Acute incapacitating hyperopia during hypoglycemic treatment

Abstract

Patients with diabetes mellitus can develop various ocular complications such as cataract, retinopathy, optic neuropathy, uveitis, and keratopathy etc. In addition, transient refractive error occurs during the course of diabetes mellitus and is associated with treatment induced changes in the plasma glucose concentration [1, 2]. The association of myopia with hyperglycaemia and hyperopia with hypoglycaemia have been reported in diabetic patients [3]. There are studies which show that an abrupt reduction in plasma glucose in diabetic patients with marked hyperglycaemia, induce transient hyperopia [1, 2, 4]. It has been seen that the degree of hyperopia is highly dependent on the magnitude of the change in plasma glucose concentration [2]. Patients may get alarmed and may request for change of glasses but fresh prescription should be given only when the refraction stabilises, otherwise, the glasses thus prescribed will soon become inadequate. A case is presented where a lady developed acute incapacitating hyperopia during hypoglycemic treatment. It is quite unusual to come across such high degree of induced transient hyperopia in clinical practice. The pattern of development and gradual decay of the transient hyperopia is described with review of relevant literature.