DOWN'S SYNDROME: OPHTHALMIC PROBLEMS. Key Points.

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(based on DSMIG guidelines for basic essential medical surveillance)

Refractive errors (including hypermetropia) very common from early childhood. If untreated cause secondary handicap. Cataract and/or glaucoma overrepresented in infancy and later. Blepharitis and nystagmus common. Keratoconus overrepresented at older ages.

Newborn and 6 weeks - check for cataract.
1st year - visual behaviour to be monitored by a paediatrician.
18m – 2yrs – Full ocular/visual assessment to include orthoptic assessment, refraction and fundus examination. One third will have refractive error. Majority will have defective accommodation.
Follow up as required for those with problems.
2 yearly full assessment (hospital or high-street) for others throughout life.
By age 4 years 50% have refractive error
Consider near correction or bifocals at all ages
If pain, and/or changing vision, and/or red eye, refer for immediate specialist opinion.

Last updated 30.01.06

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