Visual defects in Nepalese children with Down syndrome

Abstract

Background: Down syndrome (DS) is a common chromosomal anomaly. People with this syndrome have recognisable physical characteristics and limited intellectual abilities. The aim of this study was to determine visual defects, especially refractive error and binocular anomalies, in a sample of Nepalese children with DS. Methods: Thirty-six children with DS (19 boys and 17 girls) from the Kathmandu valley, aged from four months to 18 years, underwent detailed optometric examination. Cycloplegic refraction was performed on all subjects. Vision on presentation of all the children was assessed with preferential looking cards, the Kay picture cards, the BaileyLovie logMAR chart or the Snellen chart. Binocular function was assessed with cover test, Hirschberg or Bruckner test. Results: Cycloplegic refraction of the children revealed that 80 per cent of the children had significant refractive error. Most of them had hyperopia (55 per cent), followed by astigmatism (44 per cent), myopia (25 per cent) and anisometropia (19 per cent). Only two (5.6 per cent) children were strabismic and both of them were alternating esotropes. Nystagmus was present in 10 (28 per cent). Other ocular findings were upward slanting palpebral fissures, blepharitis, congenital nasolacrimal duct obstruction, blepharoconjunctivitis, chalazion and lenticular opacities. Conclusion: Nepalese children with DS have a high prevalence of refractive error and nystagmus. Regular eye examinations are indicated for these children to enable early diagnosis and appropriate management of ocular disorders to improve their vision and quality of life.

Ophthalmic manifestations of children with Down syndrome in Port Harcourt, Nigeria

“…Previous studies7–19 have established that refractive errors and strabismus are more prevalent among children and young adults with DS when compared with controls, as reported in other studies 17,23,24,38,39. For refractive errors, our finding of 38.1% prevalence of myopia (Table 1) is comparable to findings from other studies17,23,24,38,39 and lower than findings by other authors,17,24,39 although higher than findings reported by others 19,27,35,40. In children with DS, heart defects have been reported to be associated with myopia, although the mechanism is not clear 22,27,41.…”

“…Visual acuity was improved to a statistically significant degree in the DS group after refraction ( P = 0.001, χ 2 = 27.86). The prevalence of strabismus in the DS group in our study (9.5%) was higher than findings reported by Paudel et al,35 but lower than in other studies: 18.2%,19 27%,30 21.8%,31 26.7%,33 and 23% 40. As in the current study, esotropia has been reported to be more prevalent than exotropia in DS populations 16,19,25,29,37.…”

“…The prevalence of refractive errors (myopia, hyperopia, and astigmatism) ranged between 3% and 62.3%,16,19,20–27,30 strabismus 5% and 57%,16,19,21,26,29,35,36 and the prevalence of esotropia was higher than exotropia in all the studies 16,19,21,26,29,35,36. Others include reduced amplitude of accommodation (26%–91.8%),19,27,28 conjunctivitis (5.6%–6.7%),20,34 eyelid abnormalities (1%–6.7%),25,26,29,30,33,34 blepharitis (especially high, at 30%–47%),18,27,31 Brushfield spots (36%–81%),18,31 glaucoma (0.8%–6.7%),16,29,34 and retinal disorders (1.7%–40%) 27,29,31,34…”

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

“…Significant refractive error (spherical equivalent outside of the range of ‐0.50 to +1.00 D) is found in almost 80 per cent of children with Down syndrome (Table ) …”

Childhood glaucoma in Down syndrome: a case report and literature review

“…In most recent studies conducted in Asia, the prevalence of glaucoma in Down syndrome ranges from 0.4% to 1% of cases, although in one series in Malaysian Down syndrome children, the prevalence was reported to be 6.7%. [5][6][7] The commonest ocular associations of Down syndrome that are reported in the Malaysian studies are include epicanthic fold (96.7%), nystagmus (33.3%) and strabismus (26.7%). Other findings were bilateral congenital cataract (13.3%) blepharoconjunctivitis (10.0%), eyelid abnormalities (6.7%) nasolacrimal duct obstruction (3.3%) bilateral retinoblastoma (1.7%), bilateral retinal detachment (1.8%) and chronic uveitis (1.7%).…”