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Amblyopia and visual acuity in children with Down's syndrome
W G Tsiaras1, S Pueschel, C Keller
1Department of Ophthalmology, Rhode Island Hospital/Brown University School of Medicine, Providence, RI 02903, USA.
Insights
Amblyopia, or lazy eye, affects 22% of children with Down
Area of Science:
- Ophthalmology
- Genetics
- Pediatrics
Background:
- Limited research exists on amblyopia prevalence in individuals with Down syndrome.
- Down syndrome is associated with various ocular abnormalities, increasing risk for visual deficits.
Purpose of the Study:
- To determine the prevalence of amblyopia in children with Down syndrome.
- To identify associated ophthalmological conditions linked to amblyopia in this population.
Main Methods:
- Visual acuity was evaluated in 68 children (ages 5-19) with Down syndrome.
- Amblyopia was defined by visual acuity differences between eyes or fixation preference.
- Ophthalmological records were reviewed, and a subgroup underwent examination.
Main Results:
- Amblyopia was diagnosed in 15 (22%) of the participants.
- An additional 24% had bilateral vision below 20/50.
- Strabismus, high refractive errors, and anisometropia were common associated conditions.
Conclusions:
- The prevalence of amblyopia in Down syndrome is higher than previously thought.
- Nearly half (46%) of children with Down syndrome exhibited significant visual impairment.
- Regular ophthalmological screening is crucial for early detection and management.
Background/Aims:
Amblyopia in people with Down's syndrome has not been well investigated. This study was designed to determine the prevalence and associated conditions of amblyopia in a group of home reared children with Down's syndrome.
Methods:
All children in the study group underwent an evaluation of visual acuity. In addition, previous ophthalmological records were reviewed, and a subgroup of children was examined. For the purposes of this study, amblyopia was defined quantitatively as a difference of two Snellen acuity lines between eyes or if unilateral central steady maintained (CSM) vision and a clear fixation preference was observed. A high refractive error was defined as a spherical equivalent more than 3 dioptres and astigmatism more than 1.75 dioptres. Anisometropia was defined as a difference of at least 1.5 dioptres of sphere and/or 1.0 dioptre of cylinder between eyes. 68 children with Down's syndrome between the ages of 5 and 19 years were enrolled in the final study group.
Results:
Amblyopia was observed in 15 (22%) of 68 patients. An additional 16 (24%) patients had bilateral vision less than 20/50. Strabismus, high refractive errors, and anisometropia were the conditions most commonly associated with decreased vision and amblyopia
Conclusion:
This study suggests that the prevalence of amblyopia is higher than previously reported. Fully 46% of these children with Down's syndrome had evidence of substantial visual deficits. These patients may be at higher risk for visual impairment and should be carefully examined for ophthalmological problems.