Ophthalmological Findings and Their Clinical Correlations in Children With Autism Spectrum Disorder: A Comparative Study

ObjectiveAutism spectrum disorder (ASD) can affect vision both directly through central nervous system involvement and indirectly by complicating ophthalmological examinations due to limited eye contact and poor cooperation. Visual impairments may exacerbate social interaction difficulties and affect motor development in individuals with ASD. Previous studies reported ophthalmological involvement in 27-71% of children with ASD, including refractive errors, strabismus, and amblyopia. The purpose of this study was to investigate visual impairments in children with ASD and examine their relationship with ASD severity, anxiety levels, and attention disorders, while highlighting the importance of routine ophthalmological examinations.MethodParticipants were 57 children aged 7-18 years diagnosed with ASD. All except for 2 participants underwent comprehensive ophthalmological examinations and were assessed using the Childhood Autism Rating Scale (CARS), Turgay DSM-IV-based Child and Adolescent Behavior Disorders Screening Scale (T-DSM-IV-S), Strengths and Difficulties Questionnaire (SDQ), Screen for Child Anxiety Related Emotional Disorders (SCARED), and Repetitive Behaviors Scale-Revised (RBS-R).ResultsVisual impairment was detected in 24 (42.1%) participants, with exotropia (21%), stereopsis deficits (15.8%), and convergence insufficiency (5.3%) being the most common findings. The visually impaired group showed significantly higher scores in attention deficit (<i>P</i> < .001), peer relationship problems (<i>P</i> = .003), social phobia (<i>P</i> < .001), stereotypic behaviors (<i>P</i> < .001), and self-injurious behaviors (<i>P</i> < .001) compared to those without visual impairment.ConclusionsVisual impairments significantly impact attention, peer relationships, social anxiety, and repetitive behaviors in children with ASD. Early identification and treatment of visual disorders through routine ophthalmological screening may improve overall outcomes in this population.