Little Julie-Anne
Optometry & Vision Science Research Group, School of Biomedical Sciences, Biomedical Sciences Research Institute, Ulster University, Coleraine, UK.
Clin Exp Optom. 2018 Jul;101(4):504-513. doi: 10.1111/cxo.12651. Epub 2018 Jan 11.
Autism spectrum disorder (ASD) is a common neurodevelopmental condition with approximately 1-2 per cent prevalence in the population. The condition has lifelong effects for the individual and family, and early intervention and management helps maximise quality of life and outcomes. Many studies of vision in ASD have attempted to link the behavioural and sensory deficits in ASD with underlying visual processing. From this work, it is clear that individuals with ASD 'see' and process the world differently, but there remain gaps in our understanding. This review will summarise our current knowledge of key aspects of visual functions and the optometric profile of ASD. This includes findings regarding visual acuity and contrast sensitivity, refractive error, eye movements, binocular vision, near visual functions and retinal structure in ASD. From this, a pattern of knowledge emerges for children with ASD: we should expect normal visual acuity; there will likely be atypical eye movements and susceptibility for subtle visuo-motor deficits, there is an increased prevalence of strabismus; an increased likelihood of astigmatism and possibly other refractive errors; attention, crowding and task complexity will likely be problematic; and retinal structure and function may be compromised. Bringing this together, these findings highlight that further work is necessary, not only to understand how higher-level functions link to behaviours, but also to ensure there is a sound understanding of the building-blocks of vision to fully grasp the profile of visual processing as a whole in ASD. This review will give a translational viewpoint for clinicians, and underline the benefits of comprehensive vision care in ASD.
自闭症谱系障碍（ASD）是一种常见的神经发育疾病，在人群中的患病率约为1%-2%。这种疾病会对个人和家庭产生终身影响，早期干预和管理有助于最大限度地提高生活质量和改善预后。许多关于ASD视觉的研究试图将ASD中的行为和感觉缺陷与潜在的视觉处理联系起来。从这项工作中可以清楚地看出，患有ASD的个体“看”和感知世界的方式不同，但我们的理解仍存在差距。本综述将总结我们目前对ASD视觉功能关键方面和验光特征的认识。这包括关于ASD患者的视力、对比敏感度、屈光不正、眼球运动、双眼视觉、近视力功能和视网膜结构的研究结果。由此，针对患有ASD的儿童形成了一种知识模式：我们预计其视力正常；可能会有非典型的眼球运动和对细微视觉运动缺陷的易感性，斜视的患病率增加；散光和可能其他屈光不正的可能性增加；注意力、拥挤效应和任务复杂性可能会有问题；视网膜结构和功能可能会受到损害。综合起来，这些发现表明，不仅需要进一步研究以了解高级功能如何与行为相关联，还需要确保对视觉的基础有充分的理解，以便全面掌握ASD中整体视觉处理的特征。本综述将为临床医生提供一个转化视角，并强调ASD全面视力护理的益处。
