Illustration of a child's eye symbolizing diabetes and corneal health.

Kids and Diabetes: Are Their Eyes Telling a Different Story?

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"New research sheds light on corneal health in children with diabetes, challenging previous findings in adults."

Diabetes mellitus is a widespread condition known for its many complications, affecting areas from eyesight with diabetic retinopathy and cataracts to nerve function and even inflammatory eye conditions. Beyond these well-known effects, diabetes also significantly impacts the delicate structures of the cornea, including its outer layer (epithelium), base membrane, supportive tissue (stroma), and inner lining (endothelium). These impacts can show up as various issues, such as superficial punctate keratopathy, recurrent corneal erosion, and damage to the corneal endothelium.

In individuals with diabetes, persistently high blood sugar levels lead to nonenzymatic glycosylation, a process where glucose molecules attach to proteins. This results in the formation of advanced glycosylation end products (AGEs). The accumulation of AGEs in tissues triggers increased collagen crosslinking, leading to various harmful reactions within the body.

The Ocular Response Analyzer (ORA), a sophisticated tool, allows doctors to assess corneal biomechanical properties like corneal hysteresis (CH) and the corneal resistance factor (CRF) in living eyes. Corneal hysteresis measures the cornea's ability to absorb and dissipate energy from applied pressure, while the corneal resistance factor reflects the overall resistance of the cornea to deformation. This helps in understanding the cornea's structural integrity and response to pressure.

Corneal Biomechanics in Children vs. Adults: What's the Difference?

Illustration of a child's eye symbolizing diabetes and corneal health.

Previous research on adults with type 2 diabetes has shown that diabetes can change the biomechanical properties of the cornea. However, there hasn't been much research on how diabetes affects the corneas of children. This study aimed to evaluate corneal biomechanical properties in children with diabetes, filling a significant gap in our understanding.

In a recent study, researchers compared 46 children with diabetes mellitus to 50 healthy children, focusing on corneal hysteresis (CH) and corneal resistance factor (CRF). The results indicated no significant differences in CH (12.3±1.3 mmHg in the diabetic group vs. 12.5±1.5 mmHg in the control group) and CRF (12.4±1.7 mmHg vs. 11.9±1.5 mmHg, respectively).

Participants: 46 children with diabetes mellitus and 50 healthy controls.
Measurements: Corneal Hysteresis (CH) and Corneal Resistance Factor (CRF) using the Ocular Response Analyzer.
Key Finding: No significant difference in CH and CRF values between the two groups.

Interestingly, the study also found that corneal hysteresis and corneal resistance factor were not correlated with fasting glucose levels, HbA1c, age, or duration of diabetes in the children studied. These findings suggest that in children, short-term diabetes may not significantly alter corneal biomechanical properties, unlike in adults where longer disease duration and age play a more prominent role.

Future Directions: What Does This Mean for Eye Care?

This research provides a foundation for understanding how diabetes affects children's eyes, highlighting that the impact might be different from that on adults. Continuous monitoring and further studies are essential to fully understand the long-term effects of diabetes on corneal health in pediatric populations. By understanding these nuances, healthcare professionals can provide better, more tailored care to children with diabetes, preserving their vision and quality of life.

About this Article -

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Everything You Need To Know

How does diabetes affect the cornea and what are the specific parts of the cornea that are impacted?

Diabetes mellitus is a systemic disease known for its complications, including effects on the eyes. Specifically, it can impact the cornea, which includes the epithelium, stroma, and endothelium. These impacts can manifest as issues like superficial punctate keratopathy or damage to the corneal endothelium. Persistently high blood sugar can lead to nonenzymatic glycosylation, where glucose attaches to proteins, forming advanced glycosylation end products (AGEs). The accumulation of AGEs in tissues can cause increased collagen crosslinking, leading to harmful reactions within the body and affecting the cornea's structural integrity.

What is the Ocular Response Analyzer (ORA) and what does it measure?

The Ocular Response Analyzer (ORA) is a tool used to assess corneal biomechanical properties. It measures corneal hysteresis (CH), which indicates the cornea's ability to absorb and dissipate energy from applied pressure, and the corneal resistance factor (CRF), which reflects the overall resistance of the cornea to deformation. These measurements help understand the cornea's structural integrity and response to pressure.

What are corneal hysteresis (CH) and corneal resistance factor (CRF), and why are they important?

Corneal hysteresis (CH) measures the cornea's ability to absorb and dissipate energy from applied pressure, while the corneal resistance factor (CRF) reflects the overall resistance of the cornea to deformation. These measurements provide insights into the cornea's structural integrity. Understanding these properties can help in diagnosing and managing various corneal conditions, especially in the context of diseases like diabetes mellitus, where corneal biomechanical properties might be altered. However, these properties do not appear altered in children.

What did the recent study reveal about corneal biomechanical properties in children with diabetes mellitus?

A recent study showed no significant differences in corneal hysteresis (CH) and corneal resistance factor (CRF) between children with diabetes mellitus and healthy children. Furthermore, CH and CRF were not correlated with fasting glucose levels, HbA1c, age, or duration of diabetes in the children studied. This suggests that, unlike in adults, short-term diabetes may not significantly alter corneal biomechanical properties in children. This is important because it highlights differences in how diabetes affects the eyes of children compared to adults and suggests monitoring over time is a path forward.

What are the next steps in understanding the effects of diabetes on children's eyes, and why is this important?

Future research should focus on the long-term effects of diabetes on corneal health in children. Continuous monitoring of corneal biomechanical properties, such as corneal hysteresis (CH) and corneal resistance factor (CRF), is essential to fully understand the impact of diabetes on pediatric populations. This will help healthcare professionals provide better, more tailored eye care to children with diabetes, preserving their vision and quality of life.