Which visual deficits may be seen in children with Down syndrome?

• A. Nystagmus, astigmatism, strabismus
• B. Congenital cataracts, nearsightedness, farsightedness
• C. Glaucoma, color blindness, diplopia
• D. Dry eyes, blepharitis, ptosis

Answer: (B)

In Down syndrome, vision problems often come from two main areas: the refractive system and the lens. Many children have refractive errors, meaning the eye doesn’t focus light properly, and this can include both farsightedness (hyperopia) and nearsightedness (myopia), sometimes with astigmatism. Congenital cataracts can also be present, affecting clarity of the lens from birth. Seeing both a congenital cataract and a range of refractive errors together captures the common ways vision is affected in these children, making this pairing the most representative.

Other options mix in findings that are less consistently linked to Down syndrome. While issues like strabismus or eyelid problems can occur, they don’t define the typical visual deficits as clearly as congenital cataracts plus refractive errors. Glaucoma, color vision problems, or a set of purely eyelid conditions occur less consistently in this population. Early eye exams are important to identify cataracts and correct refractive errors with glasses or other interventions as needed.