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  • Comprehensive Ophthalmology, Pediatric Ophth/Strabismus

    Review of: Prevalence of Ophthalmologic Diagnoses in Children With Autism Spectrum Disorder Using the Optum Dataset: A Population-Based Study

    Chang M, Doppee D, Yu F, et al. American Journal of Ophthalmology, January 2021

    In this population-based analysis, investigators evaluated ophthalmologic disorders associated with autism spectrum disorder (ASD).

    Study design

    This is a large retrospective cohort study that included 10,815,576 typically developing (TD) children, 100,854 children with pervasive developmental disorder (PDD) and 61,167 children with autistic disorder (AD). The prevalence of 5 ophthalmologic diagnoses—amblyopia, strabismus, optic neuropathy, nystagmus or retinopathy of prematurity—were assessed by ICD-9 codes.


    Children with PDD and AD had higher rates of epilepsy, seizure as well as other comorbid conditions when compared with typically developing children. The 5 ophthalmic conditions studied were observed in 3.5% of the TD group, 12.5% of the PDD group and 13.5% of the AD group. The differences were significant (P<0.001). The odds ratio was highest for nystagmus.


    This study was a retrospective analysis of a large dataset based on administrative claims and electronic health records data, which is limited by the accuracy of coding. Rates of prematurity were under-reported and race and ethnicity were not collected by self-report. Refractive errors were not assessed due to lack of precision in billing codes despite being common in children with ASD.

    Clinical significance

    This study has looked at data from 10 million children and demonstrates an increased prevalence of ophthalmologic disorders in children with autism compared with typically developing children.