Presenting eye conditions and examination accessibility
We provided eye examinations for autistic adults to gain an understanding of presenting eye conditions in this group. We also conducted interviews with the participants to get more detailed information on the accessibility of eye examinations.
Who took part?
A total of 24 autistic adults without learning disabilities attended for an eye examination; 14 identified as male, 9 as female and 1 as non-binary.
The age range of the participants was 18-67 years. The majority of participants wore spectacles and had undergone an eye examination within the last two years. Some participants also wore tinted lenses.
What did the study involve?
Participants underwent a thorough eye examination to check spectacle prescription, eye coordination and sensitivity to patterns (visual stress).
At specific points during the eye examination, participants were asked questions about which eye tests they didn’t like and why, which tests they liked and how the experience could be improved.
Upon completion, participants were dispensed new spectacles or eye exercises if required. They attended follow-up appointments to review these.
Additionally, at the beginning and end of this study, we asked participants to complete three questionnaires. These measured:
- autistic visual sensory experiences
- how vision affected daily tasks
- the quality of vision when doing close work.
We investigated whether providing new spectacles or treating eye coordination problems affected the outcomes of these questionnaires.
What we found
Our findings suggest that autistic people are more likely to require frequent spectacle prescription updates than non-autistic people.
Additionally, eye coordination and visual stress issues were more common in our participants compared to non-autistic people. Visual stress is usually managed with tinted lenses. We found that providing up-to-date spectacles or treating eye coordination problems reduced the need for tinted lenses.
Autistic people can experience sensory issues during eye examinations due to bright lights or instruments that make physical contact, to name a few. Tests requiring instruments or the optometrist being close felt intrusive and uncomfortable.
Our participants appreciated an explanation and clear instructions before each test, and the opportunity to ask questions. They valued the patience of the optometrist, as a result feeling relaxed and comfortable.
Participants were sent an information document before the eye examination to help them prepare for the visit. The pictures, descriptions and videos of the different tests were useful to reduce their anxiety.
To improve the eye examination, participants recommended rearranging the order of tests so that the more demanding ones are conducted earlier. Also, limiting bursts of background noise would be helpful to prevent distraction.
We were surprised to find no significant changes in the questionnaire results between the first and second time that participants completed them. This shows a poor relationship between eye conditions and visual sensory experiences, how vision affects daily tasks, and the quality of vision when doing close work, in autistic adults.
However, due to a small number of participants taking part in this study, our evidence isn’t strong enough for these conclusions. We have suggested this study be repeated on a larger scale.