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Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with near heterophoria and accommodative dysfunction.

A Eusebio López-Hernández1, Carmen Miquel-López2, José Javier García-Medina2

  • 1Grupo de Investigación Optometría Clínica y Experimental, Facultad de Óptica y Optometría, Universidad de Murcia, 30100 Murcia, Spain.

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|September 21, 2025
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Summary

Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) often experience vision problems like reduced focusing ability and eye alignment issues. These visual disturbances may impact attention and concentration, particularly during near tasks.

Keywords:
Accommodative amplitudeAccommodative lagAttention-Deficit/Hyperactivity DisorderPhoriaVision

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Area of Science:

  • Neuro-ophthalmology
  • Developmental Neuroscience
  • Pediatric Optometry

Background:

  • Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition.
  • Visual disturbances are frequently reported in individuals with ADHD.
  • Understanding the relationship between ADHD and visual function is crucial for comprehensive patient care.

Purpose of the Study:

  • To investigate and compare clinical optometric measurements in individuals with and without ADHD.
  • To identify specific visual function deficits associated with ADHD.
  • To explore potential correlations between ADHD, sex, and medication use with optometric findings.

Main Methods:

  • 80 participants (40 ADHD, 40 controls) underwent comprehensive optometric testing.
  • Tests included accommodative amplitude, accommodative facility, Cover Test, and near point of convergence.
  • Subgroup analyses were conducted based on sex and medication status within the ADHD group.

Main Results:

  • The ADHD group exhibited a significantly higher lag of accommodation and greater accommodative amplitude compared to controls.
  • A higher prevalence of near-heterophoria was observed in individuals with ADHD.
  • No significant differences in optometric findings were noted between medicated and unmedicated ADHD participants.

Conclusions:

  • Individuals with ADHD commonly present with impaired accommodative responses and increased heterophoria.
  • These visual deficits may contribute to attention and concentration difficulties, especially in near-work.
  • Routine eye examinations are recommended for individuals with ADHD to address potential vision-related challenges.