Refractive Errors and Vision Problems in Autistic Children: Insights into Parental Awareness in Iraq

To evaluate parental awareness of vision problems in children with ASD.

This descriptive study included parents/caregivers of ASD children attending autism diagnosis and rehabilitation centers in Baghdad between October 2023 and April 2024. Eligible participants lived with and provided daily care for the child. Data was collected through structured interviews covering three domains: (A) demographic and socioeconomic characteristics, (B) observed visual problems in children, and (C) knowledge of visual impairment and its impact.

A total of 123 parents and caregivers participated, 65% of whom were recruited from three major centers: the National Center for Autism, Al Safa Institute, and Baghdad Governmental Center for Autism. Biological parents comprised 97.6% of the sample; 2.4% were kinship caregivers. Parents/caregivers reported that 49.6% of children had been diagnosed with visual impairments, while 20 out of 62 (16.3%) of undiagnosed children exhibited behavioral signs of vision issues, including close screen proximity. Refractive errors (43.9%) and ocular misalignments (26.8%) were most common, with myopia (33.3%) being the leading diagnosis. Awareness scores indicated that 35 (28.5%) had poor awareness, 65(52.8%) moderate, and 23 (18.7%) good. Caregivers had significantly higher awareness than biological parents (P = 0.006), while employed respondents showed lower awareness levels (P = 0.015).

Children with ASD are prone to undiagnosed visual impairments; however, a considerable proportion of parents were completely unaware of this issue. Enhancing parental awareness and integrating interdisciplinary vision screening into publicly funded ASD services are vital for early detection, prevention, and long-term management.