Characteristic ocular findings in Asian children with Down syndrome

Kim, Jae‐Hun; Jm, Hwang; Kim, Hyung Jun; Ys, Yu

doi:10.1038/sj.eye.6700208

Cited by 105 publications

(112 citation statements)

References 16 publications

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“…Historically, the prevalence of strabismus in the population with Down syndrome has ranged from 20 to 45%. 15,16 Despite this relatively high prevalence of strabismus, most of our patients (40/72 [55%]) needed no intervention because in these children the strabismus was latent or insignificant. In addition, parents did not view cosmetic correction as a high priority.…”

Section: Discussionmentioning

confidence: 99%

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Surveillance of vision and ocular disorders in children with Down syndrome

Stephen

Dickson

Kindley

et al. 2007

Develop Med Child Neuro

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Children with Down syndrome have a high prevalence of ocular disorders. The UK Down's Syndrome Medical Interest Group (DSMIG) guidelines for ophthalmic screening were locally implemented into a protocol that included neonatal eye examination by an opthalmologist and a comprehensive ophthalmological examination (cycloplegic refraction, ophthalmoscopy, and orthoptic assessement) by at least the age of 3 years, followed by preschool follow‐up as indicated. We audited retrospectively surveillance for ocular disorders before and after the DSMIG‐based guidelines were locally adopted in 1995. Results were compared for children born before and after the implementation of screening guidelines. A total of 81 children (43 females, 38 males) with Down syndrome were identified. After the DSMIG protocol, 34/36 children received a full ophthalmological examination in the neonatal period, compared with 9/27 children before 1995 (p<0.001). Neonatal screening resulted in the detection of cataracts in three infants. Mean age of first comprehensive ophthalmic screening outside the neonatal period was similar in the two groups (1y 6mo before guidelines vs 1y 9mo after), as were the proportion of children receiving preschool eye checks (27/30 before; 17/18 after). Overall, 65.7% children were screened in accordance with the guidelines, improving to 100% in recent years. At school age, 43% of the study population had significant refractive errors, with 27% having hypermetropia and astigmatism. Earlier prescription of glasses for refractive errors was seen (mean age 5y 6mo before guidelines; 3y 6mo after; p<0.001). Prevalence of other ocular disorders included strabismus (34/72, 47%), nasolacrimal duct obstruction (26/73, 35.6%), cataracts (5/64, 7.8%), and nystagmus (12/72, 16%). Establishment of the DSMIG‐based local protocol has streamlined ocular surveillance. It is anticipated that this will improve developmental and functional outcomes in Down syndrome.

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Section: Discussionmentioning

confidence: 99%

“…[15][16][17] Fine, rapid horizontal nystagmus is known to occur frequently in patients with Down syndrome and needs no specific investigation or intervention. 13 In most of our patients, the nystagmus was stable or there was spontaneous resolution.…”

Section: Discussionmentioning

confidence: 99%

Surveillance of vision and ocular disorders in children with Down syndrome

Stephen

Dickson

Kindley

et al. 2007

Develop Med Child Neuro

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“…It is associated with numerous ocular manifestations, including eyelid problems, keratoconus, Brushfield spots of the iris, refractive error, strabismus, and nystagmus. 1,2 Many studies have reported an increasing prevalence of refractive errors with age in patients with Down syndrome. 3,4 The prevalence of strabismus in these patients has been reported to be between 19 and 70%, with esotropia representing the vast majority of strabismus cases.…”

Section: Introductionmentioning

confidence: 99%

Refractive errors and strabismus in Asian patients with Down syndrome

2008

Eye

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Purpose The purpose of this study was to investigate the prevalence and patterns of refractive errors and strabismus in Asian patients with Down syndrome, as they relate to age. Methods A total of 261 Korean patients with Down syndrome were examined between March 1999 and May 2007. Eighty-nine patients were excluded from the study. The remaining 172 patients were divided into four age groups (o3 years, 3-o6 years, 6-o9 years, and X9 years). Full ophthalmologic examinations and strabismus assessments were performed. Refractive errors were defined as follows: myopia XÀ1.00 D, hyperopia X þ 1.00 D, astigmatism X±1.00 D, and anisometropia as a refractive difference between the two eyes X1.00 D. Results Hyperopia (46.5%) was slightly more common than myopia (40.1%). The prevalence of myopia increased with age, whereas that of hyperopia decreased. Astigmatism was found in 66.8% of patients, and astigmatism X2 D was found in 16.8% of patients. Anisometropia was identified in 29.7% of patients, and the incidence of anisometropia correlated significantly with age as well as with astigmatism. Esotropia (22.1%) was twice as common as exotropia (10.5%). The prevalence of esotropia increased with age, but that of exotropia decreased. Fifty patients were found to have nystagmus (29.1%). Conclusions In Asian patients with Down syndrome, esotropia was more common than exotropia and hyperopia was more common than myopia. The prevalence of exotropia and astigmatism was much higher in this study than has been previously reported.

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“…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%).…”

Section: Discussionmentioning

confidence: 99%

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

Raman

Subrayan

2017

Int J Contemp Pediatr

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Children with down syndrome have a higher prevalence of glaucoma compared to the age matched normal population. Although the management of childhood glaucoma in a down syndrome child is almost similar to primary congenital glaucoma, the outcomes and prognosis of these children vary due to the associated comorbidities. This case illustrates a classical presentation of a 5-month infant with down syndrome with clinical triad of photophobia, blepharospasm, and epiphora. Prompt recognition of the condition and timely surgical management was vision saving in this child. Extended care for visual rehabilitation was given to this child to maintain the visual outcome.

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Characteristic ocular findings in Asian children with Down syndrome

Abstract: Aims/Purpose

Cited by 105 publications

References 16 publications

Surveillance of vision and ocular disorders in children with Down syndrome

Surveillance of vision and ocular disorders in children with Down syndrome

Refractive errors and strabismus in Asian patients with Down syndrome

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

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