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Letter to the Editor
An unusual presentation of diabetic neuropathy
  1. C S DANIEL,
  2. S G FRASER,
  3. J K G DART
  1. Moorfields Eye Hospital, City Road
  2. London EC1V 2PD, UK
  1. Miss Claire Daniel

https://doi.org/10.1136/bjo.85.5.625e

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    Editor,—Diabetic neuropathy can present in numerous forms; as symmetrical sensory polyneuropathy, mononeuropathy, or as an autonomic neuropathy. The earliest functional change in diabetic nerves is delayed conduction velocity, the earliest histological change is segmental demyelination due to damage of Schwann cells. We report an uncommon but important presentation, which can easily be overlooked on clinical examination.

    CASE REPORT

    A 27 year old woman was referred to Moorfields Eye Hospital complaining of bilaterally red and irritable eyes accompanied by a gradual reduction in vision over the previous 18 months. This had not responded to a wide range of different topical medications. She had been an insulin dependent diabetic since the age of 11. History of control of her diabetes was good, on a regimen of subcutaneous Monotard and Actrapid. She had no other significant medical history.

    On examination she was noted to have bilateral corneal erosions. She had a reduced blink …

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