The Study Results
The study, published in Diabetologia, analyzed 2,470,580 babies’ development through age 25 (in most cases) to determine the connection between the birthing parent’s diabetes and the child’s increased risk of developing a vision problem. The findings indicated that mothers with diabetes, including Type 1, Type 2, or gestational, had babies with a higher risk of vision problems due to higher refractive error (RE). This means that the eye fails to properly focus images on the retina. Of all of those babies, 2.3% were exposed to diabetes. These babies had a 39% greater risk of high RE compared to the other babies. Babies from birthing parents with type 1 diabetes had a 32% higher risk, and those with type 2 had a 68% higher risk. In addition, if there were complications during the pregnancy related to diabetes, children in these situations had double the risk.
How Concerned You Should be About High Refractive Error
While RE sounds a bit scary, and we all want our children to have optimal vision throughout their lives, it’s important to know what a higher risk of RE really means. Robert Clark, MD, pediatric ophthalmologist at MemorialCare Miller Children’s & Women’s Hospital in Long Beach, Calif., says that high refractive error is not a medical condition, but rather a risk for developing a medical condition. “[RE] is caused by an abnormal shape of the eye, a mismatch between the focusing elements of the eye (cornea and lens) and light-sensing part of the eye (retina). Many people, myself included, have high refractive errors and enjoy many years of clear, comfortable vision with glasses or contact lenses,” Dr. Clark says. “Babies born to mothers with diabetes are [typically] larger and heavier than those born to non-diabetic mothers, and those physical differences likely translate to the eye growth itself, causing a mismatch in the shape of the eye and its focusing elements.” So, even if you have a pregnancy with diabetes, your baby isn’t more likely to be born with an actual medical condition, but rather at an increased risk for developing one, according to this study.
Testing to Have Done for Babies with Increased Risk
When your baby is born, a pediatrician already performs a standard eye test of the “red reflex” which involves examining the baby’s eyes to look for an equal and bright red reflex from each pupil. “Whether or not a mother is diabetic, all babies should have their eyes evaluated at birth, checking for abnormalities of the eyelids or eyeballs, checking for full movement of each eye, checking for symmetry of appearance of the eyes, and checking for symmetry of the ‘red reflex,’” says Howard R. Krauss, MD, is a neuro-ophthalmologist and Clinical Professor of Ophthalmology and Neurosurgery at Saint John’s Cancer Institute at Providence Saint John’s Health Center in Santa Monica, Calif. For premature babies, this is done by an ophthalmologist. Other babies will have this exam done by a pediatrician. “Any detected abnormality or asymmetry should lead to an Ophthalmologic consultation in the hospital nursery," he notes. From there, your child’s pediatrician should be doing eye exams on a regular basis, he explains, even when there aren’t any questions or complaints. Dr. Clark says that the pediatrician will use a photo-based screening to help identify eye concerns with children who are pre-verbal or nonverbal “quite reliably.”
Signs to Watch for at Home
You can also do some at home informal “testing” yourself, according to Dagny Zhu, MD, board-certified ophthalmologist and Medical Director of NVISION Rowland Heights. Dr. Zhu recommends watching for the following signs:
Inability to track objects or make eye contact by 3 months of ageWandering eyes or crossing eyesUnusual head tilting when viewing somethingSquinting at the TV or far away objects, for older children
“Most children do not need to wear glasses for farsightedness as their focusing power is so strong, they can overcome the farsightedness and see clearly," Dr. Zhu says. “As the eye grows larger as the child ages, the farsightedness decreases in many cases and the eye may actually become nearsighted if it grows too long. Nearsightedness usually starts and progresses around age 6 in school-age children and will require glasses.”
What You Can Do During Pregnancy To Prevent Eye Issues
If you have diabetes and are pregnant, the best thing you can do, according to all of our experts, is to work frequently and thoroughly with your OBGYN to properly control blood sugar. In addition, if you had diabetes during your pregnancy, ensure your child’s healthcare providers are completing vision exams periodically. You can also bring up your concern about the potential link between diabetes and their vision so they can be sure to monitor it going forward.
