Higher risks of hyperopia, myopia, astigmatism, and strabismus in children with autism spectrum disorder: a nationwide, population-based cohort study.

Objective: In this population-based cohort study, we compared the risks of incident hyperopia, myopia, astigmatism, and strabismus between children with autism spectrum disorder (ASD) and those without ASD.

Methods: This study included children who were born in Taiwan at any time between 2004 and 2017, using data from the Taiwan Maternal and Child Health Database (TMCHD). We included 20,688 children with ASD and 2,062,120 matched controls to estimate the risks of incident hyperopia, myopia, astigmatism, and strabismus. Cox proportional hazards regression models were conducted for risk assessment. Models were adjusted for sex, calendar year of birth, and gestational age at birth. Statistical significance was determined through adjusted hazard ratios (aHRs) and 95%CIs.

Results: Children with ASD had higher risks of incident hyperopia (aHR: 1.78; 95%CI 1.70-1.86), myopia (aHR: 1.27; 95%CI 1.24-1.30), astigmatism (aHR: 1.51; 95%CI 1.46-1.56), and strabismus (aHR: 2.18; 95%CI 2.05-2.32) compared to children without ASD.

Conclusion: Clinicians should screen children with ASD for potential eye conditions. Further studies are required to elucidate the mechanisms linking ASD with eye diseases. In addition, studies should explore how the type and severity of ASD symptoms influence the detection of these eye conditions.