The 21st of March is recognised as World Down’s Syndrome Day. Our mission is to help raise awareness of the eye conditions that may affect those with Down’s syndrome and the steps that can be taken to help those struggling.
People who have Down’s syndrome are more likely to have difficulties with their eyesight, up to half will need to wear glasses. It is vital that children, young people, and adults have regular eye checks to minimise the effects of any sight difficulty they have.
About Down’s Syndrome and The Eyes
Teenagers and adult who have Down’s syndrome should have a full assessment by an optician every year.
Anyone who has Down’s syndrome, aged 14 or over, is entitled to a free annual health check with their GP and vision should be discussed as part of this check. This is in addition to regular eye tests from an optician, it does not replace them.
Even when people with Down’s syndrome are wearing correctly fitted glasses, they will still have poor visual acuity. This means their world lacks firm details and sharp contrasts. This is the case for everyone who has Down’s syndrome.
If a person’s behaviour has changed, they appear confused or have lost skills, it’s a good idea to check for an underlying medical cause such as changes in vision. They may not be able to tell you their sight has changed.
Vision Problems in Young Children with Down’s Syndrome
Since refractive errors (long and short sight), nystagmus (wobbly eyes) and squint (eye turn) are more common in children who have Down’s syndrome, children should have a full eye examination before the age of 2.
Typically, children who have long or short sight at birth will grow out of this over the first 2-3 years. Children who have Down’s syndrome are highly unlikely to grow out of these conditions and can develop significant long or short sight in the early years. About 60% of children with Down’s syndrome will need glasses by the age of 4.
Visual acuity (detail vision) and contrast sensitivity (the ability to see faint targets) are reduced in all people who have Down’s syndrome, even when the correct glasses are worn. This means that children struggle to access conventional learning materials at school and teachers must make appropriate adjustments.
Keratoconus
Keratoconus is an eye disease that usually occurs during or after puberty. It can cause corneal thinning or haze and blurred vision. Glasses are used as an early treatment. As the disease progresses, corneal collagen cross-linking can be used. This involves a solution being applied to the eyes followed by ultraviolet light which causes new collagen bonds to form. In advanced stages, surgical options may be considered. Keratoconus is extremely common in individuals with Down’s syndrome.
Tear Ducts
Many individuals with Down’s syndrome have tear duct abnormalities. Family or caregivers may notice frequent tearing or discharge from the eyes that becomes worse during colds. Often the first line of treatment is massage over the space between the eye and the nose 2-3 times a day to attempt to open the tear duct. If the symptoms continue, the tear duct may need to be opened by a surgical procedure.
Cataracts
Children who have Down’s syndrome are at an increased risk of cataracts at birth or shortly after, the recommendation is children’s eyes should be checked for cataracts by the age of 6 weeks.
If cataracts are present from early in a child’s life, then a clear image is not delivered to the brain, and the brain does not ‘learn’ to see. If the cataract is not removed, it can result in lifelong vision impairment. This is why early detection of cataracts in infants and children is so important.
Other common eye issues in people with Down’s syndrome include strabismus (one or both eyes turn inward or outward), amblyopia (lazy eye with vision impairment), and nystagmus (involuntary movement of the eyes).
Strabismus does not necessarily cause vision impairment, it can be treated with glasses, eye patching, and in severe cases surgery. If left untreated, strabismus can cause amblyopia.
Amblyopia occurs when vision does not develop normally due to the eyes being misaligned and results in vision loss.
Nystagmus is an involuntary side to side, up and down, or circular movement of the eyes. It typically involves both eyes. Nystagmus may go away on its own with time, be managed with glasses, or in severe cases require surgery.
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If you’re worried about your or someone else’s eye health, get in contact with your local D. I. Blow Opticians and book in for an eye test today.
