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Anderson, Heather A. OD, PhD, FAAO; Benoit, Julia S. PhD; Marsack, Jason D. PhD; Manny, Ruth E. OD, PhD, FAAO; Ravikumar, Ayeswarya BSOptom, PhD2; Fern, Karen D. OD, FAAO; Trast, Kelsey R. BS

A Randomized Trial of Objective Spectacle Prescriptions for Adults with Down Syndrome: Baseline Data and Methods

publication date
September 20, 2020
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It is difficult to determine the most efficacious refractive correction for individuals with Down syndrome using routine clinical techniques. New objective methods that optimize spectacle corrections for this population may reduce limitations on daily living by improving visual quality.


This article describes the methods and baseline characteristics of study participants in a National Eye Institute–sponsored clinical trial to evaluate objectively derived spectacle corrections in adults with Down syndrome. Intersession repeatability of the primary outcome measure (distance visual acuity) is also reported.


Adults with Down syndrome were enrolled into a nine-visit study to compare clinically derived spectacle corrections and two different objective spectacle corrections derived from wavefront aberration data. Spectacle corrections were randomized and dispensed for 2 months each. Distance visual acuity was measured with a Bailey-Lovie–style chart. Intersession repeatability of acuity was established by performing difference versus mean analysis from binocular acuity measures obtained through habitual corrections at visits 1 and 2.



Thirty adults (mean ± standard deviation age, 29 ± 10 years) with a large range of refractive errors were enrolled. Presenting visual acuity at visit 1 was reduced (right eye, 0.47 ± 0.20 logMAR; left eye, 0.42 ± 0.17 logMAR). The mean difference between visits 1 and 2 was 0.02 ± 0.06 logMAR, with a coefficient of repeatability (1.96 × within-subject standard deviation) of 0.12 logMAR.


This study seeks to investigate new strategies to determine optical corrections that may reduce commonly observed visual deficits in individuals with Down syndrome. The good intersession repeatability of acuity found in this study (six letters) indicates that, despite the presence of reduced acuity, adults with Down syndrome performed the outcome measure for this clinical trial reliably.


Vision therapy is well worth the response, time and effort. Our Son had a hard time focusing and writing neatly. After vision therapy Seth could complete a task in half the time if previously took. His abilities to focus improved greatly and so did his handwriting.

Also, he was better at listening. As a parent, we wanted learning to be fun for our Son, and vision therapy made this possible.

Amanda T.

Vision Therapy is well worth the expense, time and effort. Our son had a hard time focusing handwriting neatly. After vision therapy Seth could complete a task in half the time it previously took his abilities to focus and improved greatly and so did his handwriting.

Also, he was better at listening. As a parent you wanted learning to be fun for our son and vision therapy made this possible.

Alexa H.

Vision Therapy has given or son the tools he needs to be able to scan and read the written word more effectively and efficiently.

He love working with John and these working sessions give him the motivation to gladly work on his homework assignments.

It amazed us to see the difference in the tracking of his eyes and along a line of it's from the beginning to the end of the treatment.

Dr. McBryar , Kristen and John  are all marvelous and we would recommend them to anyone I only wish that we would have found them sooner!

Charlotte M.

Prior to coming to the institute for vision development my son complained of daily headaches. Therapy has eliminated his headaches completely. I love knowing my son is able to learn pain-free for the rest of his life because of the work that has been done over just a few weeks in this office. He he absolutely loved coming that didn't even feel like going to a doctor or therapy. We are grateful for the relief he was able to find by coming here.

Thank you!

Olivia C.

Seems much less frustrated with life

Reads non-stop and fast

Spelling abilities have been hugely improved

Seems much more confident

Thank You!!!

Kelly O.

When we first came to the practice, my son did not have huge issues, but lots of small ones- trouble with reading, sports (hitting the baseball consistently), coordination, etc- that were not easily detectable,but when put together presented issues. The staff here were all very professional and loving towards him. While I was concerned in the reading, my son was concerned with the athletic side. Seeing improvement night off the bat gave him confidence that i have nor seen in him and made him want to not only Come to therapy, but also made him want to work hard. He has surpassed his grade level and above in reading and hit his first home run this year! Thank you!!!

Alice M.
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