Overview

There is an increased incidence of a range of ocular disorders in people with Down syndrome including congenital cataract, squint, glaucoma, blepharitis, blocked nasolacrimal ducts, nystagmus and keratoconus.

Significant refractive error is also more common at all ages and if uncorrected is an important cause of preventable secondary disability. Over 50% of children with Down syndrome starting primary school need spectacles to correct a refractive error compared with 5-8% in the general population.

Early correction for hypermetropia (long sight) and the use of bifocals can be beneficial in many children, to help with accommodative errors.

The possibility of eye problems should therefore be considered at every medical review, starting with the neonatal examination for congenital cataract.

Guidelines recommend regular formal visual assessments, at least every 2 years, throughout life.

Examination for keratoconus should be annual from pre-adolescence up to the age of 25 years, since treatment is viable only in the early stages.

 

Updated by Dr Liz Herrieven June 2024

DSMIG Guidance

Ophthalmic problems – basic medical surveillance essentials

DSMIG evidence-based guideline

Last updated 2012

Background notes to the basic medical essential guideline

Last updated 2012

Presentations at DSMIG Meetings

Materials from meetings are available for members only who need to log in to access them. For details on how to become a member click here.

Additional Resources

Down’s Syndrome Vision Research Unit- Cardiff University

Based on over 20 years of research into vision problems in people with Down syndrome, this site offers expert advice, information and useful web inks for parents, teachers and health professionals on eye conditions

Down’s Syndrome Association Information on Vision

DSA / DSMIG Health Series Eye Conditions  in children 

DSA / DSMIG Health Series Children – Vision, Eye tests and glasses 

DSA / DSMIG Health Series Adults – Vision, Eye Tests and Glasses

Book Chapter – Vision and eye disorders

Pat Charleton and Maggie Woodhouse

in

Down Syndrome – Current Perspectives
Edited by Richard Newton , Shiela Puri and Liz Marder 2015

Zahidi AAA, McIlreavy L, Erichsen JT, Woodhouse JM. Visual and Refractive Status of Children With Down’s Syndrome and Nystagmus. Invest Ophthalmol Vis Sci. 2022 Feb 1;63(2):28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883157/

 

Martin-Perez Y, Gonzalez-Montero G, Gutierrez-Hernandez AL, Blázquez-Sánchez V, Sánchez-Ramos C. Vision Impairments in Young Adults with Down Syndrome. Vision (Basel). 2023 Sep 10;7(3):60.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536554/

 

Kristianslund O, Drolsum L. Prevalence of keratoconus in persons with Down syndrome: a review. BMJ Open Ophthalmol. 2021 Apr 21;6(1):e000754. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061858/