Down Syndrome - Top Six Visions Problems, Their Causes and Solutions in Down Syndrome Children

By Craig Kendall
Children with Down syndrome are unfortunately vulnerable to a number of medical and health issues that go along with the disorder as your doctor, no doubt, has told you. One of them is problems with vision. Down syndrome can affect the way that eyes develop, which can impact overall vision.

Over half of people with Down syndrome have eye problems of some sort. As you probably already know, there are characteristic features in the eyes present in all or most people with Down syndrome. The eyelids slant upwards; there are folds of skin between the person's eye and nose; and there are often small white spots on the iris of the eye, which are called Brushfield's spots.

Five Common Down Syndrome Vision Problems

1. Refractive error is the most common eye issue in people with Down syndrome

Why do so many people with Down syndrome need glasses?

This is the result of something called a refractive error, which is the most common eye issue in people with Down syndrome. When someone is short-sighted, they have trouble seeing things that are in the distance. Long-sighted means that you have trouble seeing things close up. Both of these are refractive errors that can be treated with prescription eyeglasses.

2. Accommodations

There are other problems that could require the use of eyeglasses. Accommodation refers to problems focusing one's eyes on tasks nearby. People are able to change the focus of their eyes by having the muscles in the eyes change the shape of the elastic lens inside the eyes. This is not a problem of short or longsightedness. It is not usually helped by wearing glasses, but sometimes can be helped by wearing bifocals.

3. Astigmatism

Another common problem is astigmatism. Astigmatism happens when the curve of the cornea is not symmetrical. This causes the vision to be blurred no matter what the distance is. Fortunately, this can be helped by glasses that can help correct for the different curves of the cornea.

4. Tear Duct Abnormalities

Many kids with Down syndrome have tear duct abnormalities. This shows itself in discharge and tearing from the eyes. Massage of the tear sac region, between the eye and nose, can sometimes help this condition. Ask your doctor or therapist for specific instructions on addressing tear duct abnormalities in your Down syndrome child.

5. Strabismus or Squinting is Common in Down Syndrome Children

Something called strabismus, or squinting, is also common with people who have Down syndrome. Because there is not enough muscle coordination between the eyes of someone with Down syndrome, it sometimes causes the eyes to point in different directions. This may cause double vision, loss of depth perception, or vision in only a single eye. The eyes are misaligned, one might say.

Sometimes glasses can help strabismus, but your doctor or other medical specialist may recommend surgery on the eye muscles as a therapy to cure this problem.

6. The Risk of Cataracts in Down Syndrome

Perhaps the most severe problem that can affect the eyes of someone with Down syndrome is cataracts. A cataract is a clouding of the lens, resulting in blurred vision, glare when facing light, and double vision. Cataracts can often be present in older people, but with Down syndrome, babies will often have them at birth, or a very young age.

The problem with having cataracts so early in life (not that you really want to have them at any point in life), is that a young Down syndrome child who is not able to see well when they are first developing runs a risk of never being able to see well, even after the cataracts are removed. This is because if the brain doesn't learn how to see early in the development of the child, it won't be able to later, either. This is known as deprivational amblyopia. Babies and kids with Down syndrome should thus be screened regularly for eye problems.

Watch for Changes in Behavior as Signs of Visions Problems

Some kids with Down syndrome will not be able to tell you if they are having problems with their vision. If there is a change in their behavior, their cognitive function, or the activities they will participate in, these may be signs an eye exam is warranted. Other signs to look for may be squinting, tilting the head in an unusual way, or light sensitivity.

Eye issues are common in people with Down syndrome, so it is something you will want to watch out for. Most eye problems have treatments, though, so it is nothing to worry too much about and you should consult your doctor or other medical specialist to help your Down syndrome loved one. Your Down syndrome child can still thrive even if they do have some of these vision problems, so work with your doctor on therapies and cures.