Sensory Impairments

There is a high incidence of eye (ocular) disorders amongst adults with Down's syndrome. Problems with the passage of light rays through the eye (refractive errors), a loss of transparency of the crystalline lens (cataracts), increased pressure within the eye (glaucoma) and squints (strabismus) are all common and may be present from an early age. In some adults with Down's syndrome, a corneal outgrowth (keratoconus) can occur, which, if left untreated, may lead to total blindness. Repeated infection of the margins of the eyelids (blepharitis) and of the membrane covering the front of the eye (conjunctivitis) is again very common in this population. It therefore follows that as the carer or student supporting adults with Down's syndrome it is essential to have good personal care and regular eye checks should form part of annual screening assessments, which will optimise personal health outcomes.

A majority of people with Down's syndrome have a range of significant hearing impairments. Causes can be associated with the auditory nerve (sen-sorineural), stifling of the sound waves entering the auditory apparatus (conductive) or a mixture of both. The main cause of conductive loss is persistent middle-ear infection (otitis media), often with a discharge (effusion), commonly known as glue ear. In adults with Down's syndrome, this may be a predominantly recurring problem, and they will need frequent monitoring, as hearing loss could be significant (Dennis 2000). Adults with Down's syndrome have anatomically distinct narrow ear canals and this frequently causes a build-up of earwax (cerumen), which affects the hearing. In addition to obvious difficulties in daily living and education, hearing impairment should be considered within the assessment process for dementia and for mood and behaviour disorders.

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