Ophthalmological Considerations in People with Down Syndrome
Main Ophthalmological Conditions in People with Down Syndrome
People with Down syndrome exhibit specific medical characteristics that must be considered in their comprehensive care. These include thyroid disorders, heart conditions, hearing problems, obstructive sleep apnoea-hypopnoea syndrome (OSAHS), neurological alterations, and visual impairments.
In the visual domain, approximately 80% of people with Down syndrome will experience some form of ophthalmological condition, most of which are mild.
Most Prevalent Ophthalmological Conditions
- Refractive Errors
- People with Down syndrome often require glasses due to refractive issues, with high astigmatism being the most common.
- Strabismus
- Present in about half of this population, strabismus refers to ocular misalignment, which can affect binocular vision.
- Amblyopia (lazy eye)
- This often develops as a result of strabismus or uncorrected refractive errors. In such cases, eye patches or specific therapies may be needed to improve vision.
- Nystagmus
- This is a rapid, involuntary eye movement that impacts visual focus. It occurs in 20% of people with Down syndrome, particularly those with strabismus, and often necessitates compensatory head movements to enhance focus.
- Cataracts
- Although more common in older adults, approximately 3% of children with Down syndrome are born with cataracts or develop them at an early age. Surgery is typically required in such cases to prevent severe visual impairment.
- Congenital Nasolacrimal Duct Obstruction
- A frequent condition in children with Down syndrome caused by partial or complete obstruction of the tear duct, preventing normal tear drainage.
- This can result in constant tearing, recurrent conjunctivitis, and severe infections. In most cases, gentle massage of the area is recommended to help open the valve of Hasner during the first year of life.
- Blepharitis
- Chronic inflammation at the base of the eyelashes, which can cause eye irritation, light sensitivity, tearing, and dryness. Blepharitis is uncomfortable and, in severe cases, may lead to complications such as keratoconus, a deformity of the cornea.
The Importance of Regular Eye Check-ups
It is essential that all children with Down syndrome are assessed by an ophthalmologist at six months of age and continue with annual check-ups throughout their lives.
Warning Signs
The following signs may indicate the presence of a visual condition and require consultation with a paediatric ophthalmologist:
- Frequently squinting or difficulty focusing.
- Holding objects very close.
- Frequent accidents related to vision.
- Eye misalignment (strabismus).
- Persistent or constant tearing.
- Recurrent red eye.
- Light sensitivity (photophobia).
- Frequent eye rubbing.
Conclusion
People with Down syndrome are more prone to developing certain visual conditions, but early diagnosis and regular monitoring can prevent severe complications and ensure a better quality of life. If you notice any warning signs, do not hesitate to consult a paediatric ophthalmologist.
