ArticleAmerican journal of ophthalmology2026
Ophthalmic Disease Burden in Adults With Autism Spectrum Disorder.
Article in American journal of ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare the documented prevalence of common treatable ocular conditions among US adults with and without autism spectrum disorder (ASD) in a large, socioeconomically diverse cohort.
designPropensity score-matched cohort study.
participantsAdults aged 18 years or older in the National Institutes of Health All of Us Research Program database, version 8, with electronic health record data.
methodsAdults with ASD were propensity score-matched 1:4 to adults without ASD on age, sex assigned at birth, race and ethnicity, and duration of electronic health record observation. Prevalence of each ocular condition was compared between groups, and absolute prevalence differences were estimated. Logistic regression was used to evaluate the association between ASD and ocular conditions; sequential models adjusted for household income, educational attainment, and health insurance status.
main outcome measuresDocumented diagnoses of refractive/accommodative error, cataract, glaucoma, strabismus, dry eye disease, and any ocular condition.
resultsAmong 5250 matched participants, 1050 adults had ASD, and 4200 were controls; the cohort had a mean age of 39.1 years and was 49.3% male. Adults with ASD had higher documented prevalence of any ocular condition (29.5% vs 17.8%), refractive/accommodative error (22.3% vs 14.0%), cataract (9.9% vs 5.2%), dry eye disease (9.0% vs 5.5%), glaucoma (3.6% vs 1.5%), and strabismus (3.8% vs 1.7%) compared with controls. In fully adjusted models, ASD was associated with increased odds of any ocular condition (odds ratio [OR] = 2.09; 95% confidence interval [CI], 1.78-2.45), glaucoma (OR = 2.56; 95% CI, 1.67-3.88), strabismus (OR = 2.31; 95% CI, 1.53-3.44), cataract (OR = 2.16; 95% CI, 1.68-2.77), refractive/accommodative error (OR = 1.92; 95% CI, 1.61-2.29), and dry eye disease (OR = 1.80; 95% CI, 1.39-2.32). Associations were similar from unadjusted through fully adjusted models.
conclusionsAdults with ASD had higher documented prevalence and odds of multiple treatable ocular conditions when compared to matched adults without ASD. Greater attention should be directed toward autism-informed adult eye care, including proactive screening, sensory and communication accommodations, and coordinated follow-up to support timely identification and management of ocular diseases in this population.
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