Abstract
Purpose: Almost 57% of children with Down syndrome have significant refractive error (hypermetropia ≥+3.00 D, myopia ≥−1.00 D) (Woodhouse et al., 1997); they are 17 times more likely to have significant long or short sight than their typically developing peers. Also, for the age range 4.5 months to 11.1 years, 34% of children with Down syndrome have strabismus, compared with 4–7.5% of control children (British College of Optometrists, 1991–94). In addition, 82% of our cohort of children with Down syndrome (n = 100) have reduced accommodation at near. In order to investigate the influence of accommodation accuracy on refractive error and strabismus, this study compared the above parameters in children with Down syndrome who accommodated accurately with those who did not.Methods: Accommodation was measured using dynamic retinoscopy technique at testing distances of 25, 16.6 and 10 cm. An accommodative lag of plano to 0.75 D is normal for typically developing children (Rouse et al., 1984). Accurate accommodation for our cohort was therefore defined as ≤0.75 D lag of accommodation (at a minimum of two of three testing distances). Children with Down syndrome who accommodated accurately were age matched with a child with inaccurate accommodation, based on their most recent visit for which a full data set was available.Results: Chi‐square analysis of the data for the two groups revealed that there was a greater number of children with significant hypermetropia (p = 0.003) and strabismus (p = 0.003, Fisher's exact test) in the under‐accommodating group.Conclusion: Children with Down syndrome who under‐accommodate are more likely to be strabismic and have significant hypermetropia.
Published Version
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