Vision & Glasses for people with Down syndrome

In the current crisis, many people are using screens more, both for learning and for entertainment, so it’s very important to be aware of eye health. With optometrists reopening shortly, now might be a good time to consider whether your family member with Down syndrome is due for an eye test. Regular eye testing is important for all of us, but particularly children and adults with Down syndrome who are more vulnerable to a variety of eye conditions and visual difficulties.

Nichola Kennedy is a specialist optometrist with a practice in Kilcullen Co Kildare, who has particular expertise in eye conditions connected with Down syndrome. This is what she has to say on the subject:

Vision and Glasses for people with Down Syndrome

Did you know that 75% of people with Down syndrome require glasses and not just regular glasses, but glasses for far & near such as bifocals or varifocals, regardless of their age? And did you know that 80% of what we learn is learned through vision?

My name is Nichola Kennedy and I am an optometrist and styling optician. I am also trained in paediatric and special needs optometry and dispensing. I started working with clients who have special needs many years ago and I was clinical director of the Special Olympics Opening Eyes Programme back in 2000, before we hosted the World Games in 2003.

Most people associate bifocals or varifocals with old people, well at least over 50 years of age! However many people with Down syndrome, regardless of age, require these lenses as they often have difficulty focusing on near objects and maintaining that focus. The knock-on effect of this is that reading, writing, and close visual tasks such as knitting, sewing, computers or board games could be a challenge. People with Down syndrome may seem uninterested in these tasks, finding them visually too demanding, because they simply cannot see the details. Getting the right lenses could make a big difference.

It is not unusual for people with Down syndrome to have very strong lenses, which can be quite thick and heavy. It’s important to know that they can often be made lighter.

1 in every 2 people with DS can have a turn, cast, or a squint in one eye. Sometimes glasses can straighten this out, but sometimes they can’t, and patching or surgery may be required. In these cases, you might find that the person may trip over steps/curbs or misjudge distances. This could easily be misinterpreted as clumsiness but maybe a visual issue that could be improved with the right treatment.

Another vision issue prevalent in people who have Down syndrome is that even with the best glasses they don’t have 20/20 vision. This can affect the ability to learn how to read and write. If you can’t see it, how can you be expected to learn it?

What does this mean? It means that print may need to be larger than normal in order to be able to see it.

In some cases a person with Down syndrome can find it difficult to read faint print or a certain colour ink on coloured paper, eg orange ink on yellow paper. This is because they have poor contrast sensitivity vision, so print needs to be bolder to be able to see it easily.

People with Down syndrome are more prone to certain eye conditions which may require ongoing monitoring or ongoing management such as cataracts, blepharitis (a condition of the eyelids), conjunctivitis, and keratoconus.

So how do you know if this applies to your family member with Down syndrome or other special needs? Quite simply, you don’t always know! They need to be assessed by an optometrist at the time of an eye test.

And how do we test people with additional needs if they may have difficulty reading the charts or answering questions? With the use of specially designed charts and specialist equipment we can

do complete assessments on vision and the eyes to ensure the best vision for learning, resulting in the best quality of life. We will also advise on management and ongoing care at the examination.

Frame fitting in Down syndrome is very important due to unique facial features. Differently shaped bridge of the nose, lovely long eyelashes, and positioning of the ears mean that it can be challenging to get the right fit. However the fit is so important to ensure the optimum spectacle lens performance as well as comfort and style! There are specialised frames available and regular frames can sometimes be modified.

Hearing difficulties are also common, so what happens if you need glasses and a hearing aid? This can be slightly more tricky as you have the tips of the glasses and the hearing aid competing for a small space behind small ears. Frames with fine or flat, slim sides help to fit behind the ears as they are less bulky, you can get frames with plastic fronts and metal sides or all metal frames.

We would recommend annual eye exams for children and every 2 years for adults. In some cases, based on findings in the examination you may need to be seen more frequently. Sometimes there are no signs that you need an eye examination, and that’s why we recommend testing at regular intervals, as changes can occur unknown to us. There are a few signs to look out for that may mean you need to make an eye appointment sooner. Some of these are new headaches, eye rubbing, lifting glasses, or looking over glasses to try to see better, squinting to try to see better or losing interest in visual activities and tasks that used to be enjoyable.

Nichola C. Kennedy FAOI 045-484643


Finding a specialist optometrist near you.

Nichola is one of a small number of optometrists in Ireland who has completed specialist training in working with people with Down syndrome. As well as having a really good knowledge of what is happening in the eye of someone with Down syndrome, they also have specialist equipment which helps to make the eye test and the glasses that they fit much better. 

This list was prepared for Down Syndrome Ireland by Lynda Givney-Nolan . If you are an optometrist with the appropriate specialist training and equipment and would like to be added to the list, contact Lynda with details.


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