Accommodation deficit in children with Down syndrome: practical considerations for the optometrist

Little, Julie‐Anne

doi:10.2147/opto.s63351

Cited by 5 publications

(4 citation statements)

References 49 publications

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“…This deficit could involve differences in the accommodative/convergence relationship, which explains the high prevalence found of strabismus (33.54%), exotropia (4.68%), and esotropia (27.72%). A theory also proposes that the thinner crystalline lens found in DS children limits the change in shape and power increase to provide an appropriate accommodative response; however, this has not been proven experimentally [33].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of ophthalmological manifestations in pediatric and adolescent populations with Down syndrome: a systematic review of the literature

et al. 2022

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Background Down syndrome (DS) is a chromosomal anomaly that is characterized by an extra chromosome 21. Ophthalmological manifestations have a high prevalence in patients with DS. Purpose To review the scientific evidence and estimate the prevalence of ophthalmological manifestations in the pediatric population with DS. Data sources Electronic databases including MEDLINE, Cochrane Library, EMBASE, ScienceDirect, and LILACS. Study eligibility criteria Published observational studies with available and original data were included. Articles were excluded if the study design was a review, letter to the editor, case report, case series, or systematic review and if the subjects had ophthalmological manifestations secondary to other conditions. Participants and interventions Pediatric and adolescent population with DS and with ophthalmological evaluation. Study appraisal and synthesis methods A data collection form was designed in Excel. Five reviewers extracted relevant details about the design and results of each study. The quality of the studies was assessed by applying the tools for systematic reviews of prevalence and incidence from the Joanna Briggs Institute. We calculated the weighted prevalence of ophthalmological manifestations, considering only the studies reporting the measurement of each manifestation. Results Twenty-two articles (from 15 countries, published during 1994–2020) were included in the present systematic review. Ocular manifestations were observed in 85% of the studied pediatric and adolescent populations with DS. The most frequent ones were slanting fissures, oblique fissures, epicanthus, and epiblepharon. Conclusion The ocular manifestations in the pediatric and adolescent populations with DS are varied, and some can irreversibly affect visual development. Screening of the pediatric population with DS should be conducted from the first months of age and continued annually. Systematic review registration PROSPERO CRD42019127717

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Section: Discussionmentioning

confidence: 99%

Prevalence of ophthalmological manifestations in pediatric and adolescent populations with Down syndrome: a systematic review of the literature

et al. 2022

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“…Visual impairments are more common in children with neurodevelopmental disorders, according to the RCO and the UK government's National Service Framework for Disabled Children [ 30 , 31 ], these children should have a routine vision check as part of their multidisciplinary treatment. For example, children with Down syndrome had less accommodation ability [ 32 ]. However, current study showed that only 25% of participants will consider neurodevelopment disorder when prescribe correction for hyperopia.…”

Section: Discussionmentioning

confidence: 99%

Prescribing patterns for hyperopia: an insight of the optometrist perspective and practice

Alsaqr,

Alhumaid,

Alanazi

et al. 2024

BMC Ophthalmol

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Background To investigate the current prescribing patterns for correcting hyperopia among optometrists in clinical practice in Saudi Arabia and compare those to current international guidelines. And explore the factors that influence practitioners' prescribing decision. Method This cross-sectional study employed 30 items online survey that encompass demographic data, current practice and cycloplegia use, numerical response to indicate the minimum level of hyperopia at which optometrists would consider prescribing spectacles to non-strabismic children and determine the diopter value required for prescribing correction for hyperopia if present with other factors. Result A total of 104 optometrists responded to the survey (52 females and 52 males). They recruited from 35 cities across Saudi Arabia. Out of total, 44% of them considered cycloplegic refraction essential under 12 years and 56% of them extended the range to 18 years. Large variation were found between the optometrists’ responses and current guideline recommendations. Several factors influenced the decision-making of the practicing optometrist including signs and symptoms, bilateral hyperopia, average dioptric value, reading difficulty, and accommodative function. Conclusion There are some matches between the international guidelines and the practice patterns that followed by optometrists in Saudi Arabia, however, the optometrists did not report that they are following them purposefully. These findings highlight the need to improve optometrists' practice about spectacle prescription in pediatric population.

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“…e child is asked to fixate a near point target. e object is moved closer and further away from the child to seek for the neutral point at near which provides the accommodation response [18,19].…”

Section: Discussionmentioning

confidence: 99%

Challenges in Patients with Trisomy 21: A Review of Current Knowledge and Recommendations

Robinson

Pompe

Gerth‐Kahlert

2021

Journal of Ophthalmology

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Purpose. To summarize and review the common ophthalmic anomalies in children with trisomy 21 (Down syndrome) in order to propose an update to current clinical recommendations. Methods. A retrospective chart review, systemic literature review, and international survey of the frequency of ocular abnormalities, screening schedules, and challenging aspects examining children with trisomy 21. The chart review included patients treated at the Department of Ophthalmology at the University Hospital of Zurich over a two-year period. The international survey was submitted to the members of the Swiss Society of Ophthalmology, Slovenian Ophthalmological Society, and European Pediatric Ophthalmology Society. Results. Analysis of 52 patient records during the study period revealed refractive errors (astigmatism: 54% of patients, hyperopia: 26%, and myopia: 15%) as the most common diagnosis, whereas childhood cataract was reported in 5%. This is in concordance with the extended literature review of 249 publications, although congenital cataracts were reported to be higher than at our institution. The survey participants reported great challenges in taking care of these patients, despite their long professional experience (73% with over 10 years of experience). Conclusion. Care and treatment of children with trisomy 21 continues to be demanding for paediatric ophthalmologists. We recommend the following examination schedule for these patients: first, ophthalmological examination at 6–12 months of age, then once in 3–6 months for children under 2 years of age, once in 6 months for children 2–5 years of age, annually for children 5–10 years of age, and thereafter, to be decided on an individual basis depending on the presenting ocular abnormalities of the patient.

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Accommodation deficit in children with Down syndrome: practical considerations for the optometrist

Cited by 5 publications

References 49 publications

Prevalence of ophthalmological manifestations in pediatric and adolescent populations with Down syndrome: a systematic review of the literature

Prevalence of ophthalmological manifestations in pediatric and adolescent populations with Down syndrome: a systematic review of the literature

Prescribing patterns for hyperopia: an insight of the optometrist perspective and practice

Challenges in Patients with Trisomy 21: A Review of Current Knowledge and Recommendations

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