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Refractive development in children with Down's syndrome: a population based, longitudinal study.

O H Haugen1, G Høvding, I Lundström

  • 1Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway. ohha@haukeland.no

The British Journal of Ophthalmology
|May 24, 2001
PubMed
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Children with Down syndrome often have refractive errors. Stable, low hypermetropia was linked to normal accommodation, while accommodation weakness may contribute to vision problems in this population.

Area of Science:

  • Ophthalmology
  • Genetics
  • Developmental Biology

Background:

  • Down syndrome is associated with a high prevalence of refractive errors, including hypermetropia and astigmatism.
  • Understanding the longitudinal refractive development in children with Down syndrome is crucial for early intervention and management.

Purpose of the Study:

  • To longitudinally investigate refractive development in children with Down syndrome.
  • To identify correlations between refractive status, accommodation, and astigmatism in this population.

Main Methods:

  • A cohort of 60 children with Down syndrome underwent repeated retinoscopies under cycloplegia for over two years.
  • Accommodation was assessed using dynamic retinoscopy.
  • Refractive categories included stable hypermetropia, increasing hypermetropia (hypermetropic shift), and decreasing hypermetropia/myopic shift.

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Main Results:

  • Three refractive categories were observed: stable hypermetropia (n=34), increasing hypermetropia (n=11), and decreasing hypermetropia/myopic shift (n=9).
  • Accommodation weakness was present in 55% of children and was less frequent in stable, low-grade hypermetropia.
  • Astigmatism (>/=1.0 D) was found in 57% of eyes, predominantly with-the-rule, and oblique astigmatism showed specific axis directions for right and left eyes.

Conclusions:

  • Stable, low-grade hypermetropia in children with Down syndrome is significantly correlated with normal accommodation.
  • Accommodation weakness may play an etiological role in the high frequency of refractive errors observed.
  • The specific axis direction in oblique astigmatism suggests mechanical factors related to palpebral fissures may contribute to its development.