Ophthalmic Disease Burden in Adults with Autism Spectrum Disorder

Area of Science:

• Ophthalmology
• Neurodevelopmental Disorders
• Public Health

Background:

• Autism spectrum disorder (ASD) is a complex neurodevelopmental condition.
• Ocular conditions are common in the general population but may be more prevalent in individuals with ASD.
• Understanding the prevalence of treatable ocular conditions in adults with ASD is crucial for targeted healthcare interventions.

Purpose of the Study:

• To compare the documented prevalence of common, treatable ocular conditions in US adults with and without autism spectrum disorder (ASD).
• To analyze differences in conditions such as refractive error, cataract, glaucoma, strabismus, and dry eye disease.
• To investigate these differences within a large, socioeconomically diverse cohort.

Main Methods:

• A propensity score-matched cohort study was conducted using data from the National Institutes of Health All of Us Research Program.
• Adults aged 18 years and older with ASD were matched 1:4 to adults without ASD based on demographic factors and EHR observation duration.
• Prevalence of specific ocular conditions was compared, and logistic regression models adjusted for socioeconomic factors were used to assess associations.

Main Results:

• The study included 5250 matched participants (1050 with ASD, 4200 controls).
• Adults with ASD showed significantly higher documented prevalence of any ocular condition, refractive/accommodative error, cataract, dry eye disease, glaucoma, and strabismus.
• Fully adjusted models confirmed that ASD was associated with increased odds of all investigated ocular conditions.

Conclusions:

• Adults with ASD exhibit a higher documented prevalence and odds of multiple treatable ocular conditions compared to their neurotypical peers.
• There is a need for greater focus on autism-informed adult eye care.
• Recommendations include proactive screening, sensory and communication accommodations, and coordinated follow-up for timely diagnosis and management of eye diseases in individuals with ASD.