Different visual development: norms for visual acuity in children with Down’s syndrome

Zahidi, Asma A A; Viñuela-Navarro, Valldeflors; Woodhouse, J. Margaret

doi:10.1111/cxo.12684

Cited by 14 publications

(19 citation statements)

References 19 publications

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“…To provide these children with the best optical correction possible is important, but we still need to acknowledge that they still have a disadvantage in learning due to poorer vision than typical developing children (Zahidi et al. ). Further research with bifocals with full corrections of the ametropia and longer follow‐up times may possibly reveal a higher maximum VA plateau in DS.…”

Section: Discussionmentioning

confidence: 99%

“…This may suggest that 0.3 Log-Mar is the performing plateau for mean VA in children with DS as a consequence of the differences in brain development (resulting in CVI) compared to children without DS. To provide these children with the best optical correction possible is important, but we still need to acknowledge that they still have a disadvantage in learning due to poorer vision than typical developing children (Zahidi et al 2018). Further research with bifocals with full corrections of the ametropia and longer follow-up times may possibly reveal a higher maximum VA plateau in DS.…”

Section: Performing Plateaumentioning

confidence: 99%

“…Compared to other children, many ocular findings in DS occur more frequently and in a more severe form (Creavin & Brown 2009;Little et al 2009b, Afifi et al 2013Aslan et al 2014;Watt et al 2015). In literature, the following prevalences have been reported: reduced visual acuity (poorer than 0.3 LogMar) in 80-100% and poor contrast sensitivity in almost all DS children (John et al 2004;Morton 2011;Little et al 2013;Watt et al 2015;Zahidi et al 2018). Accommodation deficit occurs in 50-90% of the children with DS (Woodhouse et al 1993(Woodhouse et al , 1996(Woodhouse et al , 2000Cregg et al 2001;Nandakumar & Leat 2009Anderson et al 2011;Doyle et al 2016Doyle et al , 2017.…”

Section: Introductionmentioning

confidence: 99%

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Effects of bifocals on visual acuity in children with Down syndrome: a randomized controlled trial

Weger

Boonstra

Goossens

2018

Acta Ophthalmologica

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Purpose Children with Down syndrome ( DS ) typically have reduced visual acuity ( VA ) and accommodation lag, but it is unclear whether prescribed glasses should correct both distance VA ( DVA ) and near VA ( NVA ) due to the lack of RCT s. We therefore conducted a multicentre RCT to compare the effects of bifocals designed to correct both DVA and NVA with distance‐correcting unifocal glasses in children with DS . Methods A total of 119 children with DS , aged 2–16, were randomly allocated for bifocal or unifocal glasses (with full correction of refraction error in cycloplegia) in 14 Dutch hospitals and followed during 1 year. VA data were analysed in relation to baseline VA with ancova . Results Treatment groups showed no differences at baseline. Shortly after receiving new corrections (~6 weeks), uncrowded NVA (bifocals 0.18 ± 0.33 LogMar; unifocals 0.09 ± 0.19 LogMar) and crowded NVA with bifocals (bifocals 0.13 ± 0.36 LogMar; unifocals 0.08 ± 0.33 LogMar) were significantly better than at baseline, but these short‐term improvements in NVA were not significantly different between the two treatments (p > 0.151). The 1‐year treatment differences were as follows: significantly larger improvement for bifocals compared to unifocals in both uncrowded NVA (bifocals 0.23 ± 0.29 LogMar, unifocals 0.12 ± 0.30 LogMar, p = 0.045) and crowded NVA (bifocals 0.31 ± 0.28 LogMar; unifocals 0.16 ± 0.30 LogMar, p = 0.017). Improvements in DVA were comparable (bifocals 0.07 ± 0.21 LogMar, unifocals 0.08 ± 0.22 LogMar, p = 0.565). Children with poor baseline VA improved more. Accommodation lag stayed unchanged. Conclusion After one year, bifocals with full correction of ametropia led to significantly larger improvement of both uncrowded NVA and crowded NVA in children with DS with accommodation lag compared to unifocals.

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Section: Discussionmentioning

confidence: 99%

Section: Performing Plateaumentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of bifocals on visual acuity in children with Down syndrome: a randomized controlled trial

Weger

Boonstra

Goossens

2018

Acta Ophthalmologica

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“…Children with DS are also at risk of ocular pathology and vision problems such as reduced best corrected visual acuity, poor accuracy of accommodation, a high incidence and magnitude of refractive error with a less successful emmetropisation process, a higher incidence of strabismus, cataract, epiphora and reduced contrast sensitivity compared to typically developing children (Courage et al, 1994 ; Cregg et al, 2001 , 2003 ; Stephen et al, 2007 ; Zahidi et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Behavioural Features of Cerebral Visual Impairment Are Common in Children With Down Syndrome

Wilton

Woodhouse

Viñuela-Navarro

et al. 2021

Front. Hum. Neurosci.

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It is widely recognised that children with Down syndrome have a broad range and a high prevalence of visual deficits and it has been suggested that those with Down syndrome are more likely to exhibit visual perception deficits indicative of cerebral visual impairment. This exploratory study aims to determine the prevalence of behavioural features suggestive of cerebral visual impairment (CVI) occurring with Down syndrome and whether the visual problems can be ascribed to optometric factors. A cohort of 226 families of children with Down syndrome (trisomy 21), aged 4–17, were invited to participate in a validated question inventory, to recognise visual perception issues. The clinical records of the participants were then reviewed retrospectively. A five-question screening instrument was used to indicate suspected CVI. The majority of the 81 families who responded to the questionnaire reported some level of visual perceptual difficulty in their child. Among this cohort, the prevalence of suspected CVI as indicated by the screening questionnaire was 38%. Only ametropia was found to have a significant association with suspected CVI, although this increased the correct prediction of suspected CVI outcome by only a small amount. Results suggest that children with Down syndrome are more likely to experience problems consistent with cerebral visual impairment, and that these may originate from a similar brain dysfunction to that which contributes to high levels of ametropia and failure to emmetropise. It is important that behavioural features of CVI are recognised in children with Down syndrome, further investigations initiated and appropriate management applied.

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“…Individual patients will have different visual development experiences, and therefore limiting the explanation for difference in outcomes only to muscle tone may be artificial. This explanation does not consider the impact of visual acuity, which is also known to be reduced in individuals with Down syndrome (Zahidi et al 2018), or of the presence or absence of binocular single vision which influence the surgical outcome (Kiziltunc et al 2016).…”

Section: Type Of Surgerymentioning

confidence: 99%

Strabismus Surgery for Esotropia, Down Syndrome and Developmental Delay; Is an Altered Surgical Dose Required? A Literature Review

Harrison¹,

Allen²,

O’Connor

2020

British and Irish Orthoptic Journal

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Background and Purpose: There is a high rate of strabismus, in particular esotropia, in children with Down syndrome or developmental delay, which frequently requires surgical correction. A paper in 1994 advocated that the surgical dose be adjusted due to an altered response in these children. The aim of this literature review is to evaluate the available evidence to establish whether an altered surgical approach is required in either population. Methods: A literature review was conducted using PubMed and Web of Knowledge. Only English language papers were eligible for inclusion. The papers were collated in chronological order for analysis, and their references searched for further relevant papers. Forward citation searches were also undertaken. Results: A 2 × 2 comparison is made between publications on Down syndrome (in isolation) and developmental delay populations (including Down syndrome) with adjusted versus non-adjusted surgery. Published surgical success rates on esotropia from unaltered surgical doses range from 62.0%-85.7% (four papers) in the Down syndrome cohort, with none of the adjusted surgeries having a successful outcome. Surgical success rates from adjusted surgical doses in developmental delay cohort range from 37.5%-86.0% (seven papers), with one unadjusted surgical success rate of 76.0%. The results across the studies are summarised in a table and discussed. Conclusions: An exaggerated surgical effect in individuals with developmental delay has been reported, and this population may benefit from a reduced surgical dose. Published research does not support giving a reduced surgical dose in individuals with Down syndrome, but more research needs to be done to make a definitive conclusion.

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Different visual development: norms for visual acuity in children with Down’s syndrome

Cited by 14 publications

References 19 publications

Effects of bifocals on visual acuity in children with Down syndrome: a randomized controlled trial

Effects of bifocals on visual acuity in children with Down syndrome: a randomized controlled trial

Behavioural Features of Cerebral Visual Impairment Are Common in Children With Down Syndrome

Strabismus Surgery for Esotropia, Down Syndrome and Developmental Delay; Is an Altered Surgical Dose Required? A Literature Review

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