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Evaluation of ocular findings in children with autism spectrum disorder: Observational study.

Medicine2025

Demir Ulku

What this study means for families

This study looked at eye problems in 60 children with autism aged 4-18. Only about 1 in 3 children had normal vision. The rest had various eye conditions like farsightedness, astigmatism (blurry vision), crossed eyes, or lazy eye. Boys and girls had different rates of farsightedness. The researchers recommend regular eye check-ups for autistic children, as treating eye problems early may help with their development and social skills.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Research summary

This retrospective observational study examined eye problems in 60 children with autism spectrum disorder (40 boys, 20 girls) aged 4-18 years. The study found that only 38.33% had normal vision (emmetropia), while the majority had various eye conditions including hyperopia (21.66%), astigmatism (33.31% combined), strabismus (21.65% combined), and other conditions like amblyopia and ptosis. Hyperopia showed a statistically significant gender difference (p=0.022). The authors conclude that children with ASD have significant ophthalmological abnormalities and recommend early eye examinations to support psychomotor and social development.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Key findings

  • 1

    Only 38.33% of children with ASD had normal vision (emmetropia), with 61.67% having some form of refractive error or eye condition

    Confidence: moderateRelevance: High - indicates majority of autistic children may need vision correction
  • 2

    Combined astigmatism was present in 33.31% of participants (16.66% myopic, 14.99% hyperopic, 1.66% mixed)

    Confidence: moderateRelevance: Moderate - astigmatism may impact visual processing and learning
  • 3

    Strabismus (eye misalignment) was found in 21.65% of children (9.99% esotropia, 11.66% exotropia)

    Confidence: moderateRelevance: High - strabismus can affect depth perception and social interaction
  • 4

    Hyperopia showed statistically significant gender differences (p=0.022), being more common in one gender

    Confidence: moderateRelevance: Moderate - may inform gender-specific screening approaches

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Clinical implications

Regular comprehensive eye examinations should be standard care for children with ASD. Early detection and treatment of refractive errors and strabismus may improve visual function, potentially supporting better social interaction and developmental outcomes in autistic children.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Limitations

Small sample size (60 participants), retrospective design, single-center study, unclear selection criteria, and lack of comparison with typically developing children limit generalizability. The study does not specify which gender had higher hyperopia rates.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Original abstract

This study aims to emphasize the significance of ophthalmologic examination in children with autism spectrum disorder (ASD) and evaluate the ophthalmologic findings and their frequency. We retrospectively analyzed the files of 40 boys and 20 girls aged 4 to 18. In cycloplegic spherical equivalents, -0.50 diopter (D) or more myopia, ≥+2.0D hyperopia and ≥±1D astigmatism in cylindrical equivalents were accepted. Patients with ≥1D difference in spherical or cylindrical equivalents between the 2 eyes were considered anisometropic.

Amblyopia was defined as a best-corrected visual acuity ≤0.8 with Snellen chart and a difference of at least 2 lines between both eyes. Children were grouped as myopia, hyperopia, myopia astigmatism, hyperopia astigmatism, mixed astigmatism, emmetrope and anisometropia according to refractive errors. Strabismus was classified as esotropia, exotropia and orthophoric. Forty (66.66%) of the patients with ASD were boys and 20 (33.33%) were girls.

Emmetropia was found in 38.33%, myopia in 3.33%, hyperopia in 21.66%, myopia astigmatism in 16.66%, hyperopia astigmatism in 14.99%, mixed astigmatism in 1.66%, anisometropia in 6.66%, amblyopia in 6.66%, esotropia in 9.99%, exotropia in 11.66%, ptosis in 4.99%, and nystagmus in 1.66%. There was no statistically significant difference in the findings except hyperopia according to gender (P > .05). Hyperopia (P = .022) showed a statistically significant difference according to gender (P < .05). Children with ASD have significant ophthalmological abnormalities.

Early diagnosis and treatment of refractive errors and other eye problems may contribute to these children's psychomotor and social development.

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Evidence Grade

Emerging

limited

Grade assigned by AutismInsights based on study type and published abstract.

Study Details

Type
Observational
Journal
Medicine
Year
2025
PMID
40696676
DOI
10.1097/MD.0000000000043398

MeSH Terms

HumansMaleFemaleAutism Spectrum DisorderChildRetrospective StudiesChild, PreschoolAdolescentRefractive ErrorsVisual AcuityStrabismusAmblyopia