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A Systematic Analysis of Amblyopia and Strabismus in Children With Autism Spectrum Disorder Across Tertiary Referral
Julia Goetz1, Oluchukwu Onwuka2, Jee-Young Moon1
1Albert Einstein College of Medicine.
Insights
Children with autism spectrum disorder (ASD) have a higher prevalence of amblyopia and/or strabismus compared to their peers. This study highlights the increased risk and need for further research into eye conditions in neurodivergent children.
Area of Science:
- Ophthalmology
- Neurodevelopmental Disorders
- Pediatric Health
Background:
- Autism spectrum disorder (ASD) is a neurodevelopmental condition affecting social interaction and communication.
- Ophthalmic conditions, such as amblyopia and strabismus, are frequently observed in children.
- Understanding the co-occurrence of these conditions is crucial for comprehensive care.
Purpose of the Study:
- To determine the prevalence of amblyopia and/or strabismus in children with ASD.
- To compare these rates with age-matched controls in the United States.
- To analyze the surgical management rates for strabismus in this population.
Main Methods:
- Systematic analysis of pediatric patients diagnosed with ASD.
- Utilized the Sight Outcomes Research Collaborative (SOURCE) database.
- Compared prevalence, odds ratios, and surgical rates against age-matched controls.
Main Results:
- Children with ASD showed a higher prevalence of strabismus/amblyopia (35%) versus controls (29%), with an odds ratio of 1.33 (P < .001).
- Exotropia was more common than esotropia in both groups.
- Females with ASD had higher rates (39%) than males with ASD (34%); diagnosis rates have increased over two decades.
Conclusions:
- Children with ASD exhibit a significantly higher prevalence of amblyopia and/or strabismus.
- Further research is warranted on the mechanisms of strabismus in neurodivergent children.
- Investigating diagnostic trends of ASD and associated ophthalmic diseases is essential.
Purpose:
To evaluate the prevalence of amblyopia and/or strabismus in children with autism spectrum disorder (ASD) in tertiary referral centers across the United States and rates of surgical management of strabismus.
Methods:
A systematic analysis of pediatric patients diagnosed as having ASD was performed using the Sight Outcomes Research Collaborative (SOURCE) database. Prevalence, odds ratios, and the rate of surgical management for strabismus were determined compared to age-matched controls.
Results:
Strabismus and/or amblyopia was present in 35% of patients with ASD and 29% of age-matched controls (odds ratio = 1.33, 95% CI = 1.254 to 1.415, P < .001). Exotropia was more common than esotropia in both the ASD and control groups. The mean age at first ophthalmologic evaluation was 5.2 years for both controls and patients with ASD and strabismus/amblyopia. However, among those without strabismus/amblyopia, patients with ASD were evaluated earlier (mean ± standard deviation [SD] = 6.7 ± 4.8 years) compared to controls (mean ± SD = 7.4 ± 5.8 years). Although the ASD population had a male predominance, females had higher rates of amblyopia and/or strabismus at 39% compared to males with ASD at 34%. In all age groups, children with ASD had significantly (P < .001) higher rates of amblyopia and/or strabismus when compared to controls. The analysis found children with ASD have a higher prevalence of strabismus and/or amblyopia, with an increasing rate of diagnosis over the past two decades.
Conclusions:
Findings support further research into both the underlying mechanisms of strabismus in neurodivergent children and overall trends in the diagnosis of ASD and concomitant ophthalmic disease.
