PURPOSE:To review detailed ophthalmic examinations of myotonic dystrophy patients especially with regard to refractive error and ocular alignment.METHODS:Retrospective chart review of detailed ophthalmic examinations of 32 patients (27 children and 5 adults) with myotonic dystrophy.RESULTS:The majority (86%) of eyes were hypermetropic. The average degree of hypermetropia was +6.0 D for children and +2.10 D for adults: 56% of children had esotropia; 22% had amblyopia.CONCLUSIONS:Children with myotonic dystrophy should receive detailed eye examinations with emphasis placed on recognition and management of hypermetropia and strabismus.