

Research has shown that the risk of chronic eye disease increases with the progression of diabetes. A new study based in China found a high rate of dry eye disease (DED) in children with diabetes at three years.

In 2018, the investigators established the Shanghai Children and Adolescent Diabetes Eye (SCADE) Study, which found the prevalence of DED was much higher in children with diabetes (about 29%) compared with healthy children (5%). From this original cohort of 123 participants, diabetic children and adolescents between the ages of three and 14 who didn’t have dry eye were followed for three years. Due to the pandemic, only 40 of these participants were re-examined in early 2021.

At three years, nine of the children were diagnosed with dry eye (seven girls and two boys, roughly 23%), for an annual DED incidence rate of approximately 8%. The researchers found the main risk factor for developing DED was decreased corneal sensation (OR=25.60). Other potential contributing factors included a long course of diabetes (OR=1.80), eye pain (OR=12.27) and having parents with DED (OR=15.99).

Previous investigations in adult populations have found the longer the duration of diabetes, the more severe the damage of accessory lacrimal gland cells, in addition to less tear secretion, which causes an increased prevalence of dry eye.

Based on the current study’s findings, children with the aforementioned risk factors should receive a DED evaluation for early diagnosis and treatment to improve their prognosis and quality of life, the investigators said.

Parents of diabetic children should also be made aware of DED risk through publicity and education, they added. Simultaneously, it is necessary to establish a screening mode and a better file management system, in addition to creating prevention and treatment norms and strengthening scientific management of DED in children with diabetes, they added.

As a comparison point, prior studies have reported that the factors related to the prevalence of dry eye in adult patients with diabetes were age, sex, course of disease, corneal perception, fasting blood glucose and glycosylated hemoglobin levels.

Chen Z, Xiao Y, Qian Y, et al. Incidence and risk factors of dry eye in children and adolescents with diabetes mellitus: a three-year follow-up study. Front Med. November 29, 2021. [Epub ahead of print].