Myopia and astigmatism in adolescents with autism spectrum disorder

Of 894,375 Israeli adolescents undergoing standardized medical and ocular assessments in our nationwide cross-sectional study, 2,622 (0.3%) had autism spectrum disorder (ASD). Adolescents with ASD had significantly higher adjusted odds of both myopia and astigmatism compared with peers who did not have ASD. The relative odds of refractive error in ASD increased with both myopia severity and astigmatism cylinder power. Associations were consistent across all astigmatism axis orientations, most notably with-the-rule. These findings suggest that early and routine vision screening may be beneficial in identifying and addressing refractive errors among youth with ASD.