Do children and adolescents with attention deficit hyperactivity disorder have ocular abnormalities?

PURPOSE. To investigate visual function and ocular features in children with attention deficit hyperactivity disorder (ADHD). METHODS. Fifty-one children underwent a detailed ophthalmologic evaluation. Thirty-two were diagnosed with ADHD, and 19 children with attention deficit disorder (ADD). The mean age was 9.9 +/- 3.1 years. RESULTS. The average best-corrected visual acuity of the better-seeing eye was 1 (range 0.9-1.25) and 0.96 (range 0.5-1.25) for the fellow eye. Eighteen percent (10) had amblyopia in one or both eyes (3 had strabismic and 7 had ametropic amblyopia). Heterotropia was found in 5 (10%), and absent stereoacuity was found in 3 (6%). Subnormal convergence amplitude was noted in 2 patients (4%). The mean spherical equivalent (SE) of the eyes in this study was 0.17 +/- 1.73 (range -5.5 to +7). Twenty-two subjects (43%) had a myopia of -0.50 D or higher Hyperopia higher than 3.5 D was seen in 10 cases (20%), and astigmatism larger or equal to 1.0 D was observed in 10 patients (20%). With-the-rule astigmatism was by far most common type in the 29 eyes with an astigmatic refractive error (59%). Significant ametropia was detected in 42 (83%) of the patients. In contrast to other studies, we did not find a higher rate of convergence insufficiency or heterotropia. CONCLUSIONS. Children diagnosed with either ADHD or ADD can present with significant ametropia but infrequent heterotropia.