Visual characteristics of children with Down syndrome

Purpose To analyze long-term visual development in children with Down syndrome who received early ophthalmological intervention. Methods A total of 125 children with Down syndrome who were examined before 6 years of age and followed up for more than 5 years were selected. Visual development, refraction, visual acuity testing, and the prescription of spectacles were examined retrospectively. Results Mean visual acuity by age was as follows: 2 years, 1.13 +/- 0.23 logarithm of the minimum angle of resolution (logMAR); 5 years, 0.55 +/- 0.25 logMAR; 8 years, 0.27 +/- 0.19 logMAR; 11 years, 0.17 +/- 0.16 logMAR; and 14 years, 0.10 +/- 0.15 logMAR. In 32 children (25.6%), visual acuity reached 0.0 logMAR or better. Hyperopia of +2D or more was observed in 132 eyes (52.8%), and astigmatism of 2D or more was observed in 153 eyes (61.2%). Subjective testing was difficult in many children prior to 4.5 years of age, and grating acuity testing was necessary. Spectacles were prescribed at a mean age of 3.5 +/- 1.6 years in 120 children (96.0%). The average duration until the spectacles were worn constantly was 9.0 +/- 9.3 months. Conclusion Early ophthalmological intervention and longitudinal care is important for children with Down syndrome.