“The worst one that I’ve seen, irreversible vision loss, was a child that was not known and is still not known to be autistic … but he has lost vision. He’s registered blind … he has profound vision loss due to multiple vitamin deficiencies and being a fussy eater but not autistic, which is rare.”
The boy only ate junk food: “Hot chips, Pringles, maybe a Nutella sandwich from time to time, I think that was it.”
Escardo-Paton said the boy is irreversibly blind.
“The vision loss has not recovered and he’s still a fussy eater. He has to come into hospital once in a while for supplementation and he’s under dietitians and nutritionists, psychologists, but the vision has gone.
“It’s terrible, it’s preventable, it should never happen.”
She said most of the children they see with restrictive diets have been or are subsequently diagnosed with autism.
“We see quite a lot of kids that are really fussy eaters, mainly due to autism … they have a lot of texture problems and so they will tend to eat one or two or three foods and no variety, no fruit and vegetables, maybe no meat and so they are deficient in multiple vitamins and that is significant for vision.”
The optic nerve connecting the brain to the eyeballs is at great risk if it does not have all the necessary nutrients.
“It’ll come as a shock to people that children can lose vision because they aren’t eating a balanced diet. We really want to make it clear to people that children do have to have a wide variety of foods, they shouldn’t just hang on to one food group.”
She and fellow paediatric ophthalmologist Dr Rasha Altaie want to raise awareness of this risk and encourage parents of picky eaters to see their GP if they are concerned, because prevention is crucial.
Dr Julia Escardo Paton (left) and Dr Rasha Altaie. Photo / RNZ, Amy Williams
They both said that the parents had often tried to get their children to eat healthily and they sympathised with their situations.
Altaie said one case stuck with her.
“We had a child who was eating only chips and chicken nuggets. Unfortunately, the child is now enrolled with the school of the blind because of irreversible loss of vision.”
She said it was important to pick up before irreversible damage was done to the optic nerve.
“Unfortunately, this is untreatable and glasses will not help. Trying to reverse it by eating after the diagnosis is not going to make any difference and sadly over the years we’ve seen children who lost their vision because of that.
“It is devastating for the family, for the health worker, for the doctors, for everybody, especially when we know it is preventable.”
Treatment includes boosting vitamin levels with oral supplements and sometimes intravenous treatment and multiple specialists are involved in the children’s health.
The cases of four children in New Zealand aged 9 to 12 were recorded in the Journal of Paediatrics and Child Health in 2024 – all had been referred to ophthalmologists with unexplained vision loss and were found to have severe vitamin deficiencies, including vitamin A.
They all ate restricted diets of mainly carbohydrates and three of the four were autistic – they received treatment but suffered different degrees of long-term vision loss.
“It’s absolutely heartbreaking. Every medical specialist agrees on this, when you see a preventable cause of permanent damage it breaks your heart,” Altaie said.
Blind Low Vision New Zealand figures show it is rare – of 16,000 people registered blind with the organisation, it knew of nine who had vision loss because of malnutrition.
The rate for those with diabetes-related blindness is much higher, with 620 people registered blind because of the condition.
Even so, Autism NZ chief executive Dane Dougan said it is important to be aware of the risk.
“Hearing the fact that some people have actually gone blind is concerning and having any serious impact on people’s vision is concerning,” Dougan said.
“If any parents and whānau in our community have children who are picky eaters or even worse, do have Avoidant Restrictive Intake Disorder, it would be really worthwhile getting them checked out and making sure their eyesight is still ticking along as it should.”
He said Autism NZ recognises how hard it can be for some parents and can provide strategies for families to help their children eat a balanced diet.