Common vision problems

Blepharitis is very common in people of all ages with Down's syndrome. As with the general population, the condition responds well to lid hygiene measures.

Cataract can be congenital and a child with Down's syndrome and congenital cataract will be or have been under the care of an ophthalmologist. Developmental cataracts are also much more common in people with Down's syndrome than in the general population and appear at a much younger age. Older children and adults should be monitored regularly. Cataract extractions and implants can be very successful; don't preclude referral just because your patient has Down's syndrome. The RNIB produces useful leaflets for people with learning disabilities and for their carers on cataract and on preparing for surgery.

Find out more about cataract

Eyelash anomalies also occur commonly, especially in adults with Down's syndrome. Ingrowing eyelashes can cause considerable discomfort and are sometimes missed by a general practitioner if a patient presents them with a red eye.

Keratoconus is much more common in people with Down's syndrome than it is in the general population and can appear in late childhood / early adulthood. Contact lenses may be used in some cases, but carers will need to be confident with the lenses as well as the patient. The condition may progress to late stages and corneal transplant may eventually b offered.

Find out more about keratoconus:
National Keratoconus Foundation (USA)
Center for Keratoconus (USA)

Nystagmus occurs in about 15% of children with Down's syndrome. Occasionally it is first seen soon after birth, and in other cases appears during the first few months of life. In many cases the intensity of the nystagmus improves as the child gets older. In some cases it disappears and becomes a latent form. Children with nystagmus should be offered additional support since it constitutes a visual impairment, especially if it worsens under stress. More information on the condition and support for parents can be obtained from Nystagmus Network.