Down Syndrome and the Eyes

October is National Down Syndrome Awareness Month. Down syndrome is a condition that occurs due to an extra chromosome. It can affect a person’s physical growth and cognitive ability. The extent of developmental issues varies greatly. People with Down syndrome are also at a higher risk for certain health problems, including issues that affect the eyes and vision. 

Eye and Vision Conditions in People with Down Syndrome

The eye structure of people with Down syndrome usually involves an upward slant of the eyelids and folds between the nose and eyes. But in addition to structural differences, eye conditions are prevalent in people with Down syndrome. According to the National Down Syndrome Society, about 50 percent of people with Down syndrome have some type of eye or vision problem. The severity of the vision problem varies from mild to one that may threaten eyesight.

Although not everyone with Down syndrome will develop an eye problem, certain conditions are possible, including the following:

Refractory errors: Refractory errors, such as nearsightedness and farsightedness, occur in the general population, but they tend to develop more often in people with Down syndrome. Glasses can correct refractory errors and improve vision. The earlier a refractory error is diagnosed, the better it is for the child’s development.

Brushfield’s spots: White spots may develop in the iris, which is the colored part of the eye. The spots do not interfere with vision.

Tear duct abnormalities: It is common for people with Down syndrome to have abnormalities that involve the tear ducts. For example, excessive tearing or discharge from the eye may develop, especially when the individual has a cold. Massaging the space between the nose and the eye a few times a day may open the tear duct and decrease discharge. In some cases, if the condition continues and is bothersome, surgery is an option to open the ducts.

Cataracts: Children with Down syndrome are at an increased risk of developing early cataracts. Cataract surgery is often successful in replacing the lens and improving vision.  
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Signs to Watch for in Children with Down Syndrome  

Children and adults with Down syndrome may experience a wide variety of eye and vision problems related to the condition. In cases where communication is poor, some symptoms may go unnoticed. It is essential to notice subtle changes. Some signs and symptoms to watch for include:

• Frequent squinting
• Closing one eye
• Unusual head tilt
• Wandering or crossing of one or both eyes
• Increased light sensitivity
• Blurry vision
• Regression in developmental milestones
• Eyelid droop

If any of the above symptoms develop, it is important to see an eye doctor as soon as possible. 
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How to Keep the Eyes Healthy with Down Syndrome

Individuals with Down syndrome should follow the same guidelines for eye health as those without Down syndrome, such as eating a diet high in fruits and veggies, not smoking, and protecting their eyes from UV rays by wearing sunglasses. Use of the appropriate protective eyewear when participating in sports to avoid injuries is also recommended.

It is essential for children and adults with Down syndrome to have regular eye exams. Eye exams are helpful in diagnosing vision problems before they become serious. In children, vision issues can interfere with learning and may contribute to developmental delays.

According to the American Academy of Ophthalmology (AAO), children with Down syndrome should have an eye exam by six months of age and every year or two after as recommended by their doctor. Adults should also have regular eye exams every two years or more often if advised by their healthcare provider.

During an exam, evaluation for cataracts, nystagmus, and strabismus should start early in infancy. Since it is very common for children with Down syndrome to need glasses, the AAO also recommends annual screenings for refractory errors at least until age five.

Learning the possible eye problems associated with Down syndrome can help correct vision before it affects development and daily functioning.

We hope our post was helpful. If you have questions about eye conditions and Down syndrome, or if you would like to schedule an appointment with one of our eye doctors, please call our office at 508-746-8600.