People with Down syndrome (DS) experience many of the common eye problems that people without DS experience. Some people with DS experience these common eye problems more frequently and/or at an earlier age than people without DS. Additionally, some people with DS develop other eye problems that are not frequently developed by people without DS.
As with other aspects of health and well-being, it is important for people with DS and people who support them to monitor their vision and watch for signs that there may be a vision problem. It may be difficult for people with DS to express when they are having trouble with their vision. In addition, vision changes may happen so slowly that the individual does not realize that there is a change or issue. If there is a change in cognition, decline in ability to use previously acquired skills or complete tasks, or a change in mood, it is a good idea to consider changes in vision as a possible cause.
We recommend that adults with DS visit an eye doctor at least once every two years (or more frequently in some individuals) so that existing issues can be monitored properly and new issues can be identified in a timely manner.
Some common eye problems that people with Down syndrome may experience include:
These occur when the shape of the eyeball makes it difficult to see. Common terms used to describe refractive errors include:
- Myopia (near-sightedness)
- Hyperopia (far-sightedness)
- Astigmatism (uneven focusing of light on the retina)
- Presbyopia (far-sightedness that occurs in older age, usually between 40-45 years of age; can occur at a younger age in people with DS)
These issues are generally treated with corrective lenses (glasses or contacts).
This is inflammation or infection of the eyelids that causes dry, itchy eyelids, often with crusty eyelashes. It can be caused by bacterial infection, allergies, acne rosacea, or other causes. The eyeballs also may get irritated with blepharitis. It can be described as feeling like there is sand in the eyes.
This condition is best treated with warm compresses applied a few times a day followed by gentle scrubbing with half-strength baby shampoo on a wash cloth to keep the area clean. Eye cleansers can also be purchased at a drugstore or grocery store. Eye drops to treat an infection can be prescribed by an eye doctor.
Often called pink eye, conjunctivitis is an inflammation of the membrane covering the eye. It can cause the eyes to be red or itchy. People may wake up in the morning with debris causing their eyelids to stick together. It can be caused by a virus, bacteria, allergies, or other causes. Antibiotic eye drops are prescribed if the cause is bacteria. If a person wears contact lenses, they may need to switch to glasses until the infection is resolved.
This is a condition where the cornea (the clear part in the front of the eye) becomes thinner and more curved. The cornea becomes cone-like in shape, hence the name. This cone sticks out from the rest of the eye and can cause vision problems. The cause of keratoconus is not clear but chronic eye-rubbing seems to worsen keratoconus and should be avoided. Management may include contact lenses, corneal cross-linking (to strengthen the cornea), or corneal transplant. As stated above, we encourage regular exams by your eye doctor, including during the teenage years when this condition is most common.
Cataracts occur when the lens of the eye becomes clouded, making it difficult to see. One or both eyes can be affected. Both congenital cataracts (present at birth) and acquired cataracts (developed later in life) are more common in people with DS. Acquired cataracts also may develop at a younger age in people with DS than in people without DS.
The best treatment for cataracts is a surgery in which the lens is removed and replaced with a new one. This is usually a fairly quick and routine surgery that requires only local anesthesia and little or no sedation. However, some individuals with DS may need to have the surgery done under general anesthesia. Eye drops are usually given several times a day for at least a week following the surgery. If an individual develops a cloudy lens but the vision is not affected severely, the cataract can be monitored by an eye doctor until it is severe enough to do surgery.
Chicoine, B. & McGuire, D. (2010). The Guide to Good Health for Teens and Adults with Down Syndrome. Woodbine House: Bethesda, MD.