Refractive error, binocular vision and accommodation of children with Down syndrome

In this review of the visual development of children with Down syndrome we were specifically interested in how refractive error, binocular alignment and accommodation are different in Down syndrome from the general population. The differences and their aetiology will help practitioners make informed decisions about the visual assessment and management of these children.

Articles found using searches through Scopus, Medline and Google Scholar were evaluated by examining sample sizes, appropriate use of controls, methods of measurement and statistical significance of findings. Where the strength of evidence in an article might be weak, this is reported in the review.

The development of the visual and oculomotor systems is substantially different in Down syndrome compared with the general population. Assessment and optometric management of this special population need to be directed accordingly.