Anomalies of Refraction, Accommodation and Binocular Single Vision in Down syndrome

Abstract

Purpose: Down syndrome is one of the common chromosomal abnormalities. Many ophthalmic features are studied and reported previously. The aim of this study is to investigate and thoroughly study the anomalies of refraction, accommodation and binocular single vision in Down syndrome along with strabismus and ocular abnormalities.

Material and Methods: Total of 40 children with Down syndrome, age ranging from 6 years to 14 years old underwent ocular assessment including visual acuity assessment, non-cycloplegic refraction, ophthalmoscopy, ocular alignment and ocular motility tests and tests for binocular single vision

Results: Among the population of 40 children with Down syndrome. 40% children had hypermetropia, 37.5% had Astigmatism and 5% had myopia. Esotropia was the most common deviation with 60% involvement. The binocular single vision was found to be affected as well. It was completely absent in 12.5% of the population whereas 25% population had only grade I and 17.5% had grade II BSV. Other ocular findings were also noted and their respective prevalence was Nystagmus 15%, Cataract 25%, Blepharitis 10%, conjunctivitis 12.5%, iris abnormalities 10% and keratoconus 5%

Conclusion: Main anomalies of refraction were found to be hyperopia and astigmatism. Near point of accommodation was reduced as was the reduced amplitude of accommodation. Binocular single vision is also found to be disturbed in the presence of strabismus. Other ocular abnormalities like cataract, nystagmus and blepharitis are also encountered. Further studies are required to identify association with other anomalies which can be related to vision and must be diagnosed and treated with best treatment regime available.