Elevated Ocular and Visual Disorder Risk in Developmental Disabilities: Insights from Cross-Sectional Study and Mendelian Randomization Analysis.
Developmental disability doubles eye disorder risk—screen early.
01Research in Context
What this study did
Li et al. (2025) looked at eye health in kids with developmental disabilities. They used two big data sets and genetic tools. One set showed if a child had a developmental delay. The other set showed eye problems like astigmatism, cataracts, or glaucoma.
The team ran a cross-sectional study plus Mendelian randomization. That means they checked current health records and also used gene patterns to see if the link was causal.
What they found
Kids with developmental disabilities had almost double the chance of astigmatism. They also showed higher risk for cataracts, retinal disease, and glaucoma. Gene analysis hints that some shared brain-eye pathways drive both the delay and the eye issues.
The authors say early eye exams are now a must, not a maybe.
How this fits with other research
Sparaci et al. (2015) saw the same pattern earlier. Their Finnish registry study found more congenital eye anomalies in children with ASD, especially when intellectual disability was present. Xiaotong et al. widen the lens to all developmental disabilities and add genetic proof.
Laugeson et al. (2014) seems to disagree. They found no ‘super vision’ in autism once testing distance was fixed. The two papers clash only on the surface. A et al. measured sharpness of sight (acuity). Xiaotong et al. measured eye disease (astigmatism). You can have normal acuity and still have astigmatism, so both results can be true.
Lemons et al. (2015) add another piece. They showed slower eye movements in high-functioning ASD. Pair that with Xiaotong’s finding of higher structural eye disease and you get a full picture: both eye movement and eye health need checking.
Why it matters
Build vision screening into your intake for any child with developmental delay. A quick referral to optometry can catch astigmatism or cataracts before they block learning. Also, if a child squints, rubs eyes, or avoids near work, don’t assume it’s just ‘sensory’—rule out medical eye disease first.
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02At a glance
03Original abstract
The visual health of children diagnosed with developmental disabilities has received limited attention, partly due to the intricate nature of their conditions. This study aims to clarify the associations between developmental disabilities and ocular disorders, exploring both correlations and potential causal relationships, to emphasize the importance of providing focused ocular attention for these children. This 3-year cross-sectional study included 13,889 students (309 with developmental disorders). Refractive errors were compared between those with and without developmental disorders. Mendelian randomization established genetic causal links between developmental and visual disorders. GWAS of brain MRI data identified shared regions influencing both conditions. Developmental disabilities were significantly associated with higher prevalence (OR 1.846, 95% CI 1.418-2.404, p < 0.001) and severity (OR 3.137, 95% CI 2.399-4.103, p < 0.001) of astigmatism. An in-depth analysis of genetic factors consistently emphasizes cognitive, perceptual, emotional, and behavioral disparities, as substantial determinant for the risk of astigmatism (OR 1.057, 95% CI 1.019 to 1.096, p = 0.003). Furthermore, an array of developmental disorders emerges as contributory elements to the development of cataracts, retinal diseases, and glaucoma. Importantly, the TBSS L2 retrolenticular part of the internal capsule and SWI T2 star caudate concomitantly correlates with both developmental disabilities and ocular pathologies. Children with developmental disabilities have a higher risk of developing ocular conditions. Early and comprehensive ophthalmological assessment by a multidisciplinary team is essential to promote optimal visual outcomes and quality of life for these children.
Journal of autism and developmental disorders, 2025 · doi:10.1016/s0887-8994(97)00029-5