Content area
Full Text
It is often stated that atropine drops should not be used, or are contraindicated, in children with Down syndrome. 1 2 Some authors have stated that the mydriatic and cycloplegic effects are overly prolonged, 3 whereas others have expressed apprehension regarding potential systemic toxicity. 2 4 No evidence exists, however, to support either of these concerns.
It is plausible that previous investigators 4 might have believed that the allegedly prolonged cycloplegic effect of atropine in Down syndrome patients could lead to permanent disuse atrophy of an already hypoplastic iris and ciliary body musculature with consequent permanent loss of accommodative ability. However, by 1971, the allegedly prolonged mydriatic effect of atropine in patients with Down syndrome had already been refuted. 5 6 Moreover, since 1993, it has been understood that accommodation is inherently grossly diminished congenitally in approximately 80% of children with Down syndrome. 7 The noted lack of an accommodative ability is,...