PURPOSE: The aims of this study were to examine the distribution of refractive errors and clinical characteristics of strabismus in Korean patients with Down's syndrome. METHODS: A total of 41 Korean patients with Down's syndrome were screened for strabismus and refractive errors in 2009. RESULTS: A total of 41 patients with an average age of 11.9 years (range, 2 to 36 years) were screened. Eighteen patients (43.9%) had strabismus. Ten (23.4%) of 18 patients exhibited esotropia and the others had intermittent exotropia. The most frequently detected type of esotropia was acquired non-accommodative esotropia, and that of exotropia was the basic type. Fifteen patients (36.6%) had hypermetropia and 20 (48.8%) had myopia. The patients with esotropia had refractive errors of +4.89 diopters (D, +/-3.73) and the patients with exotropia had refractive errors of -0.31 D (+/-1.78). Six of ten patients with esotropia had an accommodation weakness. Twenty one patients (63.4%) had astigmatism. Eleven (28.6%) of 21 patients had anisometropia and six (14.6%) of those had clinically significant anisometropia. CONCLUSIONS: In Korean patients with Down's syndrome, esotropia was more common than exotropia and hypermetropia more common than myopia. Especially, Down's syndrome patients with esotropia generally exhibit clinically significant hyperopic errors (>+3.00 D) and evidence of under-accommodation. Thus, hypermetropia and accommodation weakness could be possible factors in esotropia when it occurs in Down's syndrome patients. Based on the results of this study, eye examinations of Down's syndrome patients should routinely include a measure of accommodation at near distances, and bifocals should be considered for those with evidence of under-accommodation.
Adolescent ; Adult ; Child ; Child, Preschool ; Down Syndrome/*complications/epidemiology ; Female ; Humans ; Incidence ; Male ; Prevalence ; Refractive Errors/complications/*epidemiology ; Republic of Korea/epidemiology ; Retrospective Studies ; Strabismus/complications/*epidemiology ; *Vision Screening ; Young Adult

PURPOSE: To identify the long term clinical course of amblyopia and strabismus that developed secondary to a monocular corneal opacity following suspected epidemic keratoconjunctivitis (EKC) in infancy. METHODS: This was a retrospective study analyzing the medical records of seven patients, treated in our clinic, who were followed for more than five years. RESULTS: Four patients in our clinic underwent a corneal ulcer treatment following suspected EKC. Each developed a monocular corneal opacity. Three patients with a chief complaint of corneal opacity were transferred to our clinic from other clinics. These patients had documented histories of treatment for EKC in infancy. All patients were treated with early occlusion therapy, but amblyopia persisted in four patients. Furthermore, all patients had strabismus and showed a significant reduction of stereoscopic vision. CONCLUSIONS: Although infants with EKC are not always cooperative, slit lamp examination should be performed as early as possible, and appropriate medical treatment should be performed, thus reducing the development of corneal opacity. Careful follow up should be regularly performed, and the occurrence of amblyopia or strabismus should be verified at an early stage using visual acuity or ocular alignment examination. Ophthalmologic treatments, including active occlusion therapy, should also be pursued.
Adenoviridae Infections/*complications/diagnosis/epidemiology ; Amblyopia/*etiology/pathology/physiopathology ; Child ; Child, Preschool ; Corneal Opacity/*complications/pathology ; Disease Progression ; *Epidemics ; Eye Infections, Viral/*complications/diagnosis/epidemiology ; Female ; Follow-Up Studies ; Humans ; Infant ; Keratoconjunctivitis/*complications/diagnosis/epidemiology ; Male ; Prognosis ; Refraction, Ocular ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Strabismus/*etiology/pathology/physiopathology ; Vision, Binocular ; Visual Acuity