Background, material and methods: Down's syndrome is the most common cause of mental retardation with an incidence of about 1.5/1000 live births. Life expectancy and quality of life have improved substantially for this group over the last decades. The aim of this paper is to give an updated short survey of ocular changes present in Down's syndrome based on current international literature and the clinical experience of the authors.
Results and interpretation: Ocular problems are common, mostly refractive errors, poor accommodation, strabismus, cataract, and keratoconus. Accommodation deficit is present in a majority of individuals with Down's syndrome, also in children and young people. Bifocal or progressive glasses should therefore be prescribed liberally. Because of the high frequency of ocular pathology, all individuals with Down's syndrome should be enrolled in a continuous visual screening programme from birth. We suggest the following screening guidelines: first examination at one month of age, then at one year of age, at 2-3 years of age, at 5-6 years of age (school start), and thereafter every five years. In case of positive findings (e.g. refractive errors, poor accommodation, strabismus) the frequency of examination should be increased and determined individually by the responsible ophthalmologist.