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Association between accommodative accuracy, hypermetropia, and strabismus in children with Down's syndrome
Ruth E Stewart1, J Margaret Woodhouse, Mary Cregg
1School of Optometry & Vision Sciences, Cardiff University, Cardiff, United Kingdom.
Summary
Children with Down syndrome and reduced accommodation are more likely to have hypermetropia and strabismus. This association is evident even in early infancy, suggesting a potential link between accommodation and refractive error development.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Genetics
Background:
- Reduced accommodation is common in children with Down syndrome.
- Understanding ocular comorbidities is crucial for managing visual development in this population.
Purpose of the Study:
- To investigate the association between reduced accommodation and refractive error, strabismus, and other ocular parameters in children with Down syndrome.
- To explore potential links between accommodation status and visual development in pediatric Down syndrome.
Main Methods:
- Age-matched cohort study comparing children with Down syndrome and reduced accommodation versus those with normal accommodation.
- Analysis of cross-sectional ocular and visual data using statistical tests (chi-squared, Fisher's exact, Mann-Whitney U).
Main Results:
- Children with under-accommodation were significantly more likely to have moderate/high hypermetropia (≥ +3.00 D).
- A higher prevalence of strabismus, primarily esotropia, was observed in children with reduced accommodation.
- No significant differences were found in other ocular parameters between the groups.
Conclusions:
- A strong association exists between under-accommodation, hypermetropia, and strabismus in children with Down syndrome.
- While causality cannot be established, the findings suggest an early link between accommodation and refractive error development in this cohort.
- These results highlight the importance of monitoring accommodation in children with Down syndrome to identify associated visual conditions.
