Children with Down syndrome not only see poorly in the distance, but also up close. Research by Christine de Weger-Zijlstra of Radboudumc shows that these children see much better with glasses that correct both defects. These glasses also improve their development.
Reading glasses come with age, right? Not so for children with Down syndrome. It has long been known that these children have poor distant vision, but it has recently become apparent that their near vision is also greatly impaired. This is due to abnormalities in the brain and eyes, which prevent the children from focusing properly. Christine De Weger-Zijlstra, orthoptist and researcher at the Radboudumc: ‘These children used to receive ordinary, unifocal glasses that improved their distant vision, but this left their near vision still blurred. In my PhD thesis, we investigated whether bifocal glasses, which correct both distant and near vision, improve vision of children with Down syndrome. We also evaluated the effects of these glasses on the development of these children. To this end, we measured functions such as working memory, selective attention, inhibition, and flexibility in thinking.’
Game on tablet
De Weger-Zijlstra studied more than 100 children with Down syndrome aged two to sixteen years. Half were given unifocal glasses and the other half bifocal glasses. Subsequently, various measurements were performed during one year. These were not only focused on vision. For example, she also looked at the alignment of the eyes. 'Children with Down often squint and this limits their vision’, she says. ‘An eye that is squinted does not contribute to vision.' Parents and teachers filled out questionnaires to record development, whereas the children performed a specific task on a tablet for this purpose. De Weger-Zijlstra: 'For them, this was like playing a game and they really enjoyed it.'
Improved cognitive development
The results of the study are very positive. Bifocal glasses greatly improve near vision and reduce squinting. Most strikingly, the use of the these glasses improves the children’s development. De Weger-Zijlstra: ‘We also saw the strongest development in the children with the greatest improvement in their vision. This underlines the importance of good close-up vision for the child's development. Because poor near vision is virtually non-existent in normal children, it has never received attention in Down syndrome either. Because of our studies, we can now help them much better.’
New standard treatment
The study results are now being put into practice. 'There is much support among Dutch pediatric ophthalmologists,' says Nienke Boonstra, co-supervisor and one of the research leaders. 'The study was performed in 15 hospitals and the specialists there are convinced of the effectiveness of the bifocal glasses. We expect this treatment to become the new standard in children with Down syndrome in the Netherlands and abroad.'
More information about this PhD thesis defense
PhD thesis defense of Christine de Weger-Zijlstra on October 18th at 2.30 p.m. Title of dissertation: Beyond improving visual acuity in children with Down syndrome. The effects of bifocals (available online after October 18th). (Co-)supervisors: prof. dr. A.V. van den Berg, dr. H.H.L.M. Goossens, and dr. F.N. Boonstra. The defense can be followed via this livestream.
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