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This study aims to clarify the associations between developmental disabilities and ocular disorders, exploring both correlations and potential causal relationships, to emphasize the importance of providing focused ocular attention for these children. This 3-year cross-sectional study included 13,889 students (309 with developmental disorders). Refractive errors were compared between those with and without developmental disorders. Mendelian randomization established genetic causal links between developmental and visual disorders. GWAS of brain MRI data identified shared regions influencing both conditions. Developmental disabilities were significantly associated with higher prevalence (OR 1.846, 95% CI 1.418\u20132.404, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and severity (OR 3.137, 95% CI 2.399\u20134.103, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) of astigmatism. An in-depth analysis of genetic factors consistently emphasizes cognitive, perceptual, emotional, and behavioral disparities, as substantial determinant for the risk of astigmatism (OR 1.057, 95% CI 1.019 to 1.096, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). Furthermore, an array of developmental disorders emerges as contributory elements to the development of cataracts, retinal diseases, and glaucoma. Importantly, the TBSS L2 retrolenticular part of the internal capsule and SWI T2 star caudate concomitantly correlates with both developmental disabilities and ocular pathologies. Children with developmental disabilities have a higher risk of developing ocular conditions. Early and comprehensive ophthalmological assessment by a multidisciplinary team is essential to promote optimal visual outcomes and quality of life for these children.<\/jats:p>","DOI":"10.1007\/s10803-025-06989-4","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T06:11:49Z","timestamp":1753942309000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Elevated Ocular and Visual Disorder Risk in Developmental Disabilities: Insights from Cross-Sectional Study and Mendelian Randomization Analysis"],"prefix":"10.1007","author":[{"given":"Xiaotong","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihua","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoxi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhigang","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4876-5330","authenticated-orcid":false,"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"issue":"5","key":"6989_CR3","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1352\/1944-7558-122.5.409","volume":"122","author":"CC Barney","year":"2017","unstructured":"Barney, C. 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