Visual impairment and Down syndrome

The types of visual impairments in children with Down syndrome are largely the same ones as those affecting many other children. However these impairments are more common, and may be more severe than in the rest of the population.

Early intervention for visually impaired children should begin as early as possible in a positive emotional setting that enhances the child’s motivation and relationship with their parents and carers. This approach will ensure significantly improved outcomes for the child.

View more information about early intervention for children with visual impairments, other guidance and sign posting for parents.

Types of visual loss in children with Down syndrome

Strabismus (squint) is a condition where the eyes point in different directions. One study of preschool age children with Down syndrome in Scotland found that forty seven per cent had strabismus.  A similar study found that most children with Down syndrome and strabismus had inward pointing eyes (esotropia). The same study noted that the esotropia was acquired in early years rather than existing from birth.

Common treatments for strabismus, if required, include glasses and eye exercises. If these treatments aren't successful, corrective surgery may be required. This involves moving the muscles that control the movement of the eye.

Hypermetropia or hyperopia (long sightedness) and myopia (short sightedness) - if a child is long-sighted, they will be able to see distant objects clearly, but nearby objects will be out of focus. Their eyes may also tire easily. On the other hand, a child who is short sighted will see nearby objects clearly but distant objects will be out of focus.

The Scottish study mentioned above found that 43 per cent of children with Down syndrome were either long or short sighted. The majority of those who were long sighted also had blurred or distorted vision (astigmatism).

Treatment is often corrective, using either glasses or contact lenses. Several surgical techniques have also been developed to treat the condition. Laser surgery is sometimes used although it is not suitable for children.

‘Weak accommodation’ is when children have difficulties focusing on activities near to them, regardless of whether they are long sighted, short sighted or neither. One study in 1996 found that as many as 92 per cent of children with Down syndrome may have weak accommodation. Recent research suggests that children with Down syndrome who have weak accommodation benefit from wearing bifocal lenses in their spectacles.

Problems with fitting spectacles with bifocal lenses

Children with Down syndrome generally have smaller noses and shorter distances from their ears to their eyes than other children. This can mean that standard spectacles may slip when worn. Apart from being irritating for the child, this can mean they do not look through the correct part of the lens. An optician should make sure that glasses fit comfortably and properly without slipping.

Sense Children’s Specialist Services

Sense's Children's Specialist Services are a team of specialist advisory teachers, children’s therapists, and Children and Family Support Workers.

The team provides advice and information to multi-sensory-impaired children and young people, to their families or carers, and to the professionals who work with them. They also provide support in the home, at school or at their centres of excellence.

Related links in this section

Down syndrome homepage

Hearing impairment and Down syndrome

Multi-sensory impairment and Down syndrome


The Information Standard 'Certified member' logoThis document is not a substitute for a consultation with a health professional and should not to be used as a means of diagnosing a condition.

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Reviewed: May 2015
Review due: May 2017

First published: Thursday 20 June 2013
Updated: Tuesday 22 December 2015