Ocular disorders in children with down's syndrome

To find out the frequency and nature of ocular anomalies in children with Down's syndrome. All the Down's syndrome patients attending the outdoor clinic of the department of Paediatrics Ophthalmology from June 2005 to December 2005 were included in the study. Their records were reviewed and related information regarding age and sex distribution, ocular anomalies and mental status were noted on performa. Thirty seven patients with Down's syndrome reported during 7 month period. They were examined and evaluate for the characteristics and frequency of ocular conditions of these patients, 17 [45.9%] were hypermetropes, 13 [45.9%] emmetropes, and 4 [10.8%] myopes. Astigmatism of more than 3.00 diopters was present in 3 [8.1%], Strabismus was observed in 8 [27.8%] and eight patients had esotropia. Congenital nasolacrimal duct obstruction was present in 6 subjects [16, 2%] and blepharitis in 12 [37.8%]. Nystagmus occurred in 5 [13.5%]. Brushfield spots were detected in 2 [5.4%]. Lens opacities were diagnosed in 4 [10.8%] and all had successful cataract surgery. Significant correctable ocular problems are present in person with Down syndrome. It not connected they may interfere with binocular vision and the quality of life. Surgical intervention may be necessary for strabismus and cataracts

Refractive state of children in less than five years of age

To assess the refractive errors and related visual impairment in pre-school children attending the outdoor clinic. Descriptive study. Department of Pediatric Ophthalmology at The Children's Hospital and Institute of Child Health Lahore, from January 2005 to December 2005 Children aged 1-5 years attending the outdoor clinic were included in the study. The examination included visual acuity measurements, ocular motility evaluation and retinoscopy under cycloplegia, and examination of the anterior segment, media, and fundus. Myopia was defined as spherical equivalent refractive error of at least -0.50 D and hyperopia as +2.00 D or more. A total of 410 children under the age of 5 years were examined for the refractive state of the eye. 143 [34.8 percent] were hypermetropic, 104 [25.3 percent] were myopic, 5.1 percent had hypermetropic astigmatism whereas 8.2 percent had myopic astigmatism. 106 [25.8 percent] children had emmetropia. Refractive errors are a significant cause of decrease vision in pre-school children and if timely intervention is not done may lead to visual deficit in the years to come. Early screening of refractive state of the eye should be included in the preliminary pediatric examination and should be repeated in the following years of childhood

Disease spectrum in children presenting with Proptosis

The aim of this study was to provide the reader an overview of the subject of childhood proptosis with an emphasis on the systematic and practical approach for the work-up of proptosis in children. All children with proptosis who presented to the department of Paediatric Ophthalmology of The Children's Hospital and Institute of Child Health Lahore were included in the study from January 2004 to December 2005. A total of 64 patients were evaluated. There were 40 males and 24 females. Tumors were the most common [42.18%] cause of proptosis. Out of these vascular tumors, retinoblastoma and optic nerve gliomas were on the top of the list, followed by inflammatory diseases [28.15%]. Detailed history and clinical examination remain the useful tool to reach the correct diagnosis. Radio imaging plays an important role in coming to a diagnosis. Tumors form the most common cause of proptosis in our study followed by inflammatory lesions. A systematic and multidisciplinary approach is mandatory in managing a child presenting from proptosis