Background: This study was conducted to establish the background of importance of the routine ophthalmological check-up in children with Down Syndrome (DS) in this region which is very rarely done in Bangladesh.

Objectives: To find out the oculo-visual manifestations of Down Syndrome in children who undergo follow-up regularly at a Child Development Centre in Bangladesh, which has significant role for overall development and rehabilitation.

Methods: This observational study was done to examine the ocular status of 54 children with Down syndrome who attended the Child Development Centre, Institute of Child and Mother Health (ICMH), Dhaka. After confirming the diagnosis by clinical features and karyotyping, a complete ophthalmic examination was performed by a single specialist pediatric ophthalmologist in two tertiary eye care centers (he served in both) on an out-patient basis. Records were kept and analyzed later by SSSS version 22.0.

Results: Examination of the participants revealed that no single case was free of eye problem. About 67% of the participants had significant refractive error. Most of them had hypermetropia (40.7%), followed by astigmatism (16.6%) and myopia (9.3%). Other ocular findings were the following: lacrimal system obstruction (38.9%), strabismus (18.5%), blepharitis (18.5%), nystagmus (16.6%), cataract (7.4%), amblyopia (7.4%), chalazion (3.7%), ptosis (3.7%) and retinal abnormalities (1.9%).

Conclusion: Identification, close observation and management of oculo-visual disorders by a pediatric ophthalmologist is mandatory for children with Down syndrome as a whole. The early and correct diagnosis of the ocular abnormalities will help to improve their visual, functional, psychological, and social aspects.