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Purpose
Subjects with Down syndrome have structural differences in the cornea and lens, as compared with the general population. This study investigates objectively measured refractive and corneal astigmatism, as well as calculated internal astigmatism in subjects with and without Down syndrome.
Methods
Refractive (Grand Seiko autorefraction) and anterior corneal astigmatism (difference between steep and flat keratometry obtained with Zeiss Atlas corneal topography) were measured in 128 subjects with Down syndrome (mean [±SD] age, 24.8 [±8.7] years) and 137 control subjects without Down syndrome (mean [±SD] age, 24.9 [±9.9] years), with one eye randomly selected for analysis per subject. Refractive astigmatism and corneal astigmatism were converted to vector notation (J0, J45) to calculate internal astigmatism (Refractive − Corneal) and then converted back to minus cylinder form.
Results
Mean [±SD] refractive astigmatism was significantly greater in subjects with Down syndrome than in control subjects (−1.94 [±1.30] DC vs. −0.66 [±0.60] DC, t = −10.16, p < 0.001), as were mean corneal astigmatism (1.70 [±1.04] DC vs. 1.02 [±0.63] DC, t = 6.38, p < 0.001) and mean internal astigmatism (−1.07 [±0.68] DC vs. −0.77 [±0.41] DC, t = −4.21, p < 0.001). A positive linear correlation between corneal and refractive astigmatism was observed for both study populations for both the J0 and J45 vectors (p < 0.001 for all comparisons; R2 range, 0.31 to 0.74). The distributions of astigmatism orientation differed significantly between the two study populations for comparisons of corneal and calculated internal astigmatism (χ2, p < 0.007), but not refractive astigmatism (p = 0.46).
Conclusions
This study demonstrates that corneal astigmatism is predictive of overall refractive astigmatism in subjects with Down syndrome, as it is in the general population. The greater magnitudes of astigmatism and wider variation of astigmatism orientation in subjects with Down syndrome for refractive, corneal, and calculated internal astigmatism are likely attributable to previously reported differences in the structure of the cornea and internal optical components of the eye from that of the general population.
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Family Vision Clinic changed our lives! My daughter was frequently car sick, and she was getting headaches every day, often painful enough that they brought her to tears. We saw a string of doctors and therapists, but we made no progress. Finally, we found Dr. Levi Zurcher and his eye therapist Rain. After ten weeks of eye therapy my daughter no longer gets headaches, and she no longer gets car sick. Daily tears are a thing of the past. I really can’t say enough about this clinic. It was fascinating to watch Dr. Zurcher work. For the first time, someone who knew what they were doing was intently studying my daughter, really trying to figure out all of her eye issues, and his therapist Rain is one of the most patient and lovely people that I’ve ever had the good fortune to meet. We’re finished with eye therapy—yay!—and I have switched to American Family Vision Clinic for all of my family’s other eye health needs.
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Treating diabetic retinopathy Treating diabetic retinopathy is a critical aspect of preserving vision and maintaining the overall quality of life […]
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