Clinical evaluation of ocular and visual functions in insulin-dependent juvenile diabetics.

Ocular and visual functions were evaluated in 30 insulin-dependent diabetics, aged 12 to 20 years, and 30 age- and sex-matched nondiabetics. The test and control groups were compared in terms of visual resolution, accommodative ability, color discrimination, functional retinal reserve, and afferent optic nerve function. These results were considered along with the blood-glucose level, crystalline lens, fundus appearance, level of diabetic control, and disease duration. No widespread differences in ocular or visual function were found between the test and control groups. Measures of accommodative ability, functional retinal reserve (photostress recovery time), and blood-glucose level best differentiated the two groups. This study suggests that in-office evaluation of accommodation and functional retinal reserve may be sensitive indicators of early visual functional deficits in the presence of minimal anatomical changes associated with diabetes.