Bifocals in down: A study on the effect of bifocals in children with down syndrome
N vision is reduced in most children with Down Syndrome (DS). This is an additional barrier achieving their maximum potential in development. DS is one of the most common genetic anomalies, occurring in about 14.6 in 10000 live births in the Netherlands in 2007. In the last two decades many researches has been performed to study the differences in ocular findings between children with and without DS. Some previous smaller studies by J.M. Woodhouse et al (Cardiff UK 2001-2009) and K Nanda Kumar and S.J. Leat (Toronto Canada 2009-2010) showed that bifocal correction could be a tailor-made treatment for children with DS. Therefore we started a study in children with DS in the Netherlands. Bifocals are rarely prescribed. Usually children with DS receive single vision glasses for distance. By means of our multicentre randomized controlled trail (RCT) we aim to establish whom to prescribe bifocals and to identify possible prognostic determinants (at start, baseline measurement before therapy with bifocals) for improvement of visual acuity at near. A multicentre randomized controlled trail (RCT) in 15 participating locations in the Netherlands. In order to be able to show differences between the effect of usual care and the new intervention, the bifocals, we included 110 children, 2-18 years old, with DS and accommodation deficit, who had not worn bifocals before. Bifocals were prescribed for children (n=55) in the intervention group and single vision glasses for distance were prescribed in the control group (n=55). We study the effect of these two interventions on visual acuity at near and at distance, on accommodation and occurrence of strabismus and task readiness (monitoring executive functions). Inclusion time started June 2015 and was completed March 2016. Baseline measurements such as refractive errors, near visual acuity, distance visual acuity and accommodation deficit will be presented.