Ophthalmologic Manifestations in Autism Spectrum Disorder

The purpose of this study was to describe the ophthalmologic manifestations found in patients with autism spectrum disorder (ASD) and to assess their prevalence in the different types of ASD.

This prospective observational study included 344 patients with ASD seen over a period of 8.5 years. They were classified into four subgroups (autism, Asperger syndrome, pervasive developmental disorders not otherwise specified [PDD-NOS], and other). Data obtained from ophthalmological examinations were compared between the groups. Statistical analysis was performed with chi-square, Kruskal-Wallis, and Mann-Whitney tests.

Refractive defects were detected in 48.4% of the patients, with the most prevalent being hyperopia and astigmatism. There was a higher prevalence of myopia in Asperger syndrome. Evaluation of extraocular motility revealed the presence of strabismus in 15.4% of patients, with a statistically significantly higher prevalence in autism and the "other" disorders group. The most frequent type of strabismus was exotropia. Convergence was found to be normal in 43.6% of the patients. Nystagmus was observed in only 0.9% of patients. In the binocular sensory tests performed, patients with Asperger syndrome had significantly better results compared to the other groups. Optic nerve abnormalities were found in 4% of patients, with significantly higher prevalence in the "other" disorders group.

Ophthalmologic manifestations occur more frequently in patients with ASD than in the general child population. Of these, the most frequent are refractive defects and ocular motility disorder. Therefore, we consider it necessary to perform an ophthalmological evaluation in patients with ASDs.