IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 20, Issue 6 Ser.1 (June. 2021), PP 30-33 www.iosrjournals.org DOI: 10.9790/0853-2006013033 www.iosrjournal.org 30 | Page Ophthalmic Manifestations in Childrens Presenting With Down Syndrome Dr. Jitendra Kumar 1 , Dr.Romil Gupta 2 , Dr. Dr. Praveen Kumar Naik Hasavath 3 1. Associate Professor & Head, Dept. of ophthalmology, MLB Medical College Jhansi, India. 2 Junior Resident, Dept. of ophthalmology, MLB Medical College Jhansi, India. , 3 Junior Resident, Dept. of pediatrics , MLB Medical College Jhansi, India. Corresponding author: Dr. Jitendra Kumar Abstract Purpose - To study the ophthalmic manifestations in childrens presenting with Down syndrome. Methods- This was a prospective observational study that involved 30 eyes of 15 childrens of Down syndrome presenting with low visual acuity, strabismus, nystagmus, blephritis, large epicanthal folds, nasolacrimal duct obstruction , etc. Results-There were 9 males and 6 females and the age group taken was 1 to 10 years. Most common presentation in down syndrome patients is low visual acuity ( <6/18 ) in 74% patients followed by strabismus in 68 % patients , nystagmus in 52% patients , upward slanting palpaberal fissure in 51% patients , blephritis in 34% patients, nasolacrimal duct obstruction in 32% patients ,brushfield spots in 14% patients. Most common refractive error in down syndrome children is myopia in 46% patients followed by astigmatism in 32% patients and hyperopia in 22% patients. Fundus finding are rare in downs syndrome patient but include cupping of disc and optic atrophy. Other features of down syndrome are cerebral palsy, autism , hypertelorism, flat nasal bridge, alopecia and macroglossia. Conclusion - Down syndrome is common genetic disease presenting usually with multiple systemic features. Most common ocular manifestation is low visual acuity followed by strabismus, nystagmus , blephritis , nasolacrimal duct obstruction and brushfield spots. Most common refractive error is myopia but usually difficult to correct due to nystagmus and strabismus. Assessment and regular follow-up by the pediatric ophthalmologist is important to detect abnormalities otherwise patient may develop amblyopia. Keywords: down syndrome, low visual acuity, strabismus ,myopia --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 20-05-2021 Date of Acceptance: 05-06-2021 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Down syndrome is the most common chromosomal abnormality [1]. Down syndrome occurs in approximately 1 in 700 births, and the frequency rises with maternal age due to an increase in nondisjunction events. Roughly 5,400 children with Down syndrome are born each year in the United States.[2] The reported prevalence of ophthalmic disorders in Down syndrome patients ranges from 46% to 100%.[3] The incidence of associated eye disease requiring monitoring or intervention increases with age, from 38% of Down syndrome children < 1 year old to 80% of 5 to 7 year-old children.[4] Ophthalmic Features Strabismus Strabismus, especially esodeviation, is common in children with Down syndrome. In most of the patients strabismus type is esotropia, although in few children of Down children with strabismus were found to have exotropia [5] Only one study of Down syndrome children mentions hyperdeviation .[6] Nystagmus Nystagmus is common presentation of children with down syndrome and usually it is rapid horizontal nystagmus[7] Eighty to 89% of Down syndrome children with nystagmus have a manifest nystagmus while a smaller cohort have a latent or manifest-latent nystagmus. Nystagmus in Down syndrome children has been associated with lesser visual acuities.[8] Refractive Error and Astigmatism Down syndrome children have a higher prevalence of myopia , hyperopia and astigmatism. Failure of emmetropization has been proposed as the etiology of the increase in prevalence of refractive error after