Near-point Findings in Children with Autism Spectrum Disorder and in Typical Peers
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Published on: October 3, 2018
Rachel Anastasia Coulter, Annette Bade1, Erin C Jenewein2
1Health Professions Division, College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida.
Insights
Children with autism spectrum disorder (ASD) often exhibit vision problems like exophoric posture and a receded near point of convergence. These visual deficits in ASD children are present regardless of their verbal communication level.
Area of Science:
- Ophthalmology
- Neurodevelopmental Disorders
- Pediatric Vision
Background:
- Vision problems are common in children with autism spectrum disorder (ASD).
- Establishing a standard of care for diagnosing and managing vision issues in ASD is crucial.
- Comprehensive binocular vision evaluations are important for all individuals with ASD.
Purpose of the Study:
- To compare near-point and ocular motility test results between children with ASD and typically developing (TD) peers.
- To analyze differences in visual function among ASD children based on their verbal communication level.
Main Methods:
- Sixty-one children and adolescents (34 ASD, 27 TD), aged 9-17, underwent a comprehensive eye examination.
- Tests included phoria, near point of convergence, fusional vergence, accommodative response, and oculomotor function.
- ASD children's verbal communication levels (nonverbal, short words, verbal) were recorded by parents.
Main Results:
- ASD children showed significantly more exophoric near posture and a receded near point of convergence compared to TD peers.
- Poorer stereoacuity, reduced fixation, and impaired oculomotor abilities were observed in the ASD group.
- No significant differences in visual findings were noted between ASD subgroups based on verbal communication level.
Conclusions:
- Children with ASD frequently exhibit a receded near point of convergence, poor fixation, and exophoric posture.
- These visual differences in ASD children are independent of their verbal communication abilities.
- Standardized vision assessments are vital for effective diagnosis and management in ASD.
Significance:
Clinicians can better diagnose and manage vision problems of autism spectrum disorder (ASD) children by establishing a standard of care for this population. Results also reinforce the importance of a comprehensive binocular vision evaluation in all patients with ASD.
Purpose:
The purposes of this study were to compare near-point and ocular motility test findings in ASD children and typically developing (TD) peers and to compare findings among ASD children by level of verbal communication.
Methods:
Sixty-one children and adolescents (ASD, 34; TD, 27) aged 9 to 17 years completed an eye examination protocol including tests of distance and near phoria, near point of convergence, near fusional convergence and divergence, accommodative response, and Northeastern State University College of Optometry oculomotor testing. Testing was completed through refractive correction. Parents of ASD children provided information regarding subjects' verbal communication level (nonverbal, uses short words, verbal).
Results:
Distance phoria did not differ significantly between groups. Near phoria of ASD subjects was more exophoric (difference, 2.8 prism diopters). Mean near point of convergence break and recovery were 7.0 and 8.02 cm, respectively, in ASD subjects and 2.19 and 3.99 cm in TD subjects. Near fusional divergence and convergence showed no significant difference. Autism spectrum disorder subjects had significantly poorer stereoacuity (P < .0001) and, on Northeastern State University College of Optometry Oculomotor Testing, reduced fixation, poorer accuracy and stamina/ability, and increased head and body movement. Monocular estimation method retinoscopy results did not differ significantly between ASD and TD subjects. No significant differences in phoria, near point of convergence, and near fusional divergence or convergence were observed between ASD subgroups (nonverbal, uses short words, verbal).
Conclusions:
Autism spectrum disorder children are more likely to show receded near point of convergence, poor fixation, inaccurate saccades, erratic pursuits, and exophoric posture. These differences occur, regardless of reported verbal communication level.
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