Strabismus and binocular function in children with Down syndrome. A population-based, longitudinal study.

Area of Science:

• Ophthalmology
• Genetics
• Pediatrics

Background:

• Down syndrome is associated with various ocular abnormalities.
• Strabismus is a common condition affecting eye alignment.
• Understanding strabismus in Down syndrome is crucial for visual development.

Purpose of the Study:

• To determine the frequency and types of strabismus in children with Down syndrome.
• To investigate the age of onset for strabismus in this population.
• To assess the potential for binocular vision in affected children.

Main Methods:

• A longitudinal, population-based study of 60 children with Down syndrome.
• Repeated eye examinations including Hirschberg corneal reflex test and cover test.
• Binocular function assessed using Titmus House Fly Test and Lang's stereo test.

Main Results:

• 42% of children with Down syndrome had strabismus, predominantly acquired esotropia (21 cases).
• Mean age at strabismus onset was 54 months; infantile esotropia was rare.
• Acquired esotropia was linked to hypermetropia (75%) and accommodation weakness (75%).

Conclusions:

• The majority of strabismus in Down syndrome is acquired esotropia, indicating potential for binocularity.
• Hypermetropia and accommodative weakness are significant factors in the development of esotropia.
• Early detection and management of refractive errors and accommodation may improve outcomes.