Refractive Error Characteristics in Children with Autism

Abstract

 

Purpose:

 

Autism is a disorder of neural development characterized by impaired social interaction and communications, beginning before three years of age. A small sample study (N=10) suggested that autistic children often have significant astigmatism. (Denis et al, 1997) The purpose of this study was to investigate refractive error characteristics in large cohort of autistic children during the first 12 years of life.

 

Methods:

 

Ninety-two autistic children, (15 girls; 77 boys), underwent at least one complete ophthalmologic examination. Cycloplegic refractions were converted into power vector components: M (spherical equivalent), J₀ (positive J₀ indicates with-the-rule (WTR) astigmatism and negative J₀ indicated against-the-rule (ATR) astigmatism) and J₄₅ (oblique astigmatism). Three age groups were evaluated: Age≤4 year (N=25); 4<Age≤8 year (N=45); 8<Age≤12 year (N=45).

 

Results:

 

Table 1 shows results from right eyes. Significant WTR astigmatism (J₀≥0.5D) was prevalent (over 35%) among autistic children in all age groups, which is higher than the normal population (25%). On the average, the autistic cohort had more than 1.5D cylinder astigmatism. There was no significant difference in prevalence or magnitude of astigmatism among age groups. Moreover, the spherical equivalent of autistic children demonstrated the typical myopic trend after 8 years of age but the large standard deviation during the first 12 years of life suggests abnormal emmetropization. J₄₅ was negligible.

 

Conclusions:

 

WTR astigmatism was common among autistic children during childhood, with higher prevalence than in the normal population. Early diagnosis and correction of refractive error is an essential component of medical care for autistic children.  

 

Keywords: refractive error development • astigmatism • refraction