TOPLINE:

People with strabismus, myopia, amblyopia, and other common eye conditions are 40% more likely to develop attention-deficit/hyperactivity disorder (ADHD) than those without the optical issues.

METHODOLOGY:

• Researchers conducted a nationwide retrospective cohort study using anonymized electronic medical records of insured individuals in Israel from 2010 to 2022 to assess the association between various eye disorders and the development of ADHD.
• The analysis included 665,121 individuals aged 5-30 years; 221,707 individuals had an eye disorder and were matched to 443,414 control individuals without any eye disorder; the cohort’s mean age was 14.8 years, and 41.1% were male.
• “General eye diagnosis” indicated the presence of at least one of the following: refractive errors (myopia, hyperopia, or astigmatism), strabismus (esotropia, exotropia, hypertropia, or hypotropia), or amblyopia.
• The outcome was a diagnosis of ADHD, made exclusively by board-certified pediatric psychiatrists or developmental pediatric neurologists.
• The mean follow-up duration for the overall cohort was 7.7 years.

TAKEAWAY:

• Overall, 10.4% of participants developed ADHD; 12.6% vs 9.3% of those with vs without an eye disorder experienced the outcome (P < .001). Having a general eye diagnosis was associated with a 40% increased risk of developing ADHD (hazard ratio [HR], 1.40; P < .001).
• The mean time to develop ADHD was shorter in patients with eye disorders than in those without (4.5 vs 4.9 years; P < .001).
• All evaluated eye disorders showed significant associations with an increased risk for the development of ADHD: HRs were 1.64 for strabismus, 1.52 for hyperopia, 1.52 for astigmatism, 1.40 for amblyopia, and 1.30 for myopia.
• This association was notably stronger in women than in men and in the pediatric population than in adults (P < .001 and P = .044, respectively).

IN PRACTICE:

“These findings can set up a detailed framework that may aid primary care providers and neurologists with risk stratification and early detection and intervention of ADHD, as well as guide ophthalmologists to refer high-risk patients for proper evaluation,” the researchers reported.

SOURCE:

The study was led by Asaf Israeli, Vanderbilt University Medical Center, Nashville, Tennessee. It was published online on January 9, 2026, in Eye.

LIMITATIONS:

Because the study was retrospective, certain confounding variables may have been missed. Additional limitations included reliance on electronic medical records, which depended on the accuracy of the physicians’ documentation. Educational level and access to healthcare could not be accounted for due to their absence from electronic records.

DISCLOSURES:

The study was funded by Marom — Maccabi Healthcare Services research program, Tel Aviv, Israel. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.