POOR VISION AS A CONTRIBUTORY FACTOR IN DIABETIC NEURO-ARTHROPATHY

Two patients with longstanding insulin-dependent diabetes mellitus (ID DM) complicated by neuropathy, nephropathy and retinopathy leading to poor vision each developed a swollen and relatively painless foot. The previous day, both had been walking over uneven ground. At initial pr esentation, no X-ray was taken of the foot in case one and no action w as taken over an undisplaced navicular fracture in case two. A few wee ks later, a midfoot Charcot had developed in both cases. Poor vision m ay increase the risk of injury to the feet and may be an important ris k factor for Charcot neuro-arthropathy. Plain radiographs are an impor tant investigation for the swollen insensitive foot, even in the absen ce of pain. (C) 1997 Elsevier Science Ireland Ltd.