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Tomoko Terai,1,2 Shohei Eda,1,2 Jun Sugasawa,2 Masahiro Tonari,2 Junko Matsuo,2 Hidehiro Oku,2 Tsunehiko Ikeda2 1Department of Ophthalmology, Shiga Medical Center for Children, Moriyama-City, Shiga, Japan; 2Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan Purpose: To investigate the age-related development of refractive errors and changes of visual acuity (VA), and the systemic and ocular anomalies in Japanese children and young adults with Down syndrome (DS).Design: Retrospective cohort study.Subjects and methods: This study involved 222 Japanese children and young adults with DS (age range: 3 months to 19 years) seen at the Department of Ophthalmology, Shiga Medical Center for Children, Shiga, Japan. The subjects were divided into the following six age groups: 1) infant (age 0 to |