Children with fetal alcohol spectrum disorder show an amblyopia-like pattern of vision deficit.

Aim: The aim of the study was to assess and characterize visual functioning in children with fetal alcohol spectrum disorder (FASD) using a broader and more inclusive range of measures than has been reported previously.

Method: Standard tests of visual functioning were used to assess 21 children (11 females, 10 males) with FASD and 21 sex- and age-matched comparison children without FASD. The age of the children ranged from 6 years 9 months to 11 years 11 months (mean 9y 6mo). Children were tested individually under standardized conditions for visual acuity, stereoacuity, contrast sensitivity, ocular alignment/motility, color vision, and refractive error.

Results: Compared with non-affected children, children with FASD showed deficits in visual acuity, contrast sensitivity, and stereoacuity. Ocular alignment/motility, refractive error, and color vision measures were normal. Among children with FASD, 62% met the criteria for referral to an eye specialist, compared with 20% of children without FASD.

Interpretation: Children with FASD showed an amblyopia-like pattern of vision deficit in the absence of the optical and oculomotor disruptions of early experience that usually precede this condition. Evidence from animal models suggests that the deficits in spatial vision may be due to alterations in the functional architecture of the neocortex that occurs following prenatal alcohol exposure.