The Underestimated Role of Refractive Error (Hyperopia, Myopia, and Astigmatism) and Strabismus in Children With ADHD

Reimelt, Charlotte; Wolff, Nicole; Hölling, Heike; Mogwitz, Sabine; Ehrlich, Stefan; Roessner, Veit

doi:10.1177/1087054718808599

Cited by 12 publications

(11 citation statements)

References 47 publications

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“…Common vision anomalies that remain untreated have been reported to affect reading and academic performance, in particular uncorrected hyperopia (Kulp et al, 2016;Narayanasamy et al, 2015a;Rosner & Rosner, 1997;Shankar et al, 2007;van Rijn et al, 2014), uncorrected astigmatism (Harvey et al, 2016;Narayanasamy et al, 2015b), and reduced stereoacuity (Kulp et al, 2016). Furthermore, vision anomalies have been reported to be more prevalent in children and adolescents with dyslexia compared with controls (Vikesdal et al, 2020), and hyperopia, astigmatism, and strabismus are reported to be associated with attention deficit hyperactivity disorder (Reimelt et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Vision status and reading test results in Norwegian adolescents

Hagen¹,

Gilson²,

Baraas³

2020

Scand J Optom Vis Sci

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Uncorrected vision anomalies may cause headaches and may affect reading and academic performance. The purpose of this study was to quantify the frequency of vision anomalies, frequency of eye examinations, and use of corrective eye wear in adolescents in Norway, and to explore whether such vision anomalies affect reading test results or frequency of headaches. A cross-sectional study was performed in 436 adolescents (42.0% males) aged 16–19 years living in South-East Norway. Cycloplegic autorefraction, habitual stereoacuity, and habitual monocular amplitudes of accommodation were measured, and all participants reported the frequency of eye examinations, the use of spectacles and/or contact lens wear, and the frequency of headaches. Reading comprehension and decoding skills were evaluated for a subgroup of the participants (189 participants, 34.4% males) by their performance in national reading tests. Vision anomalies were defined as having refractive errors, poor habitual stereoacuity, or poor habitual amplitude of accommodation in at least one eye. Overall, 44.0% were classified as having a refractive error, and a total of 61.9% were measured to have vision anomalies. More frequent headaches were associated with poor habitual amplitude of accommodation when adjusted for sex (p = 0.04). The frequency of poor reading comprehension was higher in the group of adolescents with vision anomalies (n = 109, 31.2%) compared with those with no vision anomalies (n = 80, 18.8%; p = 0.05). Of those with vision anomalies, 33.5% had never had an eye examination, and 63.9% reported not wearing a correction. In Norway, there is no mandatory vision screening after 4 years of age. The results here show that a nation-wide programme of regular eye examinations and proper treatment of vision anomalies for all children and adolescents in Norway should be considered. Identifying and treating children with common eye problems in primary and secondary school will improve educational attainment and increase each child’s chances of succeeding in further education.

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Section: Introductionmentioning

confidence: 99%

Vision status and reading test results in Norwegian adolescents

Hagen¹,

Gilson²,

Baraas³

2020

Scand J Optom Vis Sci

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“…Garnet et al found a threefold increase in the incidence of ADHD among patients with convergence insufficiency compared with the general population in a retrospective study [26]. In a large-scale cohort study by Reimelt et al, strabismus and refractive error were linked to ADHD [28]. In another large-scale cross-sectional telephone survey in the United States [29], children with eye problems had a higher prevalence of ADHD (15.6%) than those with normal vision (8.3%).…”

Section: Discussionmentioning

confidence: 99%

High Risk for Attention-Deficit Hyperactive Disorder in Children with Strabismus: A Nationwide Cohort Study from the National Health Insurance Research Database

Tsai

Liu

et al. 2021

Life

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Strabismus is associated with amblyopia and a lower quality of life. Attention-deficit hyperactivity disorder (ADHD) is common among children and adolescents, and influences their academic, vocational, and social life. Previous studies have suggested an association between strabismus and ADHD. Using data from the Taiwan National Health Insurance Research Database between 2000 and 2010, we performed a large-scale cohort study comparing the incidence, risk factors, and severity of ADHD in children with and without strabismus. A total of 2049 patients <18 years old with newly diagnosed strabismus (esotropia: 404; exotropia: 1645) were identified, and 8196 age- and sex-matched controls without strabismus were also included. After an average of 6.5 ± 2.9 years of follow-up, the incidence of ADHD per 1000 person-years was 5.39 in the strabismus group (esotropia: 9.93; exotropia: 4.11) and 3.23 in the control group. The cumulative incidence of ADHD was significantly greater in the esotropia (hazard ratio [HR]: 2.04; 95% confidence interval [CI]:1.36–3.06; p = 0.0007) and exotropia groups (HR: 1.44; 95% CI: 1.03–2.03; p = 0.038) than in the controls. Patients with strabismus had more comorbidities than those without (p < 0.05). In summary, this large-scale study found a higher cumulative incidence of ADHD in patients with strabismus, especially in those with esotropia.

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“…Abnormal visual experience may cause asthenopia and inattentiveness. Researches [32,33] considered that refractive error seemed to be leaded to symptoms of inattention and hyperactive activity independently. Our study found that corrected visual acuity of the left eye was negatively correlated with SNAP positive result.…”

Section: Discussionmentioning

confidence: 99%

High Risk for Attention-Deficit Hyperactive Disorder in Pediatric inpatients with Strabismus in Tianjin, China: Hospital-based Cross-sectional Study

Xue

Sun

Chen

et al. 2022

Preprint

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Background The hospital-based cross-sectional study aimed to explore the high risk for Attention-Deficit Hyperactive Disorder (ADHD) in Pediatric inpatients with Strabismus. Methods Using data from the Tianjin Eye Hospital, we performed a study comparing the incidence, risk factors, and severity of ADHD in children with and without strabismus by the SNAP-IV tool. Results A total of 401 patients with strabismus (exotropia:313; esotropia:42; vertical deviation:46) that ranged from 4 to 24 yrs and 200 healthy controls. SNAP screening detected that incidence of ADHD with strabismus was higher than controls (P=0.005).'' Inattentiveness '', as one subitem of SNAP, showed higher score in strabismic patients than control groups (P=0.027) and significantly associated with age (r=-0.126, P=0.011) and gender (r=-0.129, P=0.010). ADHD with exotropia was higher than other strabismus types(P=0.019), especially in intermittent exotropia patients (P=0.025). Additionally, the incidence of ADHD was significantly greater in male (HR = 0.539; 95% CI 0.331 - 0.331; P = 0.013) and left eye corrected visual acuity (the most dominant eyes) (HR = 0.097; 95% CI 0.012 - 0.775; P = 0.028) for strabismus patients. Subitems analysis of SNAP, except for inattentiveness, were only influenced by gender in strabismus group. Concomitant strabismic patients were more likely presented with oppositional defiant (P=0.009). Conclusions Patients with strabismus, especially in those with exotropia, had a high possibility of ADHD, which were closely linked to gender and the dominant eye‘s visual acuity, and might have an increased risk for ADHD .

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The Underestimated Role of Refractive Error (Hyperopia, Myopia, and Astigmatism) and Strabismus in Children With ADHD

Cited by 12 publications

References 47 publications

Vision status and reading test results in Norwegian adolescents

Vision status and reading test results in Norwegian adolescents

High Risk for Attention-Deficit Hyperactive Disorder in Children with Strabismus: A Nationwide Cohort Study from the National Health Insurance Research Database

High Risk for Attention-Deficit Hyperactive Disorder in Pediatric inpatients with Strabismus in Tianjin, China: Hospital-based Cross-sectional Study

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