Ocular findings in Down’s syndrome: evaluation of 66 Hong Kong Chinese children

Abstract

Aim: To identify the most common ocular findings in a group of children with Down’s syndrome in a retrospective case-series study at a regional hospital in Hong Kong.

Patients and methods: Sixty six children with Down’s syndrome aged between 2 and 18 years underwent ocular examination from June 1998 to December 2001. The presence of ocular abnormalities after examination, including visual acuity assessment, slit-lamp biomicroscopy, ocular motility, cycloplegic retinoscopy, and indirect ophthalmoscopy, were measured.

Results: Matching tests were found to be the most useful method of visual acuity assessment. Ocular abnormalities in decreasing frequency were as follows: refractive errors (85.0%), strabismus (24.0%), nystagmus (24.0%), cataract (18.0%), severe myopia (11.0%), myopic fundal changes (6.0%), myelinated nerve fiber (4.5%), and optic disc coloboma (3.0%). No patient had Brushfield spots or keratoconus. The frequency of ocular abnormalities increased with age.

Conclusions: Early diagnosis of the ocular abnormalities in patients with Down’s syndrome together with the treatment of refractive errors, strabismus, cataract, and amblyopia may minimize handicaps. Therefore, referral programs should be advocated for all children with Down’s syndrome and annual reassessment by ophthalmologists is recommended.