Ocular involvement in diabetes is very common.
Structure-wise ocular lesions are as follows:
1. Lids. Xanthelasma and recurrent stye or internal
hordeolum
2. Conjunctiva. Telangiectasia, sludging of the blood
in conjunctival vessels and subcon-junctival
haemorrhage
3. Cornea. Pigment dispersal at back of cornea,
decreased corneal sensations (due to trigeminal
neuropathy), punctate kerotapathy, Descemet’s
folds, higher incidence of infective corneal ulcers
and delayed epithelial healing due to abnormality
in epithelial basement membrane
4. Iris. Rubeosis iridis (neovascularization)
5. Lens. Snow-flake cataract in patients with IDDM,
posterior subcapsular cataract, early onset and
early maturation of senile cataract
6. Vitreous. Vitreous haemorrhage and fibre- vascular
proliferation secondary to diabetic retinopathy
7. Retina. Diabetic retinopathy and lipaemia retinalis
(see page 259).
8. Intraocular pressure. Increased incidence of
POAG, neovascular glaucoma and hypotony in
diabetic ketoacidosis (due to increased plasma
bicarbonate levels)
9. Optic nerve. Optic neuritis
10. Extraocular muscles. Ophthalmoplegia due to
diabetic neuropathy
11. Changes in refraction. Hypermetropic shift in
hypoglycemia, myopic shift in hyperglycemia and
decreased accommodation
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