Development of Refractive Error and Strabismus in Children with Down Syndrome

Cregg, Mary; Woodhouse, J. Margaret; Stewart, Ruth E.; Pakeman, Valerie H.; Bromham, Nathan; Gunter, Helen Louise; Trojanowska, Lidia Danuta; Parker, Margaret G.; Fraser, William

doi:10.1167/iovs.01-0131

Cited by 100 publications

(107 citation statements)

References 33 publications

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“…This increase in the prevalence of refractive errors in children with Down syndrome might reflect a failure of emmetropization. 12 Earlier reports have documented that esotropia is common and exotropia is uncommon in individuals with …”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Refractive errors and strabismus in Asian patients with Down syndrome

2008

Eye

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“…65,66 A more dramatic failure of emmetropisation can be observed in Down's syndrome despite the good visual acuity usually observed in this condition. 67,68 It has been proposed that the apparent absence of emmetropisation in Down's syndrome would reveal the underlying pattern of genetically determined eye growth. 69 The patterns of refractive development in Down's syndrome are instead highly variable and display the mathematical features of a random walk typical of a stochastic process.…”

Section: Clinical Examples Of a Failure Of Emmetropisationmentioning

confidence: 99%

“…69 The patterns of refractive development in Down's syndrome are instead highly variable and display the mathematical features of a random walk typical of a stochastic process. 67,68 A comprehensive model of the mechanisms involved in refractive development This paper has reviewed the major influences on refractive development from birth to adulthood. These are the initial refraction at birth, the efficacy and duration of the emmetropisation process in the first few years of life, the poorly understood mechanisms of myopia onset and progression, stochastic influences on eye growth, and, more rarely, sources of major genetic bias towards myopia or hyperopia.…”

Section: Clinical Examples Of a Failure Of Emmetropisationmentioning

confidence: 99%

Emmetropisation and the aetiology of refractive errors

Flitcroft

2014

Eye

146

124

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The distribution of human refractive errors displays features that are not commonly seen in other biological variables. Compared with the more typical Gaussian distribution, adult refraction within a population typically has a negative skew and increased kurtosis (ie is leptokurtotic). This distribution arises from two apparently conflicting tendencies, first, the existence of a mechanism to control eye growth during infancy so as to bring refraction towards emmetropia/low hyperopia (ie emmetropisation) and second, the tendency of many human populations to develop myopia during later childhood and into adulthood. The distribution of refraction therefore changes significantly with age. Analysis of the processes involved in shaping refractive development allows for the creation of a life course model of refractive development. Monte Carlo simulations based on such a model can recreate the variation of refractive distributions seen from birth to adulthood and the impact of increasing myopia prevalence on refractive error distributions in Asia.

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“…These findings suggest that reported prevalence estimates vary by the definition used for refractive errors and the techniques used to identify refractive errors. More recently, Cregg et al [2003] found that refractive errors among infants with Down syndrome increased with age from infancy to 30 months, a pattern opposite of that expected in early child development.…”

Section: Vision Problems Among Specific Populationsmentioning

confidence: 82%

“…(Table 1) [Maino et al, 1990;Pueschel, 1995;Saenz, 1999;Smith, 2001]. The prevalence of strabismus has been reported to range from 9 to 69% among individuals with Down syndrome, compared with Ͻ1 to 10% in the general population and 4 to 45% in the overall population of individuals with ID [Cullen and Butler, 1963;Lyle et al, 1972;Markovits, 1975;Jaeger, 1980;Woodruff et al, 1980;NCHS, 1983;Levy, 1984;Shapiro and France, 1985;Jacobson, 1988;Caputo et al, 1989;Aitchison et al, 1990;Catalano, 1990;Cooley and Graham, 1991;Hestnes et al, 1991;Sacks et al, 1991;Pérez-Carpinell et al, 1994;Prasher, 1994;Roizen et al, 1994;Berk et al, 1996;da Cunha and Moreira, 1996;Maino et al, 1996;McCulloch et al, 1996;Block et al, 1997;Woodhouse et al, 1997van Allen et al, 1999;Buch et al, 2001;Merrick and Koslowe, 2001;Cregg et al, 2003;van Splunder et al, 2003bvan Splunder et al, , 2004Gormezano and Kaminski, 2005;Murphy et al, 2005]. In addition, the prevalence of cataracts, which tends to increase with age in the general population, increases to a greater extent with age for individuals with Down syndrome …”

Section: Vision Problems Among Specific Populationsmentioning

confidence: 99%

Vision and oral health needs of individuals with intellectual disability

Owens

Kerker

Zigler

et al. 2006

Ment. Retard. Dev. Disabil. Res. Rev.

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Over the past 20 years, there has been an increased emphasis on health promotion, including prevention activities related to vision and oral health, for the general population, but not for individuals with intellectual disability (ID). This review explores what is known about the prevalence of vision problems and oral health conditions among individuals with ID, presents a rationale for the increased prevalence of these conditions in the context of service utilization, and examines the limitations of the available research. Available data reveal a wide range of prevalence estimates for vision problems and oral health conditions, but all suggest that these conditions are more prevalent among individuals with ID compared with the general population, and disparities exist in the receipt of preventive and early treatment for these conditions for individuals with ID. Recommendations for health improvement in these areas include better health planning and monitoring through standardized population-based data collection and reporting and increased emphasis on health promotion activities and early treatment in the healthcare system.

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Development of Refractive Error and Strabismus in Children with Down Syndrome

Abstract: The retention or development of infantile refractive errors in many children with Down syndrome indicates a failure of emmetropization. All children were at risk of strabismus whatever the refractive error. The findings have implications for timing of screening programs.

Cited by 100 publications

References 33 publications

Refractive errors and strabismus in Asian patients with Down syndrome

Refractive errors and strabismus in Asian patients with Down syndrome

Emmetropisation and the aetiology of refractive errors

Vision and oral health needs of individuals with intellectual disability

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