Ophthalmic abnormalities in children with Down syndrome.

A comprehensive review of the available literature was performed to determine the common ophthalmic disorders in children aged 0 to 16 years with Down syndrome. The UK National Library for Health interface was used to search seven electronic databases, including MEDLINE and EMBASE. Terms related to Down syndrome, ophthalmology, and pediatrics were combined in the search strategy, which yielded 230 articles. Application of exclusion criteria left 23 articles to include in the review. Literature synthesis demonstrated that children with Down syndrome are at risk for several ocular disorders. Refractive error was a common finding, particularly hyperopia. Strabismus was also reported regularly, particularly esodeviation. Other frequent findings included poor visual acuity, nystagmus, and blepharitis, whereas cataract and glaucoma were less common but had potentially serious implications for future vision. Only one study compared routine pediatric examination to that of a pediatric ophthalmologist. The findings of this review confirm the need for an ophthalmic screening program for children with Down syndrome. Additional work should investigate how such a program could be best implemented and ascertain how to involve different professionals in such a service.