Eye findings in 8 children and a spontaneously aborted fetus with RSH/Smith-Lemli-Opitz syndrome

We evaluate the ophthalmologic findings in 8 children with RSH/Smith-Lemli- Opitz syndrome (SLOS) and document abnormal concentrations of cholesterol a nd cholesterol precursors in the ocular tissues in a case of SLOS, The most common ophthalmologic finding was blepharoptosis, which was found in 6 of 8 patients, with the severity ranging from mild to moderate. None of the pa tients in the present study demonstrated cataracts; none had amblyopia from blepharoptosis, One patient had a right hypertropia with overaction of the inferior oblique muscle. This patient also had optic atrophy and a second patient had bilateral optic nerve hypoplasia, The importance of these findi ngs to the visual function remains to be defined. Sterol analysis from ocul ar tissues of an aborted fetus with SLOS showed increased 7- and 8-dehydroc holesterol and a low cholesterol concentration in the retinal pigment epith elium, lens, cornea, and sclera, Routine ophthalmologic examination is indi cated in SLOS because of the high incidence of abnormalities, most likely d ue to the abnormal synthesis of cholesterol and cholesterol precursors in t he ocular tissues of these patients, as evidenced by sterol analysis of the ocular tissues in a case of SLOS, Am. J, Med. Genet, 80:501-505, 1998. (C) 1998 Wiley-Liss, Inc.