Prevalence and Potential Risk Factors of Ocular Disorders Among Institutionalised Adults With Intellectual Disabilities-A City-Wide Survey in Taipei City.
Down syndrome and cerebral palsy are red flags for eye disease in institutional adults with ID—screen them first.
01Research in Context
What this study did
A city team visited every large care home for adults with intellectual disability in Taipei. They gave each adult a full eye exam. They noted who had Down syndrome or cerebral palsy. Then they counted how many people had myopia, crossed eyes, high eye pressure, or cataracts.
What they found
Most residents had at least one eye problem. Down syndrome and cerebral palsy pushed the risk much higher than IQ level alone. Eye doctors had not seen many of these adults before.
How this fits with other research
Lin et al. (2007) showed the same homes rack up over 25 clinic visits a year per person. The new data say many visits could be replaced by one eye check.
Lin et al. (2015) found weak bones in half of these residents. Like eye disease, bone loss is silent until late. Both studies flag the same lesson: screen for hidden body damage, not just behavior.
Fahmie et al. (2013) recorded pain signs in 18% of residents, but few got pain meds. Ching-Ju et al. now show eye disease is also missed. Together the papers paint a pattern: institutional adults with ID suffer unseen medical load.
Why it matters
If you serve adults with ID, add vision to your annual nursing review. Ask about Down syndrome or cerebral palsy first; those labels trump IQ when you triage eye referrals. A quick visual acuity test and a flash-light check for red reflex can catch cataracts early. Schedule the ophthalmologist before problems hurt learning or behavior.
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02At a glance
03Original abstract
BACKGROUND: To conduct a city-wide survey and investigate the risk factors of ocular disorders among institutionalised adults with intellectual disabilities (ID) in Taipei City. METHOD: A cross-section city-wide ophthalmic survey was conducted in Taipei City from 2016 to 2017, involving full-day residents with ID aged over 18. Participant characteristics, including age, gender, ID severity and associated diseases, were collected for multiple logistic regression analysis to identify ocular disorder risk factors. RESULT: A total of 687 participants, comprising 70.9% of the eligible individuals, were included. Refractive errors (73.8%), strabismus (32.6%), ocular hypertension (26.0%) and cataract (15.3%) were the most common ocular disorders. Myopia (73.2%) is the most common refractive error, with 14.6% being high myopia. Down's syndrome (DS) was a common risk factor for developing strabismus (OR, 2.87; 95% confidence interval [CI], 1.54 to 3.35), nystagmus (OR, 6.50; 95% CI, 2.22 to 19.0), high myopia (OR, 2.62; CI, 1.85 to 3.09), high astigmatism (OR, 3.06; CI, 1.65 to 5.69) and cataracts (OR, 8.00; CI, 3.50 to 18.30), while it served as a protective factor against ocular hypertension (OR, 0.14; CI, 0.03 to 0.62). Cerebral palsy (CP) was identified as a common risk factor for strabismus (OR, 2.17; CI, 1.16 to 4.05), nystagmus (OR, 4.22; CI, 1.51 to 11.8) and high myopia (OR, 2.22; CI, 1.04 to 4.73). CONCLUSION: High prevalence of myopia, strabismus, ocular hypertension and cataract was observed in institutionalised adults with ID. DS and CP were more significant risk factors than ID severity for ocular disorders. Regular ophthalmic exams, particularly monitoring intraocular pressure, are crucial for this population.
Journal of intellectual disability research : JIDR, 2025 · doi:10.1111/jir.13258