Vision in Children and Adolescents with Autistic Spectrum Disorder: Evidence for Reduced Convergence

  • Elizabeth MilneEmail author
  • Helen Griffiths
  • David Buckley
  • Alison Scope
Original Paper


Evidence of atypical perception in individuals with ASD is mainly based on self report, parental questionnaires or psychophysical/cognitive paradigms. There have been relatively few attempts to establish whether binocular vision is enhanced, intact or abnormal in those with ASD. To address this, we screened visual function in 51 individuals with autistic spectrum disorder and 44 typically developing individuals by measuring visual acuity, stereoacuity, convergence, divergence, ocular motility, incidence of strabismus and integrity of the optokinetic response. The data suggest that many aspects of vision, including visual acuity, are unaffected in ASD, but that convergence is an aspect of visual function that merits further research in those with ASD.


Vision Perception Visual acuity Convergence Low-functioning autism Autistic spectrum disorder 



We thank David Burton, Bhavna Singh and Charlotte Westerman for assistance with data collection and for useful discussions about the work presented here. We are grateful to all participants, Rowan Primary School, Nook Lane Primary School, Bents Green Secondary School, Dobcroft Junior School, All Saints Catholic High School, Alderwasley Hall School, Fullerton House School and Wilsic Hall School for generously giving their time to participate in the research. This work was supported by the Economic and Social Research Council (research grant RES-000-22-1868) and has been presented in part at the following meetings: Autism Research, UK (Milton Keynes, 2007), the 8th International Congress of Autism Europe (Norway, 2007) and the XI International Orthoptic Congress (Antwerp, 2008).


  1. Ashwin, E., Ashwin, C., Rhydderch, D., Howells, J., & Baron-Cohen, S. (2009). Eagle-eyed visual acuity: An experimental investigation of enhanced perception in autism. Biological Psychiatry, 65, 17–21. doi: 10.1016/j.biopsych.2008.06.012.PubMedCrossRefGoogle Scholar
  2. Cooper, J., & Feldman, J. (1979). Assessing the Frisby Stereo Test under monocular viewing conditions. Journal of the American Optometric Association, 50, 807–809.PubMedGoogle Scholar
  3. Creel, D., Crandall, A. S., Pingree, C., & Ritvo, E. R. (1989). Abnormal electroretinograms in autism. Clinical Vision Sciences, 1, 85–88.Google Scholar
  4. de Jonge, M. V., Kemner, C., de Haan, E. H., Coppens, J. E., van der Berg, T. J. T. P., & van Engeland, H. (2007). Visual information processing in high-functioning individuals with autism spectrum disorders and their parents. Neuropsychology, 21, 65–73. doi: 10.1037/0894-4105.21.1.65.PubMedCrossRefGoogle Scholar
  5. Denis, D., Burillon, C., Livet, M. O., & Burguiere, O. (1997). Ophthalmologic findings in the autistic child. Journal Francais d’Ophtalmologie, 20(2), 103–110.PubMedGoogle Scholar
  6. Ffooks, O. (1965). Vision test for children: Use of symbols. The British Journal of Ophthalmology, 49, 312–314. doi: 10.1136/bjo.49.6.312.PubMedCrossRefGoogle Scholar
  7. Field, A. (2005). Discovering statistics using SPSS (2nd ed.). London: Sage Publications.Google Scholar
  8. Garbutt, S., & Harris, C. M. (2000). Abnormal vertical optokinetic nystagmus in infants and children. British Journal of Orthoptics, 84, 451–455. doi: 10.1136/bjo.84.5.451.CrossRefGoogle Scholar
  9. Graham, P. A. (1974). The epidemiology of strabismus. The British Journal of Ophthalmology, 58, 224–231. doi: 10.1136/bjo.58.3.224.PubMedCrossRefGoogle Scholar
  10. Gronlund, M. A., Andersson, S., Aring, E., Hard, A. L., & Hellstrom, A. (2006). Ophthalmological findings in a sample of Swedish children aged 4–15 years. Acta Ophthalmologica Scandinavica, 84, 169–176. doi: 10.1111/j.1600-0420.2005.00615.x.PubMedCrossRefGoogle Scholar
  11. Hall, D. M. B., & Elliman, D. (2003). Health for all children. Oxford: Oxford University Press.Google Scholar
  12. Hirsch, M. J. (1963). Changes in astigmatism during the first eight years of school—an interim report from the Ojai Longitudinal study. American Journal of Optometry, 40, 127–132.Google Scholar
  13. Kaplan, M., Rimland, B., & Edelson, S. M. (1999). Strabismus in autism spectrum disorder. Focus on Autism and Other Developmental Disorders, 14, 101–105. doi: 10.1177/108835769901400205.CrossRefGoogle Scholar
  14. Kay, H. (1983). New method of assessing visual acuity with pictures. The British Journal of Ophthalmology, 67, 131–133. doi: 10.1136/bjo.67.2.131.PubMedCrossRefGoogle Scholar
  15. Kemner, C., van der Geest, J. N., Verbaten, M. N., & van Engeland, H. (2004). In search for neurophysiological markers of pervasive developmental disorders: smooth pursuit eye movements. Journal of Neural Transmission, 111, 1617–1626. doi: 10.1007/s00702-004-0164-5.PubMedCrossRefGoogle Scholar
  16. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223. doi: 10.1023/A:1005592401947.PubMedCrossRefGoogle Scholar
  17. Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview—Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685. doi: 10.1007/BF02172145.PubMedCrossRefGoogle Scholar
  18. Milne, E., & Griffiths, H. (2007). Visual perception and visual dysfunction in autistic spectrum disorder: A literature review. British and Irish Orthoptics Journal, 4, 15–20.Google Scholar
  19. Milne, E., Swettenham, J., Hansen, P., Campbell, R., Jeffries, H., & Plaisted, K. (2002). High motion coherence thresholds in children with autism. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 43, 255–263. doi: 10.1111/1469-7610.00018.PubMedCrossRefGoogle Scholar
  20. Minshew, N. J., Luna, B., & Sweeney, J. A. (1999). Oculomotor evidence for neocortical systems but not cerebellar dysfunction in autism. Neurology, 52, 917–922.PubMedGoogle Scholar
  21. Mottron, L., Dawson, M., Souliėres, I., Hubert, B., & Burack, J. A. (2006). Enhanced perceptual functioning in autism: An Update and eight principles of autistic perception. Journal of Autism and Developmental Disorders, 36, 27–43. doi: 10.1007/s10803-005-0040-7.PubMedCrossRefGoogle Scholar
  22. Mottron, L., Mineau, S., Martel, G., St-Charles Bernier, C., Berthiaume, C., Dawson, M., et al. (2007). Lateral glances toward moving stimuli among young children with autism: Early regulation of locally oriented perception? Development and Psychopathology, 19, 23–26. doi: 10.1017/S0954579407070022.PubMedCrossRefGoogle Scholar
  23. O’Connor, A. R., Stephenson, T. J., Johnson, A., Tobin, M. J., Ratib, S., Moseley, M., et al. (2004). Visual function in low birthweight children. The British Journal of Ophthalmology, 88, 1149–1153. doi: 10.1136/bjo.2003.035154.PubMedCrossRefGoogle Scholar
  24. O’Riordan, M., Plaisted, K., Driver, J., & Baron-Cohen, S. (2001). Superior visual search in autism. Journal of Experimental Psychology. Human Perception and Performance, 27, 719–730. doi: 10.1037/0096-1523.27.3.719.PubMedCrossRefGoogle Scholar
  25. Plaisted, K., O’Riordan, M., & Baron-Cohen, S. (1998). Enhanced visual search for a conjunctive target in autism: A research note. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 39, 777–783. doi: 10.1017/S0021963098002613.PubMedCrossRefGoogle Scholar
  26. Robaei, D., Huynh, S. C., Kifley, A., Gole, G. A., & Mitchell, P. (2007). Stereoacuity and ocular associations at age 12 years: Findings from a population-based study. Journal of AAPOS: The Official Publication of the American Association for Pediatric Ophthalmology and Strabismus/American Association for Pediatric Ophthalmology and Strabismus, 11(4), 356–361.CrossRefGoogle Scholar
  27. Rogers, S. J., & Ozonoff, S. (2005). Annotation: What do we know about sensory dysfunction in autism? A critical review of the empirical evidence. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 46, 1255–1268. doi: 10.1111/j.1469-7610.2005.01431.x.PubMedCrossRefGoogle Scholar
  28. Scharre, J. E., & Creedon, M. P. (1992). Assessment of visual function in autistic children. Optometry and Vision Science, 69, 433–439. doi: 10.1097/00006324-199206000-00004.PubMedCrossRefGoogle Scholar
  29. Schopler, E., Reichler, R. J., & Renner, B. R. (1988). The childhood autism rating scale. Los Angeles: Western Psychological Services.Google Scholar
  30. Shah, A., & Frith, U. (1983). An islet of ability in autistic children: A research note. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 24, 613–620. doi: 10.1111/j.1469-7610.1983.tb00137.x.PubMedCrossRefGoogle Scholar
  31. Skjeldal, O. H., Sponheim, E., Ganes, T., Jellum, E., & Bakke, S. (1998). Childhood autism: The need for physical investigations. Brain & Development, 20(4), 227–233. doi: 10.1016/S0387-7604(98)00031-X.CrossRefGoogle Scholar
  32. Stayte, M., Reeves, B., & Wortham, C. (1993). Ocular and vision defects in pre-school children. The British Journal of Ophthalmology, 77, 228–232. doi: 10.1136/bjo.77.4.228.PubMedCrossRefGoogle Scholar
  33. Stuart, J., & Burian, H. (1962). A study of separation difficulty: Its relationship to visual acuity in normal and amblyopic eyes. American Journal of Ophthalmology, 53, 471–477.PubMedGoogle Scholar
  34. Takarae, Y., Minshew, N., Luna, B., Krisky, C. M., & Sweeney, J. A. (2004). Pursuit eye movement deficits in autism. Brain, 127, 2584–2594. doi: 10.1093/brain/awh307.PubMedCrossRefGoogle Scholar
  35. von Noorden, G. K., & Campos, E. C. (2002). Binocular vision and ocular motility. Theory and management of Strabismus (6th ed.). St Louis, MO: Mosby.Google Scholar
  36. Wechsler, D. (1999). Wechsler abbreviated scale of intelligence. San Antonio, TX: The Psychological Corporation.Google Scholar
  37. Zadnik, K., Mutti, D. O., & Adams, A. J. (1992). Astigmatism in children: What’s the rule? Ophthalmic and Visual Optics Technical Digest, 3, 68–71.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Elizabeth Milne
    • 1
    Email author
  • Helen Griffiths
    • 2
  • David Buckley
    • 2
  • Alison Scope
    • 1
  1. 1.Department of PsychologyWestern BankSheffieldUK
  2. 2.Academic Unit of Ophthalmology and OrthopticsSchool of Medicine & Biomedical SciencesSheffieldUK

Personalised recommendations