• Aubrey L. Gilbert
  • Melanie KazlasEmail author
Part of the Current Clinical Psychiatry book series (CCPSY)


Due to the high prevalence of ophthalmic pathology among individuals with autism spectrum disorder (ASD), a comprehensive examination is recommended for every patient. While individuals with ASD may have problems that are standard in the world of ophthalmology, they may also suffer from more unusual disorders of visual processing that may contribute to behavioral and other issues. Evaluation and management of ophthalmic issues in patients with ASD can be challenging, and each patient requires a tailored approach that takes into account their special needs. While most medical literature related to ophthalmologic care in ASD is focused on the pediatric population, good care, including regular screening, is needed throughout the life span. There is a clear need for more research and more providers with comfort and experience in the ophthalmologic care of adults with ASD. In this chapter, specific considerations in ophthalmic evaluation and management of patients with ASD are discussed.


Ophthalmology Eye exam Visual processing 


  1. 1.
    Albrecht MA, Stuart GW, Falkmer M, et al. Brief report: visual acuity in children with autism spectrum disorders. J Autism Dev Disord. 2014;44(9):2369–74.CrossRefGoogle Scholar
  2. 2.
    American Academy of Ophthalmology Preferred Practice Patterns Committee. Preferred practice pattern® guidelines. Comprehensive adult medical eye evaluation. San Francisco: American Academy of Ophthalmology; 2015. Available at: Accessed 15 Dec 2017.Google Scholar
  3. 3.
    Anderson CJ, Colombo J, Jill Shaddy D. Visual scanning and pupillary responses in young children with autism spectrum disorder. J Clin Exp Neuropsychol. 2006;28(7):1238–56.CrossRefGoogle Scholar
  4. 4.
    Black K, McCarus C, Collins ML, Jensen A. Ocular manifestations of autism in ophthalmology. Strabismus. 2013;21(2):98–102.CrossRefGoogle Scholar
  5. 5.
    Blake R, Turner LM, Smoski MJ, Pozdol SL, Stone WL. Visual recognition of biological motion is impaired in children with autism. Psychol Sci. 2003;14(2):151–7.CrossRefGoogle Scholar
  6. 6.
    Briegel W, Schimek M, Kamp-Becker I. Moebius sequence and autism spectrum disorders – less frequently associated than formerly thought. Res Dev Disabil. 2010;31(6):1462–6.CrossRefGoogle Scholar
  7. 7.
    Brosnan MJ, Gwilliam LR, Walker IJ. Brief report: the relationship between visual acuity, the embedded figures test and systemizing in autism spectrum disorder. J Autism Dev Disord. 2012;42(11):2491–7.CrossRefGoogle Scholar
  8. 8.
    Chawarska K, Shic F. Looking but not seeing: atypical visual scanning and recognition of faces in 2 and 4-year-old children with autism spectrum disorder. J Autism Dev Disord. 2009;39(12):1663–72.CrossRefGoogle Scholar
  9. 9.
    Chiu M, Watson S. Xerophthalmia and vitamin A deficiency in an autistic child with a restricted diet. BMJ Case Rep. 2015;5:2015.Google Scholar
  10. 10.
    Cléry H, Bonnet-Brilhault F, Lenoir P, Barthelemy C, Bruneau N, Gomot M. Atypical visual change processing in children with autism: an electrophysiological study. Psychophysiology. 2013;50(3):240–52.CrossRefGoogle Scholar
  11. 11.
    Dakin S, Frith U. Vagaries of visual perception in autism. Neuron. 2005;48(3):497–507.CrossRefGoogle Scholar
  12. 12.
    Davis RA, Bockbrader MA, Murphy RR, Hetrick WP, O’Donnell BF. Subjective perceptual distortions and visual dysfunction in children with autism. J Autism Dev Disord. 2006;36(2):199–210.CrossRefGoogle Scholar
  13. 13.
    Ezegwui IR, Lawrence L, Aghaji AE, et al. Refractive errors in children with autism in a developing country. Niger J Clin Pract. 2014;17(4):467–70.CrossRefGoogle Scholar
  14. 14.
    Furman JM, Osorio MJ, Minshew NJ. Visual and vestibular induced eye movements in verbal children and adults with autism. Autism Res. 2015;8:658–67.CrossRefGoogle Scholar
  15. 15.
    Frey HP, Molholm S, Lalor EC, Russo NN, Foxe JJ. Atypical cortical representation of peripheral visual space in children with an autism spectrum disorder. Eur J Neurosci. 2013;38(1):2125–38.CrossRefGoogle Scholar
  16. 16.
    Grossman RB, Steinhart E, Mitchell T, McIlvane W. “Look who’s talking!” Gaze patterns for implicit and explicit audio-visual speech synchrony detection in children with high-functioning autism. Autism Res. 2015;8(3):307–16.CrossRefGoogle Scholar
  17. 17.
    Guy J, Mottron L, Berthiaume C, Bertone A. The developmental trajectory of contrast sensitivity in autism spectrum disorder. Autism Res. 2015;9(8):866–78.CrossRefGoogle Scholar
  18. 18.
    Happé FG. Studying weak central coherence at low levels: children with autism do not succumb to visual illusions. A research note. J Child Psychol Psychiatry. 1996;37(7):873–7.CrossRefGoogle Scholar
  19. 19.
    Ikeda J, Davitt BV, Ultmann M, Maxim R, Cruz OA. Brief report: incidence of ophthalmologic disorders in children with autism. J Autism Dev Disord. 2013;43(6):1447–51.CrossRefGoogle Scholar
  20. 20.
    Isler JR, Martien KM, Grieve PG, Stark RI, Herbert MR. Reduced functional connectivity in visual evoked potentials in children with autism spectrum disorder. Clin Neurophysiol. 2010;121(12):2035–43.CrossRefGoogle Scholar
  21. 21.
    Johansson M, Gillberg C, Råstam M. Autism spectrum conditions in individuals with Möbius sequence, CHARGE syndrome and oculo-auriculo-vertebral spectrum: diagnostic aspects. Res Dev Disabil. 2010;31(1):9–24.CrossRefGoogle Scholar
  22. 22.
    Kabatas EU, Ozer PA, Ertugrul GT, Kurtul BE, Bodur S, Alan BE. Initial ophthalmic findings in Turkish children with Autism Spectrum Disorder. J Autism Dev Disord. 2015;45(8):2578–81.CrossRefGoogle Scholar
  23. 23.
    Lavoie J, Maziade M, Hébert M. The brain through the retina: the flash electroretinogram as a tool to investigate psychiatric disorders. Prog Neuro-Psychopharmacol Biol Psychiatry. 2014;48:129–34.CrossRefGoogle Scholar
  24. 24.
    Nebel MB, Eloyan A, Nettles CA, et al. Intrinsic visual-motor synchrony correlates with social deficits in autism. Biol Psychiatry. 2016;79(8):633–41.CrossRefGoogle Scholar
  25. 25.
    Manning C, Tibber MS, Charman T, Dakin SC, Pellicano E. Enhanced integration of motion information in children with autism. J Neurosci. 2015;35(18):6979–86.CrossRefGoogle Scholar
  26. 26.
    McCurry TC, Lawrence LM, Wilson ME, Mayo L. The plusoptiX S08 photoscreener as a vision screening tool for children with autism. J AAPOS. 2013;17(4):374–7.CrossRefGoogle Scholar
  27. 27.
    Pensiero S, Fabbro F, Michieletto P, Accardo A, Brambilla P. Saccadic characteristics in autistic children. Funct Neurol. 2009;24(3):153–8.PubMedGoogle Scholar
  28. 28.
    Pineles SL, Avery RA, Liu GT. Vitamin B12 optic neuropathy in autism. Pediatrics. 2010;126(4):e967–70.CrossRefGoogle Scholar
  29. 29.
    Schwarzkopf DS, Anderson EJ, de Haas B, White SJ, Rees G. Larger extrastriate population receptive fields in autism spectrum disorders. J Neurosci. 2014;34(7):2713–24.CrossRefGoogle Scholar
  30. 30.
    Shafai F, Armstrong K, Iarocci G, Oruc I. Visual orientation processing in autism spectrum disorder: no sign of enhanced early cortical function. J Vis. 2015;15(15):18.CrossRefGoogle Scholar
  31. 31.
    Shi L, Zhou Y, Ou J, et al. Different visual preference patterns in response to simple and complex dynamic social stimuli in preschool-aged children with autism spectrum disorders. PLoS One. 2015;10(3):e0122280.CrossRefGoogle Scholar
  32. 32.
    Steinemann TL, Christiansen SP. Vitamin A deficiency and xerophthalmia in an autistic child. Arch Ophthalmol. 1998;116(3):392–3.CrossRefGoogle Scholar
  33. 33.
    Stewart CR, Sanchez SS, Grenesko EL, et al. Sensory symptoms and processing of nonverbal auditory and visual stimuli in children with autism spectrum disorder. J Autism Dev Disord. 2016;46(5):1590–601.CrossRefGoogle Scholar
  34. 34.
    Stroganova TA, Butorina AV, Sysoeva OV, et al. Altered modulation of gamma oscillation frequency by speed of visual motion in children with autism spectrum disorders. J Neurodev Disord. 2015;7(1):21.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OphthalmologyBoston Children’s Hospital, Massachusetts Eye and Ear InfirmaryBostonUSA

Personalised recommendations