Bifocals and Down’s syndrome: correction or treatment?

Abstract

Bifocals are an effective correction for the reduced accommodation in children with DS and also act to improve accommodation with a success rate of 65%. Bifocal wear can therefore be temporary, i.e. a 'treatment' for the deficit, in at least one third of children.

Development and distribution of refractive error in children with Down's syndrome

“…Myopic children are prescribed a full correction at a time when distance targets become of interest. Since 2004, children with an accommodative deficit and/or strabismus at near have been prescribed bifocals; for those who were emmetropic, plano-distance bifocals were prescribed 14 18 23 24…”

Static and Dynamic Measurements of Accommodation in Individuals with Down Syndrome

“…1,5 A recent study supports the explanation of sensory deficits based on observed improvements of accommodative accuracy in young subjects with DS after a period of bifocal wear. 13 The authors of that study suggested that the improvement would not have occurred if accommodation were limited by mechanical deficits. 13 Knowledge of accommodative dysfunction in individuals with DS is limited to lag.…”

“…13 The authors of that study suggested that the improvement would not have occurred if accommodation were limited by mechanical deficits. 13 Knowledge of accommodative dysfunction in individuals with DS is limited to lag. One previous study attempted to measure accommodative amplitudes in these subjects, 2 but a later publication by the same laboratory acknowledged that this goal may not have been met.…”

“…1,2 Several studies have used dynamic retinoscopy to measure accommodative lag in subjects with DS, 2-10 and bifocal prescriptions have been evaluated as a treatment option. [11][12][13] However, the cause of poor accommodative accuracy is still unknown. One possible explanation is that poor accommodative accuracy is related to a mechanical deficit of the eye in which the accommodative mechanism is limited in its ability, such as with presbyopia.…”

How to help children with neurodevelopmental and visual problems: a scoping review

“…One35 reported that all 40 children (with previous hypoaccommodation) accommodated better with their bifocals and 26/40 (65%) also demonstrated better accommodation through the distance part of the lens, implying improved active accommodation rather than just the passive optical enhancement of accuracy of near viewing. The other36 reported that all 11 children improved the accuracy of their accommodation through the bifocal segment but not through the upper segment of their glasses.…”