[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-420631-105":59,"doc-detail-420631-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","understanding-keratoconus-in-down-syndrome-a-narrative-review","Understanding Keratoconus in Down Syndrome - A Narrative Review","","Pediatricians are often the first to identify children with Down syndrome (DS) and guide timely referral for ocular diagnosis and management. Keratoconus (KC) shows substantially higher prevalence in DS than in the general population, and knowledge of KC is essential to prevent vision loss. This narrative review integrates epidemiology, pathophysiology, diagnostic barriers, and treatment options. Thinner, steeper corneas from birth, limited cooperation with imaging, and scan quality compromise—sometimes requiring sedation—complicate diagnosis. Early corneal cross-linking (CXL) helps halt progression, while advanced surgical care carries higher risks due to eye rubbing, infections, and postoperative compliance challenges. A comprehensive, early-referral strategy is emphasized, alongside future work on gene prediction and standardized screening protocols to improve quality of life.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/understanding-keratoconus-in-down-syndrome-a-narrative-review/420631/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/understanding-keratoconus-in-down-syndrome-a-narrative-review/420631.png","ImageObject",300,407,{"name":92,"@type":93},"moss~","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is keratoconus more common in children with Down syndrome?","Question",{"text":112,"@type":113},"The review describes KC as having a markedly higher incidence and prevalence in DS than in the general population. It links DS to ocular comorbidities and notes Trisomy 21 as the primary cause of DS.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What makes diagnosing keratoconus in DS more difficult?",{"text":117,"@type":113},"Children with DS tend to have thinner and steeper corneas from birth, and they may have poor cooperation during imaging. This can reduce scan quality, necessitate sedation, and complicate scan repeatability.",{"name":119,"@type":110,"acceptedAnswer":120},"How does corneal cross-linking help in DS-related keratoconus?",{"text":121,"@type":113},"Early intervention with corneal cross-linking (CXL) is presented as effective for halting disease progression. Timely referral and pre-emptive diagnosis are emphasized to enable this earlier treatment window.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},420631,1791103129,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Clinical Ophthalmology  \nOpen Access Full Text Article REVIEW  \nUnderstanding Keratoconus in Down Syndrome: From Etiology to Management – A Narrative Review  \nVenugopal Anitha 1 , Nambi Nallasamy2 , Josephine S Christy 3 , Olav Kristianslund 4 , Kirk AJ Stephenson 5 , Hassan Hashemi 6 , Revathi Rajaraman 7 , Soheila Asgari8  \n1Department of Cornea & Refractive Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, TN, India; 2Department of Ophthalmology and Visual Sciences, Kellogg Eye Centre, Ann Arbor, MI, USA; 3Department of Cornea & Refractive Services, Aravind Eye Hospital, Pondicherry, India; 4Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; 5Department of Ophthalmology, Royal Victoria Eye & Ear Hospital, Dublin, Ireland; 6Department of Ophthalmology, Noor Research Centre for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran; 7Department of Cornea & Refractive services, Aravind Eye Hospital, Coimbatore, TN, India; 8Department of Ophthalmology, Noor Ophthalmology Research Centre, Noor Eye Hospital, Tehran, Iran  \nCorrespondence: Venugopal Anitha, Department of Cornea & Refractive services, Aravind Eye Hospital and postgraduate institute of Ophthalmology, S.N High Road, Tirunelveli, TN, India, Tel +91 9442930404, Email [dranitha@aravind.org](dranitha@aravind.org)  \n\n| Abstract: Paediatricians are often the first to identify children with DS and their awareness on associated ocular comorbidities, playa critical role in ensuring timely referral to general ophthalmologists for diagnosis and management. Among these, keratoconus (KC) has a significantly higher prevalence among Down syndrome (DS) compared to the general population. The awareness and understanding of KC, is essential for preventing vision loss. This review summarizes the current understanding of KC in DS, on epidemiology, pathophysiology, diagnostic challenges, and management. The children with DS, have thinner and steeper corneas since birth, complicates the diagnostic and management protocols. Poor cooperation of the children for imaging, compromised scan qualities, need for sedation and repeatability of scans poses diagnostic challenges. Early intervention with corneal cross-linking (CXL) is shown to be effective in halting disease progression. The surgical options in advanced cases, carry higher risks in DS patients due to factors such as eye rubbing, increased infection rates, and challenges in postoperative compliance. Managing KC in DS requires a comprehensive approach involving early referral by Paediatricians, pre-emptive diagnosis, and timely intervention with CXL to prevent disease progression. Future research should focus on preclinical gene prediction and developing standardized screening protocols for KC among DS to prevent vision loss and thereby improve quality of life among them.\u003Cbr>Keywords: keratoconus, acute hydrops, down syndrome, corneal tomography |\n| --- |\n| Introduction\u003Cbr>In 1736, Benedict Duddell described keratoconus (KC) in a 14-year-old albino boy with nystagmus and cone-shaped corneas. Renamed “Staphyloma Diaphanum” by Burchard Mauchart in 1748, Johann Horner coined the term keratoconus in 1869. By 1989, increased enzymatic activity was linked to corneal thinning and vision distortion.1 KC is typically sporadic,2 with rising incidence and prevalence over the past two decades due to heightened awareness and advanced diagnostic techniques.2,3 It is associated with genetic and multi-system disorders, 1,4 including Down syndrome (DS), which affects 1 in 800 births and is linked to conditions such as congenital cardiac disease, thyroiditis, and neurological issues. Ocular manifestations in DS include refractive errors (20–50%), strabismus (33–57%), KC (15–71%), and nystagmus (11–29%) .1,5,6 Trisomy 21 is the primary cause of DS (92–95%) . Improved medical care has increased life expectancy for children with DS from 9 years in 1910 to 49 years in 1997. KC incidence in DS (0–71%)","cbCaimNIWq122Vd6","https://ap.wps.com/l/cbCaimNIWq122Vd6","pdf",3848216,15,"English","# Introduction\n## Epidemiology and historical background\n## Etiology and associated systemic conditions\n# Methodology of Literature Search\n## Databases and search keywords\n# Diagnosis and clinical challenges\n## Imaging limitations and cooperation issues\n## Sedation and scan repeatability\n# Management strategies\n## Early corneal cross-linking (CXL)\n## Surgical options for advanced cases\n# Future directions\n## Gene prediction and standardized screening","[{\"question\":\"Why is keratoconus more common in children with Down syndrome?\",\"answer\":\"The review describes KC as having a markedly higher incidence and prevalence in DS than in the general population. It links DS to ocular comorbidities and notes Trisomy 21 as the primary cause of DS.\"},{\"question\":\"What makes diagnosing keratoconus in DS more difficult?\",\"answer\":\"Children with DS tend to have thinner and steeper corneas from birth, and they may have poor cooperation during imaging. This can reduce scan quality, necessitate sedation, and complicate scan repeatability.\"},{\"question\":\"How does corneal cross-linking help in DS-related keratoconus?\",\"answer\":\"Early intervention with corneal cross-linking (CXL) is presented as effective for halting disease progression. Timely referral and pre-emptive diagnosis are emphasized to enable this earlier treatment window.\"}]","Understanding Keratoconus in Down Syndrome - A Narrative Review | PDF",1790621758,38]