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.
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.