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Assessment of visual function in autistic children
1Illinois College of Optometry, Chicago.
Insights
This study found significant visual dysfunctions in autistic children, including atypical eye movements and reduced visual acuity. These visual impairments may explain some characteristic behaviors observed in autism spectrum disorder.
Area of Science:
- Ophthalmology
- Neurodevelopmental Disorders
- Pediatric Medicine
Background:
- Autism spectrum disorder (ASD) is characterized by social interaction deficits and repetitive behaviors.
- Atypical visual behaviors, such as altered gaze patterns and stereotypies, are common in children with autism.
- The relationship between these visual signs and underlying visual dysfunction requires further investigation.
Purpose of the Study:
- To evaluate visual functions in children with autism.
- To identify potential visual dysfunctions related to observed visual signs and symptoms in autism.
- To provide data for further research into visual processing in autism.
Main Methods:
- Evaluated 34 autistic children (ages 2-11) for ocular alignment, refractive error, visual acuity, oculomotility, and stereopsis.
- Utilized acuity card procedure for binocular visual acuity and near retinoscopy for refractive errors.
- Assessed stereopsis with Lang stereo testing and oculomotility via voluntary pursuit and saccadic fixations, and optokinetic nystagmus (OKN).
Main Results:
- No ocular disease, seizure disorders, or dysmorphic features were found.
- Prevalence of strabismus was 21% at distance and 18% at near.
- Atypical optokinetic nystagmus (OKN) responses were observed in 31 children (91%), with only 14.7% exhibiting voluntary pursuit movements.
Conclusions:
- Autistic children exhibit a high prevalence of visual dysfunctions, including strabismus, impaired oculomotility, and abnormal OKN responses.
- These visual impairments may be linked to the characteristic visual behaviors and stereotypies seen in autism.
- Further research is warranted to understand the impact of visual dysfunction on development and behavior in children with autism.
Abstract:
Children with autism demonstrate "atypical" gaze or social "looking" and frequently manifest such sterotypies as eye pressing, hand flicking, and light gazing. This study's purpose was to evaluate autistic children for visual dysfunction that may be related to the manifested visual signs and symptoms. Thirty-four autistic children, ages 2 to 11 years (median age = 7 years, 6 months) were evaluated for ocular alignment, refractive error, visual acuity, oculomotility skills, and stereopsis. None of the children manifested ocular disease, known seizure disorders, or dysmorphic features. Their developmental levels ranged from average intelligence to severely retarded. Binocular visual acuity was measured with the acuity card procedure. Monocular visual acuity was not obtained. Refractive errors ranged from -4.25 to +3.25 D; the median was plano with the near retinoscopy technique. Of the 34 children, 21% were strabismic at far and 18% were strabismic at near. Lang stereo testing was attempted on all children and completed on 17. Of the 17, all but 3 exhibited 550 sec arc. Only 14.7% of the children exhibited voluntary pursuit movements, and all the children demonstrated saccadic fixations. Thirty-one children had atypical optokinetic nystagmus (OKN) responses such as delayed onset, short duration, gaze avoidance, or stereotypic behavior. Repeated testing revealed consistent visual responses on OKN and visual acuity. Given these findings, research with this population should be pursued further.