Manifestações oculares em crianças e adolescentes com a Síndrome de Down

Manifestações oculares em crianças e adolescentes com a Síndrome de Down


Rosana Nogueira Pires da Cunha,
José Belmiro de Castro Moreira


Arquivos Brasileiros de Oftalmologia

versão impressa ISSN 0004-2749versão On-line ISSN 1678-2925

Arq. Bras. Oftalmol. vol.58 no.3 São Paulo jun. 1995


152 children with Down 's Syndrome were submitted to an ocular examination. The ocular findings, in decreasing rate of occurrence were: slanting palpebral fissure (82%), epicanthal folds (61%), astigmatism (60%), iris anomalies (52%), strabismus (38%), nasolacrimal duct obstruction (30%), blepharitis (30%) retinal anomalies (28%), hipermetropia (26%), amblyopia (26%), nystagmus (18%), cataract (13%) and myopia (13%).

Analysing each ocular feature by age groups we observed that astigmatism, iris anomalies and strabismus were more common in children 5 years and older as compared to a group of children under 5 years of age; hyperopia was more prevalent in children under 5 years of age than in children 5 years and older and cataract was more prevalent in children 12 years and older as compared to children under 12 years old.

The preferencial looking test was the most useful method for visual acuity assessment in these children. The iris anomalies were more often seen in those with blue iris and the retina anomalies in the myopic patients and those with congenital cardiopathy.

The early diagnosis of the ocular anomalies in Down 's Syndrome patients, the treatment of the refractive errors, as well as the prevention and treatment of amblyopia contribute immensely to diminish the several dificulties these children face in their social interaction.


1 DOWN, J. L. H. - Observations on an ethnic classification of idiots. Clinical Lectures and reports by Medical and Surgical Staff of the London Hospital Resports, 3: 259-62, 1866.
2 PENROSE, L. S. & SMITH, G. F. - Down 's anomaly. Boston, Little, BROWN & CO; 1966.
3 ALTIMARI, D. & BEÇAK, W. - Síndrome de Down. Dados adicionais sobre alguns parâmetros. Ciência e Cultura, 21 (suppl. 2) 295-6, 1969.
4 SMITH, F. G., & J. M. - Down's anomaly. Edinburgh, Churchill Livingston, 1976. p. 1-13, 33-7, 246-63.
5 TELLER, D. Y.; McDONALD, M. A.; PRESTON, K. L.; SEBRIS, S. L.; DOBSON, V. Assessment of visual acuity in infants and children: the acuity procedure. Dev. Med. Child. Neurol., 28: 779-89, 1986.
6 SOLOMONS, G.; ZELLEWEGER, H.; JAHNKE, P. G.; OPITZ, E. - Four commom eye signs in Mongolism. Amer. J. Dis. Child., 110: 46-50, 1965.
7 CATALANO, R. A. - Down Syndrome. Survey Ophthalmol., 34 (suppl 5): 385-98, 1990.
8 EISSLER, R. & LONGENECKER, P. L. - The common eye findings in mongolism. Am. J. Ophthalmol., 54 (suppl. 3): 398-406, 1962.
9 TRABOULSI, E. I.; LEVINE, E.; METS, M. B.; PARELHOFF, E. S.; O'NEIL, J. F.; GAASTERLAND, D. E. - Infantile Glaucoma in Down's Syndrome (Trisomy 21). Am. J. Ophthalmol., 105: 389-94, 1988.
10 AWAN, K. J. - Uncommon ocular changes in Down's syndrome (mongolism). J. Pediatr. Ophthalmol., 14: 215-216, 1977.
11 GARDINER, P. A. - Visual defects in cases of Downs' syndrome and in other mentally handicapped children. Br. J. Ophtalmol., 51: 469-74, 1967.
12 WARSHOWSKY, J. - A vision screening of a Down's syndrome population. J. Am. Optometric Assoc., 52 (suppl. 7): 605-7, 1981.
13 WAGNER, R. S.; CAPUTO, A. R.; REYNOLDS, R. D. - Nystagmus in Down's Syndrome. Ophthalmology, 97: 1349-54, 1990.
14 JAEGER, E. A. - Ocular findings in Down's Syndrome. Trans. Am. Ophthalmol Soc. 798: 808-45, 1980.
15 KARA-JOSÉ, N.; TAIAR, A.; SCARPI, M. J. - Incidência de ambliopia em 1400 escolares da cidade de São Paulo, em 1975. In Congresso Latino Americano de estrabismo 5, Guarujá, São Paulo, 1976. Anais. São Paulo, Ed. Loyola, 1976. p. 319-24.
16 SHAPIRO, M. B. & FRANCE, T. D. - The ocular features of Down's Syndrome. Am. J. Ophthalmol., 99: 659-63, 1985.
17 HILES, D. A.; HOYME, S. H.; McFARLANE, F. - Down's syndrome and strabismus. Am. Orthop. J., 24: 63-8, 1974.
18 BRUSHFIELD, T. - Mongolism. Br. J. Child. Dis., 21: 241-58, 1924.
19 IGERSHEIMER, J. - The relationship of lenticular chages in Mongolism. Trans. Am. Ophthalmol. Soc., 49: 595-624, 1951.
20 WILLIAMS, E. J.; McCORMICK, A. Q.; TISCHILER, B. M. - Retinal vessel in Down's syndrome. Arch. Ophthalmol., 89: 269-71, 197.