visual impairment and color vision deficiency associated with glycemic control and duration of illness in children with type 1 diabetes mellitus: a cross-sectional study

Background and objectives: eye examinations in children with type 1 diabetes mellitus (t1d) are often underemphasized, as diabetic retinopathy (dr) is primarily associated with adults. however, decreased visual acuity (va) and color vision deficiency (cvd) may be early signs of micro-vascular complications. this study aims to underscore the significance of early ocular screening in children with t1d to identify anomalies prior to the dr development. methods: a cross-sectional study conducted on 32 children with t1d, in the age range of <18, from the pediatric endocrinology outpatient clinic at dr. soetomo general hospital. clinical and laboratory evaluations were carried out. the laboratory test of hba1c level using a verified enzyme-linked immunosorbent assay (elisa) kit (bt lab bioassay, china). results: thirteen children (40.62%; 95% ci: 23.6%-57.7%) had decreased va, 11 (34.37%) of them had hba1c levels > 9.0, and two (6.25%) had hba1c levels between 7.5 and 9.0. among the six children with t1d for less than five years who exhibited decreased va, one had mild impairment, two had moderate impairment, two had severe impairment, and one presented with cvd. a total of four children were identified with cvd (12.5%; 95% ci: 1.03%-23.97%). conclusion: diabetic children with visual impairment (vi) are a significant and complex issue that affects qol. functional and structural eye problems that emerge earlier can occur within a few years after the t1d onset. poorly managed hba1c levels significantly influence the development of visual disturbances and cvd, both of which can serve as early predictors of dr.