Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with near heterophoria and accommodative dysfunction

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition in young populations and is often associated with visual disturbances. This study investigated clinical measurements in individuals with ADHD and compared them with individuals without ADHD. This study included 80 participants: 40 with ADHD and 40 age- and sex-matched controls. The mean age ± standard deviation was 19.93 ± 6.42 (range 6-36). The optometric tests performed assessed accommodative and binocular visual functions, including accommodative amplitude, monocular and binocular accommodative facility, Cover Test, near point of convergence, monocular estimated method, and calculated accommodation convergence/accommodation ratio. Subgroup analysis within the ADHD group, based on sex and medication use, explored the associations with optometric findings. The ADHD group showed a significantly higher lag of accommodation (+0.30 ± 0.17 D) than the control group (+0.18 ± 0.23 D) and a higher accommodative amplitude (ADHD group = 13.15 ± 1.73, control group = 12.07 ± 1.60). ADHD was also associated with a higher prevalence of near-heterophoria. No differences were observed between medicated and medication-free at testing individuals with ADHD. Furthermore, males demonstrated higher near heterophoria than females, with males having significantly more phorias at near. The results of this paper demonstrate that individuals with ADHD commonly experience compromised accommodative responses and a heightened occurrence of heterophoria compared with individuals without ADHD. These results emphasize the importance of eye exams for ADHD patients, as vision issues may reduce attention and concentration, especially for near-work tasks.