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Down Syndrome and the Eye

Have you ever wondered what makes the eyes of someone with Down syndrome unique?  Not only is the outward appearance of the eye different, but certain eye conditions can be more common in patients with Down syndrome as well. 

A characteristic upward slanting of the eyelids, as well as, prominent skin folds between the eye and the nose are usually visible in someone with Down syndrome.  On top of those external traits, there are many other characteristics that can be more common with the condition making the need for regular eye exams very important.

Children with Down syndrome are much more likely to need glasses and are also more likely to have difficulty with accommodation, or focusing from far to near.  Often bifocal glasses can be very helpful to provide the best possible vision.  Strabismus, a misalignment of the eyes, is also more common and sometimes can be difficult to detect.  If not detected early, strabismus can also cause reduced vision in one eye and impair depth perception.  If caught early, simply wearing the correct glasses prescription can often correct these issues.  When glasses aren’t enough, a surgery on the muscles to re-align the eyes can be performed.

Several eye diseases are also more common in Down syndrome.  At a young age, the drainage system for the tears may not be properly formed and can cause the eyes to water.  Massaging the area frequently helps but surgical intervention is sometimes required.  Cataracts are also a concern as they can significantly impair vision development if not caught early.  If a child is born with cataracts they must be treated early to prevent long-term vision loss.  About 30% of Down syndrome patients also develop keratoconus, which is a cone-shaped distortion on the front of the eye.  In addition, a rhythmic moving of the eyes back and forth called nystagmus is more common.  

Like all people, annual eye exams are important for individuals with Down syndrome. All aspects of the eyes’ health can be evaluated and any year over year changes accurately documented. However, if there are any noticeable changes of a person’s eye health or their vision between appointments, a comprehensive eye exam can be scheduled to determine if there has been any change that may require new attention.  

By Ashley Herde, OD

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