Sujatha Nambudiri1, Sinumol Sukumaran Thulaseedharan2, Seena T.V.3 1,
BACKGROUND
Down syndrome, first described in 1866, is the most common chromosomal
derangement in live births. More than half of the patients with Down syndrome
have ophthalmic manifestations. We wanted to evaluate the most common ocular
abnormalities in children with Down syndrome in South India.
METHODS
All children with positive chromosomal analysis report for Down syndrome
between 2 - 18 years attending a semi-urban, tertiary medical care centre from
1/1/2013 to 1/1/2015 were included in this hospital based clinical cross sectional
study. Detailed ocular examination included visual acuity assessment using age
specific tests, diffuse light examination, assessment of ocular alignment, motility,
cover tests, slit-lamp biomicroscopy, cycloplegic refraction and direct and indirect
ophthalmoscopy.
RESULTS
In our study, 95 % of children had ocular abnormalities. The most important
defects were refractive errors (83.33 %), hyperopia (35 %), myopia 21 % of whom
2 children had high myopia of more than - 6D, and astigmatism (15 %). Among
the refractive errors, hyperopia was the commonest. Other ocular abnormalities
were cataract (13.33 %), esotropia (13.33 %), exotropia (3.33 %), nystagmus
(6.67 %), nasolacrimal duct obstruction (8.3 %) and optic disc coloboma (1.6 %).
CONCLUSIONS
Refractive errors, strabismus were the most common and significant visual defects
identified in children with Down syndrome in our study. Early detection of
refractive errors, strabismus and prompt and appropriate intervention like glasses
for refractive errors and surgical correction of strabismus is absolutely necessary
to prevent development of amblyopia. Improvement of vision accelerates the
overall development of the child. Management of Down syndrome children should
be a team approach with ophthalmologist playing an important role. These
children should have early and regular ophthalmological evaluations to maximise
the benefit.
