Cataract in children with type 1 diabetes: a single-center experience from North India on an underrecognized complication
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Devi Dayal
,
Soumya Jyoti Raha
,
Sayan Banerjee
,
Anju Bala
Abstract
Objectives
Consensus guidelines recommend cataract screening, along with a comprehensive eye evaluation, based on symptoms or at the time of screening for retinopathy in type 1 diabetes (T1D). This study evaluated the prevalence of cataract in T1D children and factors associated with it in resource-limited settings.
Methods
We conducted a retrospective, hospital-based observational study at a tertiary care center in North India, analyzing children with T1D who developed cataracts between April 2015 and March 2025. Clinical, anthropometric, biochemical, and ophthalmologic data were extracted from medical records.
Results
Of 1776 children diagnosed with T1D in the study period, 21 (1.18 %) developed cataracts. The median age at diabetes diagnosis was 7.7 years, and cataract diagnosis occurred at a median age of 9.9 years. Bilateral involvement was universal. Cataracts were present at the time of diagnosis of diabetes in 14.2 % and developed within the first year (early cataract) in 28.6 %. Posterior subcapsular cataract was the most common morphology. Notably, 38.1 % had Mauriac syndrome, all of whom developed cataracts later in the disease course, with significantly lower c-peptide levels. A strong negative correlation existed between baseline HbA1c and cataract onset interval (r=−0.468, p=0.032). Six children improved with glycemic control alone, while 10 underwent surgery.
Conclusion
Cataracts in children with T1D can occur early and may reflect poor metabolic control or autoimmune triggers. Screening should be considered at diagnosis and within the first year. Our findings underscore the need for region-specific guidelines to facilitate early detection and management of this vision-threatening yet treatable complication.
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Research ethics: The study was conducted after approval from the Institutional Ethics Committee (IEC-INT/2025/Study-2838). The ethics certificate is attached as a supplementary file in the submission process.
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Informed consent: The study was conducted after approval from the Institutional Ethics Committee; since it involved analysis of hospital records, waiver of consent was applied for.
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Author contributions: Devi Dayal and Soumya Jyoti Raha wrote the first draft; Soumya Jyoti Raha, Sayan Banerjee and Anju Bala were involved in patient care, assessment, and follow-up. Soumya Jyoti Raha and Sayan Banerjee were involved in collecting data, analysing, and literature review. Jaspreet Sukhija and Srishti Raj were involved in surgery and provided inputs about the ophthalmological management. Devi Dayal, Rakesh Kumar and Jaivinder Yadav supervised the work and finalised the draft. Jaivinder Yadav will act as guarantor for this manuscript. Devi Dayal and Soumya Jyoti Raha contributed equally to this work and share first authorship.
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Use of Large Language Models, AI and Machine Learning Tools: None declared.
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Conflict of interest: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: The data that support the findings of this study are available from the corresponding author [Jaivinder Yadav] or are available within the article (in reference section).
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