Appeal for retinoscopy skill retention

The Down’s Syndrome Association is spearheading a push for optometrists to keep their retinoscopy skills.

Although retinoscopy is dwindling in the profession, it can be a useful tool for picking up the early warning signs of keratoconus among children living with Down’s syndrome.

The call from the Down’s Syndrome Association’s (DSA) follows research that reveals keratoconus can affect as many as one in 10 people with Down’s syndrome. The condition can lead to a loss of vision if not diagnosed in the early stages.

DSA chief executive, Carol Boys, told OT that the organisation was urging optometrists to retain their retinoscopy skills and safeguard the health of people with Down’s syndrome by using the necessary equipment to make informed assessments.

“We also ask that professionals ensure their knowledge around the visual problems that affect people with Down’s syndrome is up-to-date, to ensure these individuals receive the best possible care,” she said.

A study by Cardiff University researchers tracked 45 young patients with Down’s syndrome.

Eleven participants had keratoconus, and the remainder were demonstrated to have healthy corneas.

Of the assessed optometric diagnostics, only retinoscopy identified the early stages of keratoconus among the young patients with Down’s syndrome.

It is thought that people with Down’s syndrome are less likely to report changes to their eye sight, and keratoconus symptoms can go unnoticed by family, friends and carers.

Rachel Hutchinson, who has Down’s syndrome, has worn spectacles since the age of 10. Routine optometry check-ups did not highlight any additional eyesight problems.

However, the 29-year-old was diagnosed with keratoconus two years ago after her father, Simon Hutchinson, became concerned about her eyesight.

He approached the Down’s Syndrome Association, which put him in contact with Cardiff University senior lecturer, Dr Maggie Woodhouse.

Dr Woodhouse diagnosed Ms Hutchinson with keratoconus within 30 seconds.

Dr Woodhouse, a winner of the AOP Lifetime Achievement Award, expressed her concern that many optometrists were at risk of losing the invaluable skill of retinoscopy.

“For people with Down's syndrome, it means that treatable conditions like keratoconus are inevitably going to be missed,” she highlighted.

“It also means that optometrists can't offer eye examinations to young children or anyone with learning disabilities who cannot use hi-tech instrumentation,” Dr Woodhouse concluded.

For more information, see the OT retinoscopy video. 

Image credit: National Eye Institute