{
  "abstract": "Purpose\n\nTo explore the association of anisometropia, strabismus, and amblyopia with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and their comorbidity.Design\n\nPopulation-based cross-sectional study.Subjects\n\nChildren aged 6-10 years in Hong Kong.Methods\n\nParticipants underwent comprehensive ocular examinations. Attention-deficit/hyperactivity disorder and ASD diagnoses were made by qualified physicians using International Classification of Diseases 10 criteria.Main outcome measures\n\nThe prevalence of anisometropia, strabismus and amblyopia.Results\n\nA total of 10 936 children were included, comprising 153 (1.4%) with ASD only, 413 (3.8%) with ADHD only, 276 (2.5%) with comorbid ASD-ADHD, and 10 094 (92.3%) healthy controls. The prevalence of anisometropia was 9.8%, 8.7%, 15.2%, and 6.0% across the respective groups (P < 0.001). The corresponding prevalence of strabismus was 4.6%, 2.9%, 4.0%, and 1.7% (P < 0.001), and for amblyopia, it was 7.2%, 2.7%, 4.0%, and 2.9% (P = 0.03). Autism spectrum disorder (ASD only plus comorbidity) was associated with higher risks of anisometropia (odds ratio [OR] = 1.51, P = 0.04), strabismus (OR = 2.30, P = 0.01), and amblyopia (OR = 1.91, P = 0.02), whereas ADHD (ADHD only plus comorbidity) was associated with anisometropia (OR = 1.58, P = 0.008) after adjusting for covariates. In subgroup analyses, the ASD-only group showed associations with strabismus (OR = 2.47, P = 0.04) and amblyopia (OR = 2.46, P = 0.02). The comorbid ASD-ADHD group exhibited a higher risk of anisometropia (OR = 2.17, P < 0.001), whereas children with ADHD only showed no association with the aforementioned ocular disorders.Conclusions\n\nChildren with ASD only and ASD-ADHD comorbidity were associated with increased and distinct patterns of anisometropia, strabismus, and amblyopia, while children with ADHD only showed no such association.Financial disclosures\n\nThe author has no/the authors have no proprietary or commercial interest in any materials discussed in this article.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.",
    "Department of Ophthalmology, The University of Hong Kong, Hong Kong SAR, People's Republic of China.",
    "Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, People's Republic of China.",
    "Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China.",
    "Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China.",
    "Tianjin Eye Hospital, Tianjin, People's Republic of China.",
    "Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, People's Republic of China.",
    "Hong Kong Eye Hospital, Hong Kong, People's Republic of China.",
    "Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong, People's Republic of China.",
    "Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
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        0
      ],
      "name": "Xiu Nian Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuzhou Zhang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xiu Juan Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Charlene Yim"
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    {
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        0,
        2
      ],
      "name": "Ka Wai Kam"
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    {
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        0
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      "name": "Mandy P H Ng"
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      ],
      "name": "Patrick Ip"
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    {
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        4
      ],
      "name": "Ian C K Wong",
      "orcid": "0000-0001-8242-0014"
    },
    {
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        5
      ],
      "name": "Wei Zhang"
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    {
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        2
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      "name": "Alvin L Young"
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      "name": "Clement C Tham"
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        6,
        8
      ],
      "name": "Chi Pui Pang"
    },
    {
      "affs": [
        0,
        1,
        6,
        8
      ],
      "name": "Li Jia Chen"
    },
    {
      "affs": [
        0,
        2,
        6,
        7,
        8,
        9
      ],
      "name": "Jason C Yam"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/csr9c608888mv.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xops.2026.101406",
  "fulltext_url": "https://europepmc.org/articles/PMC13693087",
  "id": "csr9c608888mv",
  "issns": [
    "2666-9145"
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  "landing_url": "https://europepmc.org/article/MED/42921403",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "openalex",
      "2713|Ophthalmology and Visual Impairment Studies"
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  "pdf_url": "https://europepmc.org/articles/PMC13693087?pdf=render",
  "pmcid": "PMC13693087",
  "pmid": "42921403",
  "published": "2026-09-09",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/csr9c608888mv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:02Z",
      "native_id": "MED:42921403",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42921403"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Ophthalmology and Visual Impairment Studies",
      "subfield": "epidemiology-public-health"
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  ],
  "title": "Anisometropia, Strabismus, and Amblyopia in Children with Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, and Their Comorbidity.",
  "title_text": "Anisometropia, Strabismus, and Amblyopia in Children with Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, and Their Comorbidity.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:02Z",
  "url": "https://research.draconitic.com/paper/csr9c608888mv",
  "venue": "Ophthalmology science",
  "versions": []
}