The Underestimated Role of Refractive Error (Hyperopia, Myopia, and Astigmatism) and Strabismus in Children With ADHD

Objective: To examine the association of refractive error (myopia, hyperopia, astigmatism) and strabismus with ADHD. Method: Based on data from the large, representative, epidemiological sample of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study ( N = 13,488), the associations of myopia, hyperopia, astigmatism, and strabismus with ADHD were examined, with and without consideration of other common ADHD risk factors. Results: In single logistic regression models, all examined forms of refractive error and strabismus showed an association with ADHD. After controlling for confounding variables, results remained stable and showed an increased risk for ADHD in children with hyperopia, astigmatism, and strabismus compared with the control group. Only the association between myopia and ADHD in children was not significant. Conclusion: Hyperopia, astigmatism, and strabismus seem to be independently associated with ADHD. Health care professionals in different medical fields should consider this association to adequately diagnose and treat affected children.