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Visual acuity and accommodation in infants and young children with Down's syndrome
J M Woodhouse1, V H Pakeman, K J Saunders
1Department of Optometry and Vision Sciences, UWCC.
Insights
Children with Down syndrome often have poor accommodation and declining visual acuity. This study confirms these visual impairments begin in early childhood, suggesting potential visual cortex development changes.
Area of Science:
- Ophthalmology
- Developmental Pediatrics
- Genetics
Background:
- Down syndrome is associated with various health issues, including visual impairments.
- Previous research indicates deficits in accommodation and visual acuity in older individuals with Down syndrome.
Purpose of the Study:
- To investigate accommodation and visual acuity in infants and young children with Down syndrome.
- To compare visual development in children with Down syndrome to typically developing controls.
- To identify the onset and progression of visual impairments in early childhood.
Main Methods:
- Measured accommodation and visual acuity in 53 children with Down syndrome (12 weeks–57 months).
- Compared results with 136 typically developing control children (4 weeks–48 months).
- Analyzed visual acuity in relation to age, refractive error, and accommodation.
Main Results:
- 92% of children with Down syndrome exhibited defective accommodation, with no age-related improvement.
- Visual acuity was normal in younger children but below normal in those over 2 years.
- Below-normal visual acuity in older children was not explained by refractive error or poor accommodation.
Conclusions:
- Defective accommodation is prevalent in young children with Down syndrome.
- A decline in visual acuity occurs after 2 years of age, potentially linked to visual cortex development.
- Findings confirm early onset of visual impairments previously observed in older individuals with Down syndrome.
Abstract:
Accommodation and visual acuity were measured in 53 children with Down's syndrome aged between 12 weeks and 57 months. Results were compared with data for 136 control (typically developing) children aged between 4 weeks and 48 months. Whereas the control children accommodated accurately on near targets, accommodation was defective in 92% of the children with Down's syndrome, and there was no change in accommodative ability with age. On the other hand, visual acuity lay within normal limits for the younger children. Children over the age of 2 years showed a below-normal visual acuity, which is not explained either by refractive error or by the effect of poor accommodation. The data suggest a sudden change in the rate of development of visual acuity which may be associated with physiological changes in the visual cortex. Previously reported defects of accommodation and visual acuity in older children and adults with Down's syndrome are confirmed by our findings in infants and young children.