Child Behavior and Axial Length

Is there a neurologic link?...

There are associations between ocular development and behavioral patterns in children, particularly with axial length, neuroanatomic findings, and conditions such as attention-deficit/hyperactivity disorder (ADHD) among others.

Just published today (4/1/25), exploring these relationships was studied in children aged 6 to 9 using the Conners’ Parent Rating Scale-Revised, a validated tool for assessing pediatric behavior. As just one example, it was found children with hyperopia, especially those with significant shorter axial lengths, exhibited poor scores in behavioral scales measuring inattention, impulsivity, emotional lability, and hyperactivity. These behaviors were evident even in children who had been wearing corrective lenses for more than six months, suggesting refractive correction alone may not be sufficient to normalize behavior or cognitive performance.

This strongly implies axial length may reflect a broader aspect of neurodevelopment. It also aligns with existing neuroimaging studies in shorter eyes often showing reduced volumes in brain regions like the frontal lobe and anterior cingulate cortex, areas key for executive function and attention regulation. These shared structural anomalies in both the eye and brain support a developmental linkage between visual and cognitive systems.

We're now reminded to consider integrated management approaches, combining ophthalmic and neurobehavioral assessments, to better understand and support children at risk of behavioral and learning challenges related to visual development.

Go to the article in Clinical Ophthalmology HERE.

- JRM