Children with autism spectrum disorder (ASD) have a higher rate of vision problems than their healthy counterparts, yet not enough of these patients are assessed by eye care professionals in the United States, a recent study in Optometry and Vision Science suggests. Autistic children are at a higher risk for significant refractive error, strabismus, amblyopia, visual field defects, abnormal color vision and eye movement and retinal disorders, to name a few.

Based on data from 2011 to 2012, researchers found that 82.2% of children with ASD had a vision screening. Among those younger than five, 8.9% had a vision screening at a pediatrician's office, 41.1% at school and 37.6% by an eye doctor. Of note, none of the children who were screened in a pediatrician’s office were also seen by an eye care provider. Among those older than five, 24.8% were screened at school, 22.2% at a pediatrician’s office and about half by an ECP.

“Because of the high prevalence of eye disorders among children with ASD, it is important to note the number of children seen in eye care providers’ offices. Almost 50% of all children with ASD received evaluation in an eye care provider’s office,” the study authors wrote in their final paper. “This rate is higher than that seen in children without ASD but is far less than the 100% eye care provider examination rate called for by some national organizations.”

The lower rates of dual screening in ECPs’ offices and other testing locations suggest that either referral from outside sources is low, there is little follow-up (even if referrals are made) or both, investigators noted. In the absence of a cohesive eye care practitioner evaluation mandate across all stakeholders, education about the prevalence of vision abnormalities in children with ASD is necessary for caregivers, pediatricians and others, they added.

Swanson MW, Lee SD, Frazier MG, et al. Vision screening among children with autism spectrum disorder. Optom Vis Sci. October 30, 2020. [Epub ahead of print].