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Ketotic hypoglycemia in children can lead to cataracts, impacting vision. Early ophthalmic exams are crucial for timely treatment and preventing vision loss due to stimulus deprivation amblyopia.
Area of Science:
- Pediatric Ophthalmology
- Endocrinology
- Metabolic Disorders
Background:
- Ketotic hypoglycemia is a common metabolic disorder in children.
- Ocular complications, particularly cataracts, can arise in affected individuals.
- Understanding the link between ketotic hypoglycemia and visual impairment is critical for early intervention.
Purpose of the Study:
- To investigate the incidence and characteristics of cataracts in children with ketotic hypoglycemia.
- To identify associated ocular abnormalities and neurological impairments.
- To emphasize the importance of prompt ophthalmic examinations for early diagnosis and management.
Main Methods:
- Retrospective analysis of 40 patients diagnosed with ketotic hypoglycemia.
- Ophthalmic examinations were conducted to identify cataracts and other ocular abnormalities.
- Assessment of neurological status, including epilepsy and psychomotor development.
Main Results:
- 15 out of 40 patients (37.5%) developed cataracts, with a mean age of onset at 20 months.
- Cataracts were bilateral in most cases; 7 patients developed complete cataracts.
- Stimulus deprivation amblyopia was the primary cause of visual loss post-surgery; strabismus and nystagmus were also observed. Neurological impairment was present in over half the patients.
Conclusions:
- Ketotic hypoglycemia is associated with a significant risk of developing cataracts in children.
- Early detection and management of cataracts are essential to prevent irreversible visual impairment.
- Routine ophthalmic screening for all children with ketotic hypoglycemia is strongly recommended.
Abstract:
Of 40 patients with ketotic hypoglycemia, 15 (nine boys and six girls) developed cataracts. The mean age at onset of the first hypoglycemic attack was 20 months, and the average age at the time the cataracts were discovered was 3 1/4 years. The average birth weight of 14 children was 2060 g. The cataracts were bilateral in all but one case. Seven patients (11 eyes, bilateral in four patients) developed complete cataracts. Despite aphakic correction and occlusion therapy, the major cause of visual loss after cataract surgery was stimulus deprivation amblyopia. Other ocular abnormalities included strabismus and jerky horizontal nystagmus. Neurologic impairment--epilepsy, psychomotor retardation, and/or electroencephalographic abnormalities--was present in over one half of the patients. All children with ketotic hypoglycemia should be referred promptly for an ophthalmic examination so that appropriate therapy can be implemented early.