VISUAL ACUITY IN INFANTS AND CHILDREN WITH DOWN SYNDROME

A combined prospective and retrospective study of patients with Down's syndrome showed that these patients have narrowed and slanted palpebral fissures but that the fissures are of normal height. Patients with Down's syndrome also had increased prevalences (compared with control subjects) of blepharitis (23 of 53 patients or 46%), strabismus (23 of 53 patients or 43%), nystagmus (five of 53 patients or 9%), light-colored and spotted irides (46 of 53 patients or 87% and 43 of 53 patients or 81%, respectively), keratoconus (eight of 53 patients or 15%), cataracts (seven of 53 patients or 13%), severe myopia (13 of 48 patients or 27%), and astigmatism of more than 3 diopters (12 of 48 patients or 25%).

Although gross abnormalities have been described in the brains of patients with Down's syndrome (DS), microscopic studies have revealed only minor and inconsistent findings. We compared two DS brains, in whole-brain serial sections, with similarly prepared age- and sex-matched normal controls. Architectonic abnormalities were noted, and cell counts revealed a significant poverty of granular cells in the DS brains, particularly in granular fields such as areas 3, 17, and 41. Golgi studies demonstrated all major cell types. A striking feature of the brain morphology in DS may be the curtailment of a specific cell type, most likely the aspinous stellate.