ABSTRACT.Aims: To characterize ophthalmological findings in a sample of Swedish children aged 4-15 years. Methods: A prospective cross-sectional comprehensive ophthalmological investigation was performed on a sample of 143 children (67 girls, 76 boys) aged 4-15 years. Results: Visual acuity (VA) in the better eye ‡1.0 (£0.0 logMAR) was found in 79% of subjects. None of the children had VA in the better eye <0.5 (>0.3 logMAR). Amblyopia was found in 0.7% of subjects. A total of 68% of the children had no refractive errors. Hyperopia ( ‡2.0 dioptres [D] in spherical equivalent [SE]) was found in 9% and myopia ( ‡0.5 D SE) in 6% of children. Astigmatism ( ‡0.75 D) was recorded in 22% and anisometropia ( ‡1.0 D SE) in 3%. A total of 8% were optically corrected. Strabismus was recorded in 3.5%. Signs of visuoperceptual problems were reported in 3% of the children. Conclusion: This sample of Swedish children may serve as a comparison group regarding ophthalmological findings in children aged 4-15 years.

Aims To investigate visual function and ocular features in children with attention deficit hyperactivity disorder (AD/HD) and establish whether treatment with stimulants is reflected in functioning of the visual system. Methods Detailed ophthalmologic evaluations without and with stimulants were performed in 42 children (37 boys) with AD/HD, mean age 12 years, and compared with a reference group (ref; n ¼ 50; mean age 11.9 years; 44 boys). For a comparison between two groups, Mann-Whitney's U-test was used for ordered and continuous variables; for dichotomous variables, Fisher's exact test was used. For paired comparison (with and without treatment), sign test was used. Results In all, 83% had visual acuity of 40.8 (o0.1 logMAR) without treatment, 90% with stimulants (ref 98%; P ¼ 0.032 and n.s., respectively). Heterophoria was found in 29% without, and in 27% with, stimulants (ref 10%; P ¼ 0.038 and n.s., respectively) and subnormal stereovision (460 s of arc) in 26% (ref 6%; P ¼ 0.016) without stimulants, and in 27%, with (P ¼ 0.014). Abnormal convergence (46 cm or absent) was noted in 24% (ref 6%; P ¼ 0.031) without treatment and in 17%, with (n.s.). Astigmatism (Z1.0 D) was observed in 24% (ref 6%; P ¼ 0.03), and signs of visuoperceptual problems in 21% (ref 2%; P ¼ 0.007). We found smaller optic discs (n ¼ 8/38) and neuroretinal rim areas (n ¼ 7/38) (Po0.0001) and decreased tortuosity of retinal arteries (n ¼ 6/34) (P ¼ 0.0002) than that of controls.Conclusions Children with AD/HD had a high frequency of ophthalmologic findings, which were not significantly improved with stimulants. They presented subtle morphological changes of the optic nerve and retinal vasculature, indicating an early disturbance of the development of these structures.

In this study, 143 well-defined children were investigated with a battery of accurately described tests, commonly used in clinical practice. These results are in agreement with those of other studies examining one or few variables in larger populations and the authors therefore conclude that their results may be used for comparisons with different patient groups.

This study establishes values for visual fixation behaviour in a non-clinical population aged 4-15 years, which can be used for identifying children with fixation abnormalities.