Social connection and living with severe chronic obstructive pulmonary disease: A qualitative analysis.

Autism Spectrum Disorder (ASD) is a multifaceted neurodevelopmental condition characterized by difficulties in social interaction, communication, and the presence of restricted or repetitive behaviors. Over the past few decades, the global prevalence of ASD has increased significantly. In 2020, the prevalence of autism spectrum disorder (ASD) was 27.6 per 1,000 (1 in 36) among 8-year-old children in the United States, with a 3.8-fold higher rate in boys than in girls (43.0 vs 11.4), while in China the prevalence from 2017 to 2023 was 7 per 1,000, indicating an upward trend compared with pre-2017 estimates (26.50 per 10,000), and such rising rates highlight mounting public health demands for full-spectrum ASD research and interventions. While numerous studies have used visual tracking to examine attention in children with ASD, far fewer have focused on their ocular health and related visual abnormalities. Recent literature has highlighted that 13–71% of children with ASD present with ocular complications, with refractive errors (42%), strabismus (22–57%), amblyopia (19–31%), optic neuropathy (4%), and nystagmus (3%) being the most common conditions observed. Additionally, population-based studies have shown that children with ASD are more likely to experience vision problems than their neurotypical peers. Despite these findings, there is still a substantial gap in research on the ocular manifestations of ASD, especially in Chinese cohorts. Maternal health status during pregnancy, mode of delivery, and adverse exposures during early life stages, consistent with the maternal immune activation (MIA) hypothesis of ASD, may significantly impact children’s neurodevelopment, thereby increasing the risk of ASD. Emerging evidence underscores the critical influence of prenatal factors on both neurodevelopment and ocular health. For instance, maternal stress during pregnancy has been shown to disrupt fetal development, potentially leading to visual deficits. Chronic stress can trigger hypothalamic-pituitary-adrenal axis dysregulation, resulting in fetal exposure to elevated glucocorticoid levels, which can impair ocular development. Studies such as those by Lingham et al have demonstrated that pregnancy-induced hypertension and abnormal umbilical cord structures are significantly associated with amblyopia and anisometropia in offspring.