A United States study has found children with neurodevelopmental and behavioural disorders are less likely to undergo strabismus surgery, despite having higher levels of paediatric eye disease.1
The study authors found that neurodevelopmental disorders (NDDs) and behavioural disorders had an increased risk of amblyopia (HR: 1.60; 95% CI: 1.45–1.79), strabismus (HR: 1.66; 95% CI: 1.57–1.71), and myopia (HR: 1.55; 95% CI: 1.45–1.70). The increased risk was seen across clinically relevant disease subtypes, individual disorders, and multiple follow-up intervals.
“Beyond their effects on cognition, behaviour, and psychosocial functioning, NDDs and behavioural disorders may also influence visual development, visual function, and access to routine ophthalmic care during childhood,” the study authors wrote.
The study also found children with NDDs or behavioural disorders underwent strabismus surgery less frequently than controls (19.2% vs 28.4%), despite a higher proportion of unspecified esotropia, a category that includes infantile esotropia, for which early surgical correction is associated with improved binocular outcomes.
Lower rates were observed among children with attention-deficit/hyperactivity disorder (20.3%), autism spectrum disorder (24.9%), conduct disorder (22.2%), and learning disorders (24.2%) compared with controls without NDDs.
The study authors concluded paediatric eye disease may represent an important component of the overall health burden in this population.
“These findings support heightened clinical awareness and developmentally appropriate vision screening strategies in children with NDDs or behavioural disorders. Lower rates of strabismus surgery in this population warrant further investigation.”
The study was published in Ophthalmology.
Reference
- Shah J, Pathuri S, Dersch AM, et al. Risk of pediatric eye disease in children with neurodevelopmental and behavioral disorders in the United States. Ophthalmology. 2026 Aug 5. Online ahead of print. doi: 10.1016/j.ophtha.2026.07.037.
