Profile of refractive errors in European Caucasian children with Autistic Spectrum Disorder; increased prevalence and magnitude of astigmatism

Pamela Anketell, Kathryn Saunders, Stephen Gallagher, Claire Bailey, Julie-Anne Little

Research output: Contribution to journalArticle

2 Citations (Scopus)



Autistic Spectrum Disorder (ASD) is a common neurodevelopmental disorder characterised by impairment of communication, social interaction and repetitive behaviours. Only a small number of studies have investigated fundamental clinical measures of vision including refractive error. The aim of this study was to describe the refractive profile of a population of children with ASD compared to typically developing (TD) children.


Refractive error was assessed using the Shin‐Nippon NVision‐K 5001 open‐field autorefractor following the instillation of cyclopentolate hydrochloride 1% eye drops.


A total of 128 participants with ASD (mean age 10.9 ± 3.3 years) and 206 typically developing participants (11.5 ± 3.1 years) were recruited. There was no significant difference in median refractive error, either by spherical equivalent or most ametropic meridian between the ASD and TD groups (Spherical equivalent, Mann–Whitney U307 = 1.15, p = 0.25; Most Ametropic Meridian, U305 = 0.52, p = 0.60). Median refractive astigmatism was −0.50DC (range 0.00 to −3.50DC) for the ASD group and −0.50DC (Range 0.00 to −2.25DC) for the TD group. Magnitude and prevalence of refractive astigmatism (defined as astigmatism ≥1.00DC) was significantly greater in the ASD group compared to the typically developing group (ASD 26%, TD 8%, magnitude U305 = 3.86, p = 0.0001; prevalence ( , p < 0.0001).


This is the first study to describe the refractive profile of a population of European Caucasian children with ASD compared to a TD population of children. Unlike other neurodevelopmental conditions, there was no increased prevalence of spherical refractive errors in ASD but astigmatic errors were significantly greater in magnitude and prevalence. This highlights the need to examine refractive errors in this population.

Original languageEnglish
Pages (from-to)395-403
Number of pages9
JournalOphthalmic and Physiological Optics
Issue number4
Early online date21 Feb 2016
Publication statusPublished - 31 Jul 2016



  • Autistic Spectrum Disorder
  • astigmatism
  • children
  • refractive error

Cite this