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Autism And Vision: Annual Eye Exams Are Essential

Published on 05/13/2024
autism and vision annual eye exams are essential

All children should visit an optometrist during their toddler and pre-k years, but that’s especially true for children with autism spectrum disorder (ASD). Kids with ASD are more likely to have specific vision issues.

If the child is nonverbal or ASD affects their performance in school, vision issues are more likely to go undetected and negatively impact their social-emotional development.

Schedule An Eye Exam With A Family Optometrist During The Toddler Years

The College of Optometrists in Vision Development (COVD) states that key signs and indicators of a vision problem “...can be masked by the behaviors that autistic individuals use to cope with the sensory overload of the world around them.”

While it may take more preparation and the right optometrist or ophthalmologist to assess your child (the Autism Response Team can provide resources for those who specialize in ASD patients in our area), these vision specialists have a range of tools available to detect vision issues -especially for nonverbal children.

It’s a good idea to schedule an appointment with an optometrist when your child is two or three years old. A 20/20 vision test using a Snellan or related chart cannot rule out all potential issues. The earlier children have access to vision correction and related vision therapy, the more successful other behavioral therapies will be, and the less likely they will struggle with academics or social settings.

Common Vision Issues Affecting Children With Autism Spectrum Disorder

Sometimes, primary caregivers, teachers, and others mistakenly believe that the symptoms of a potential vision problem are just typical autism behaviors. However, any of the following could be more visually rather than behaviorally related. Once corrected, certain ASD behaviors or responses may disappear or be minimized.

  • Not making eye contact.
  • Not tracking things in motion with their eyes.
  • Seeming to look through or beyond people or objects.
  • Eye alignment.
  • Reciprocal play.
  • Wandering eyes.
  • Poor depth perception (which may display as an extreme fear of heights or a misperception of how high something actually is from the ground).
  • Light sensitivity.
  • Rolling eyes.
  • Turning their head to look at things from the side rather than head-on.
  • Eyes that race from one thing to another or move quickly back and forth.
  • Flapping their hands rapidly in front of their eyes (visual stimming).

While some of these may have nothing to do with a child’s vision, assuming that it’s purely behavioral prevents the possibility of interventions to improve vision, which often has a directly positive impact on their behaviors and school performance.

Some of the most common vision issues that affect children with ASD are:

Strabismus

Strabismus occurs when eye muscles struggle to remain in focus, causing muscle spasms. The eyes will look as if they’re vibrating or spasming. As many as 15% of children on the ASD spectrum have some degree of strabismus, which can be supported with the right lenses and vision therapies. Strabismus creates a double-vision experience, which can be very confusing. Eventually, the brain cuts off the signal from the weaker eye, which leaves it permanently diminished - and that can also cause a lazy or wandering eye.

Farsightedness (hyperopia)

Nearly 50% of those with autism have trouble seeing into the distance. This affects their ability to concentrate in school or navigate their environments, especially if other sensitivities are involved. Visual communication tools, like picture-based charts or PECS Cards, are a first-line behavioral therapy tool, so you can see how essential it is to correct any potential vision problem.

Astigmatism

Astigmatism occurs when the lens or eye is more oblong than spherical. This causes light entering the eye to focus on two separate points at the rear of the retina rather than at a single point, causing blurry vision at both near and far ranges. The more oblong the shape, the further apart those light points are, and the blurrier the image appears.

Nearsightedness (myopia)

Nearsightedness is also prevalent in those on the ASD spectrum, although it seems to affect those with Asperger’s Syndrome (high-functioning autism) more than others. Up to 18% of children diagnosed with Asperger's are nearsighted.

Legal blindness

Studies have shown that autism is at least ten times more common in blind people. There are many resources available for children who are legally blind, but we also recommend having them assessed early for any signs of autism. Children who are blind and on the ASD spectrum require different types of behavioral and occupational therapy than their counterparts.

A study reviewing ASD and increased risk of vision problems, cited by autism.org, concluded:

Ophthalmologic manifestations occur more frequently in patients with ASD than in the general child population…. Therefore, we consider it necessary to perform an ophthalmological evaluation in patients with ASDs.

Common Treatments And Therapies For Vision Problems Linked To ASD

Some of the most common treatments for vision problems are the same for children with and without ASDs, like prescription lenses. However, depending on the patient, optometrists, ophthalmologists, and applied behavioral analysts may use different or additional therapies to support a child’s success at home, school, social settings, etc. 

This may include:

  • Strengthening weaker eye muscles to support visual stability.
  • Increasing eye coordination.
  • Improving central vision. 
  • Creating visually organized spaces that support visual acuity and visual sensitivities.
  • Using therapies that support and develop visual information processing.
  • Increasing visual-spatial organization.

Behavioral Analysts Work Collaboratively With Medical And Vision Professionals 

The Autism Response Team collaborates with doctors, neurologists, optometrists, and ophthalmologists to provide comprehensive and cooperative therapies and interventions. Our goal is to meet children and families where they’re at, learn more about their lives and goals, and then create realistic plans that cultivate increased joy, well-being, and integration at home and in the world at large.

We see first-hand what a difference it makes when clients have access to high-level vision care from professionals who understand the needs of children with ASD and their families. Contact us to learn more about our program and how we can help.

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