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We included observational studies reporting at least one measure of vision in people of any age meeting DSM\/ICD criteria for ADHD and in people without ADHD; or the prevalence of ADHD in people with and without vision disorders. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Random effects meta-analyses were used for data synthesis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We included 42 studies in the narrative synthesis and 35 studies in the meta-analyses (3,250,905 participants). We found meta-analytic evidence of increased risk of astigmatism (OR\u2009=\u20091.79 [CI: 1.50, 2.14]), hyperopia and hypermetropia (OR\u2009=\u20091.79 [CI: 1.66, 1.94]), strabismus (OR\u2009=\u20091.93 [CI: 1.75, 2.12]), unspecified vision problems (OR\u2009=\u20091.94 [CI: 1.38, 2.73]) and reduced near point of convergence (OR\u2009=\u20095.02 [CI: 1.78, 14.11]); increased lag (Hedge\u2019s <jats:italic>g<\/jats:italic>\u2009=\u20090.63 [CI: 0.30, 0.96]) and variability (Hedge\u2019s <jats:italic>g<\/jats:italic>\u2009=\u20090.40 [CI: 0.17, 0.64]) of the accommodative response; and increased self-reported vision problems (Hedge\u2019s <jats:italic>g<\/jats:italic>\u2009=\u20090.63 [CI: 0.44, 0.82]) in people with ADHD compared to those without ADHD (with no significant heterogeneity). We also found meta-analytic evidence of no differences between people with and without ADHD on retinal nerve fiber layer thickness (Hedge\u2019s <jats:italic>g<\/jats:italic>\u2009=\u2009\u22120.19 [CI: \u22120.41, 0.02]) and refractive error (Hedge\u2019s <jats:italic>g<\/jats:italic>\u2009=\u20090.08 [CI: \u22120.26, 0.42]) (with no significant heterogeneity).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>ADHD is associated with some self-reported and objectively ascertained functional vision problems, but not with structural alterations of the eye. Further studies should clarify the causal relationship, if any, between ADHD and problems of vision.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>PROSPERO registration: CRD42021256352.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/s41380-022-01699-0","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T13:06:24Z","timestamp":1659704784000},"page":"410-422","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["Association between ADHD and vision problems. 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With his institution, he has US patent US20130217707 A1 for the use of sodium-hydrogen exchange inhibitors in the treatment of ADHD. He also receives royalties from books published by Guilford Press: <i>Straight Talk about Your Child\u2019s Mental Health<\/i>, Oxford University Press: <i>Schizophrenia: The Facts<\/i> and Elsevier: ADHD: <i>Non-Pharmacologic Interventions<\/i>. He is Program Director of . MS received fees from Angelini and Lundbeck. All other authors declare no Competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}