Refractive and ocular motor status in autistic adults without learning disabilities: an exploratory study

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Parmar, K. R., Porter, C. S., Dickinson, C. M., Baimbridge, P., & Gowen, E. (2024). Refractive and ocular motor status in autistic adults without learning disabilities: an exploratory study. Clinical and Experimental Optometry, 108(7), 821-829. https://doi.org/10.1080/08164622.2024.2413701

Publication date: 23 Oct 2024 Added to AutiHub: 7 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
5
Publication authors identified as autistic
1 / 5 (20.0%)
  1. Ketan R. Parmar
  2. Catherine S. Porter
  3. Christine M. Dickinson
  4. Peter Baimbridge *
  5. Emma Gowen

Abstract

CLINICAL RELEVANCE: Refractive and ocular motor anomalies may be more prevalent among autistic adults without learning disabilities, compared to a non-autistic clinical population. In line with current guidance, optometrists should exclude these anomalies prior to prescribing tinted lenses. BACKGROUND: Autistic adults report various visual experiences with largely negative consequences on daily living. Some of these overlap with symptoms of refractive and ocular motor anomalies. Therefore, this study investigated refractive and ocular motor status, and pattern glare, in autistic adults without learning disabilities. The impact of appropriate treatment on visual experiences was explored. METHODS: Twenty four autistic adults, aged 19-67 years, underwent an eye examination involving refraction, ocular motor and pattern glare assessments. Based on pre-determined criteria, anomalies were treated with spectacles, orthoptic exercises, or tinted lenses. Participants completed three questionnaires (Glasgow Sensory Questionnaire, Visual Function Index and Convergence Insufficiency Symptoms Survey) at the start and end of the study to assess the impact of treatment. RESULTS: Relative to population norms, a notable proportion of participants had: a significant change in refractive correction (83.3%); accommodative infacility (72.7%); convergence insufficiency (37.5%); uncompensated distance dissociated heterophoria (33.3%); significant accommodative inaccuracy (27.2%); and positive pattern glare (25%). All participants required treatment. 16.7% were given orthoptic exercises only. New spectacles were dispensed to 79.2%, followed by 16.7% requiring orthoptic exercises and 4.2% dispensed tinted lenses. Questionnaire scores did not significantly change post-treatment. CONCLUSION: This exploratory study suggests autistic adults may be more likely to present with refractive, ocular motor and pattern glare issues. Impacts on autistic visual sensory experiences, vision-related quality of life and visual function remain unclear. Pattern Glare Test scores of autistic adults appear to be reduced by appropriate refractive and/or ocular motor management. Therefore, optometrists should take a conservative approach, managing refraction and ocular motor status of autistic patients prior to considering tinted lenses.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 12 Sep 2026 01:04.

Cited references
51
With a DOI
44
Without a DOI, from raw bibliography text
7
5 / 51 (9.8%) cited references include at least one author identified as autistic.
References with data to complete
4 / 51 (7.8%)
References with detected author names
47 / 51 (92.2%)
Without detected author names
4
Without a structured title
3
Without a stable identifier
6
References with raw author names still to review
3
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
193
From DOI or external metadata
193
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
8
32 / 193 (16.6%) names are linked to an author already present in AutiHub. 161 / 193 (83.4%) names are not yet linked.
Names linked to a person identified as autistic
5 / 193 (2.6%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 5 / 32 (15.6%). Distinct people identified as autistic: 4 / 156 (2.6%).
  1. Lydia Whitaker , Catherine R.G. Jones , Arnold J. Wilkins , Debi Roberson (2016). Judging the Intensity of Emotional Expression in Faces: the Effects of Colored Tints on Individuals With Autism Spectrum Disorder . Autism Research, 9(4), 450-459. Wiley.
    Type: Article DOI: 10.1002/aur.1506 OpenAlex: https://openalex.org/W1893352736
    Crossref OpenAlex OpenCitations
  2. (n.d.). Brugha T Cooper S McManus S et al. Estimating the prevalence of autism spectrum conditions in adults: extending the 2007 adult psychiatric. 2012.
    Type: Other
    Crossref
  3. Pamela M. Anketell , Kathryn J. Saunders , Stephen Gallagher , Clare Bailey , Julie‐Anne Little (2016). Profile of refractive errors in European Caucasian children with Autistic Spectrum Disorder; increased prevalence and magnitude of astigmatism . Ophthalmic and Physiological Optics, 36(4), 395-403. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1111/opo.12286 OpenAlex: https://openalex.org/W2273769940
    Crossref OpenAlex OpenCitations
  4. B. J. W. Evans , S. J. Stevenson (2008). The Pattern Glare Test: a review and determination of normative values . Ophthalmic and Physiological Optics, 28(4), 295-309. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1111/j.1475-1313.2008.00578.x OpenAlex: https://openalex.org/W1972758414
    Crossref OpenAlex OpenCitations
  5. Brent Taylor , Hershel Jick , Dean MacLaughlin (2013). Prevalence and incidence rates of autism in the UK: time trend from 2004–2010 in children aged 8 years . BMJ Open, 3(10), e003219. BMJ.
    Type: Article DOI: 10.1136/bmjopen-2013-003219 OpenAlex: https://openalex.org/W2065911440
    Crossref OpenAlex OpenCitations
  6. Jorge Jorge , Alberto Diaz-Rey , Madalena Lira (2022). Prevalence of binocular vision dysfunctions in professional football players . Clinical and Experimental Optometry, 105(8), 853-859. Informa UK Limited.
    Type: Article DOI: 10.1080/08164622.2021.2002667 OpenAlex: https://openalex.org/W4200306878
    Crossref OpenAlex OpenCitations
  7. Miriam L. Conway , Jennifer Thomas , Ahalya Subramanian (2012). Is the Aligning Prism Measured with the Mallett Unit Correlated with Fusional Vergence Reserves? PLoS ONE, 7(8), e42832. Public Library of Science (PLoS).
    Type: Article DOI: 10.1371/journal.pone.0042832 OpenAlex: https://openalex.org/W1975429326
    Crossref OpenAlex OpenCitations
  9. Pamela M. Anketell , Kathryn J. Saunders , Stephen M. Gallagher , Clare Bailey , Julie-Anne Little (2015). Brief Report: Vision in Children with Autism Spectrum Disorder: What Should Clinicians Expect? Journal of Autism and Developmental Disorders, 45(9), 3041-3047. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-015-2431-8 OpenAlex: https://openalex.org/W1986507139
    Crossref OpenAlex OpenCitations
  10. Bruce J. W. Evans (2005). The need for optometric investigation in suspected Meares–Irlen syndrome or visual stress . Ophthalmic and Physiological Optics, 25(4), 363-370. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1111/j.1475-1313.2005.00289.x OpenAlex: https://openalex.org/W1978377520
    Crossref OpenAlex OpenCitations
  11. JANICE EMIGH SCHARRE , MARGARET PROCYK CREEDON (1992). Assessment of Visual Function in Autistic Children . Optometry and Vision Science, 69(6), 433-439. Wiley.
    Type: Article DOI: 10.1097/00006324-199206000-00004
    Crossref OpenCitations
  12. Wen-Hung Chen , William Lenderking , Ying Jin , Kathleen W. Wyrwich , Heather Gelhorn , Dennis A. Revicki (2014). Is Rasch model analysis applicable in small sample size pilot studies for assessing item characteristics? An example using PROMIS pain behavior item bank data . Quality of Life Research, 23(2), 485-493. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s11136-013-0487-5 OpenAlex: https://openalex.org/W1981698528
    Crossref OpenAlex OpenCitations
  13. Hassan Hashemi , Mehdi Khabazkhoob , Payam Nabovati , Fatemeh Azad Shahraki , Hadi Ostadimoghaddam , Mohammad Faghihi et al. (2019). Accommodative insufficiency in a student population in Iran . Journal of Optometry, 12(3), 161-167. Elsevier BV.
    Type: Article DOI: 10.1016/j.optom.2018.03.006 OpenAlex: https://openalex.org/W2804871547
    Crossref OpenAlex OpenCitations
  14. Jamie Ikeda , Bradley V. Davitt , Monica Ultmann , Rolanda Maxim , Oscar A. Cruz (2013). Brief Report: Incidence of Ophthalmologic Disorders in Children with Autism . Journal of Autism and Developmental Disorders, 43(6), 1447-1451. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-012-1475-2 OpenAlex: https://openalex.org/W2002122073
    Crossref OpenAlex OpenCitations
  15. Kourosh Sabri , Christopher M. Knapp , John R. Thompson , Irene Gottlob (2006). The VF-14 and Psychological Impact of Amblyopia and Strabismus . Investigative Opthalmology & Visual Science, 47(10), 4386. Association for Research in Vision and Ophthalmology (ARVO).
    Type: Article DOI: 10.1167/iovs.05-1365 OpenAlex: https://openalex.org/W1986607111
    Crossref OpenAlex OpenCitations
  16. Emrah Utku Kabatas , Pinar Altiaylik Ozer , Gokce Tasdemir Ertugrul , Bengi Ece Kurtul , Sahin Bodur , Burcu Ersoz Alan (2015). Initial Ophthalmic Findings in Turkish Children with Autism Spectrum Disorder . Journal of Autism and Developmental Disorders, 45(8), 2578-2581. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-015-2428-3 OpenAlex: https://openalex.org/W2077489562
    Crossref OpenAlex OpenCitations
  17. Julie‐anne Little (2018). Vision in children with autism spectrum disorder: a critical review . Clinical and Experimental Optometry, 101(4), 504-513. Informa UK Limited.
    Type: Article DOI: 10.1111/cxo.12651 OpenAlex: https://openalex.org/W2792416677
    Crossref OpenAlex OpenCitations
  18. Kelsey Black , Cheryl McCarus , Mary Louise Z. Collins , Allison Jensen (2013). Ocular Manifestations of Autism in Ophthalmology . Strabismus, 21(2), 98-102. Informa UK Limited.
    Type: Article DOI: 10.3109/09273972.2013.786733 OpenAlex: https://openalex.org/W2039059776
    Crossref OpenAlex OpenCitations
  20. ESTEBAN PORCAR , ANTONIO MARTINEZ-PALOMERA (1997). Prevalence of General Binocular Dysfunctions in a Population of University Students . Optometry and Vision Science, 74(2), 111-113. Wiley.
    Type: Article DOI: 10.1002/j.1538-9235.1997.tb04602.x OpenAlex: https://openalex.org/W2010793470
    Crossref OpenAlex
  22. JANICE EMIGH SCHARRE , MARGARET PROCYK CREEDON (1992). Assessment of Visual Function in Autistic Children . Optometry and Vision Science, 69(6), 433-439. Wiley.
    Type: Article DOI: 10.1002/j.1538-9235.1992.tb02948.x OpenAlex: https://openalex.org/W2019652914
    OpenAlex
  24. Paul Courtright , Christina I. Poon , John S.F. Richards , Debbie L. Chow , Simon P. Holland (1998). Visual function among corneal disease patients waiting for penetrating keratoplasty in British Columbia . Ophthalmic Epidemiology, 5(1), 13-20. Swets & Zeitlinger Publishers.
    Type: Article DOI: 10.1076/opep.5.1.13.1498 OpenAlex: https://openalex.org/W2029903738
    Crossref OpenAlex OpenCitations
  25. Hassan Hashemi , Reza Pakzad , Samira Heydarian , Abbasali Yekta , Mohamadreza Aghamirsalim , Fereshteh Shokrollahzadeh et al. (2019). Global and regional prevalence of strabismus: a comprehensive systematic review and meta-analysis . Strabismus, 27(2), 54-65. Informa UK Limited.
    Type: Article DOI: 10.1080/09273972.2019.1604773 OpenAlex: https://openalex.org/W2940939835
    Crossref OpenAlex OpenCitations
  26. Earl P. Steinberg (1994). The VF-14 . Archives of Ophthalmology, 112(5), 630. American Medical Association (AMA).
    Type: Article DOI: 10.1001/archopht.1994.01090170074026 OpenAlex: https://openalex.org/W2300351767
    Crossref OpenAlex OpenCitations
  27. Michael W. Rouse , Eric J. Borsting , G. Lynn Mitchell , Mitchell Scheiman , Susan A. Cotter , Jeffrey Cooper et al. (2004). Validity and reliability of the revised convergence insufficiency symptom survey in adults . Ophthalmic and Physiological Optics, 24(5), 384-390. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1111/j.1475-1313.2004.00202.x OpenAlex: https://openalex.org/W2030139076
    Crossref OpenAlex OpenCitations
  28. Zhujun Fu , Hao Hong , Zhicai Su , Bin Lou , Chen-Wei Pan , Hu Liu (2020). Global prevalence of amblyopia and disease burden projections through 2040: a systematic review and meta-analysis . British Journal of Ophthalmology, 104(8), 1164-1170. BMJ.
    Type: Article DOI: 10.1136/bjophthalmol-2019-314759 OpenAlex: https://openalex.org/W2983975441
    Crossref OpenAlex OpenCitations
  29. ESTEBAN PORCAR , ANTONIO MARTINEZ-PALOMERA (1997). Prevalence of General Binocular Dysfunctions in a Population of University Students . Optometry and Vision Science, 74(2), 111-113. Wiley.
    Type: Article DOI: 10.1097/00006324-199702000-00023
    OpenCitations
  30. Pamela M. Anketell , Kathryn J. Saunders , Stephen M. Gallagher , Clare Bailey , Julie‐Anne Little (2018). Accommodative Function in Individuals with Autism Spectrum Disorder . Optometry and Vision Science, 95(3), 193-201. Wiley.
    Type: Article DOI: 10.1097/opx.0000000000001190 OpenAlex: https://openalex.org/W2790578016
    Crossref OpenAlex OpenCitations
  31. Amanda K. Ludlow , A. Giannadou , A. Franklin , P.M. Allen , D.R. Simmons , A.J. Wilkins (2020). The possible use of precision tinted lenses to improve social cognition in children with autism spectrum disorders . Vision Research, 170, 53-59. Elsevier BV.
    Type: Article DOI: 10.1016/j.visres.2020.03.007 OpenAlex: https://openalex.org/W3014116138
    Crossref OpenAlex OpenCitations
  32. Ewelina Rydzewska , Laura A Hughes-McCormack , Christopher Gillberg , Angela Henderson , Cecilia MacIntyre , Julie Rintoul et al. (2019). Prevalence of sensory impairments, physical and intellectual disabilities, and mental health in children and young people with self/proxy-reported autism: Observational study of a whole country population . Autism, 23(5), 1201-1209. SAGE Publications.
    Type: Article DOI: 10.1177/1362361318791279 OpenAlex: https://openalex.org/W2890709960
    Crossref OpenAlex OpenCitations
  33. Ashley Robertson , David R. Simmons (2013). The Relationship between Sensory Sensitivity and Autistic Traits in the General Population . Journal of Autism and Developmental Disorders, 43(4), 775-784. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-012-1608-7 OpenAlex: https://openalex.org/W2096113836
    Crossref OpenAlex OpenCitations
  34. Amanda K. Ludlow , A.J. Wilkins , Pamela Heaton (2008). Colored overlays enhance visual perceptual performance in children with autism spectrum disorders . Research in Autism Spectrum Disorders, 2(3), 498-515. Elsevier BV.
    Type: Article DOI: 10.1016/j.rasd.2007.10.001 OpenAlex: https://openalex.org/W2066794534
    Crossref OpenAlex OpenCitations
  35. (n.d.). Emmerson E Robertson J. The estimated prevalence of visual impairment among people with learning disabilities in the UK. 2011.
    Type: Other
    Crossref
  37. Ayisha Atiya , Jameel Rizwana Hussaindeen , Supraja Kasturirangan , Srikanth Ramasubramanian , K. Swathi , Meenakshi Swaminathan (2020). Frequency of undetected binocular vision anomalies among ophthalmology trainees . Journal of Optometry, 13(3), 185-190. Elsevier BV.
    Type: Article DOI: 10.1016/j.optom.2020.01.003 OpenAlex: https://openalex.org/W3031466220
    Crossref OpenAlex OpenCitations
  38. Mark Linder (1999). Validity of the Visual Function Index (VF-14) in Patients With Retinal Disease . Archives of Ophthalmology, 117(12), 1611. American Medical Association (AMA).
    Type: Article DOI: 10.1001/archopht.117.12.1611 OpenAlex: https://openalex.org/W2077949459
    Crossref OpenAlex OpenCitations
  39. Amélia Fernandes Nunes , Pedro Lourenço Monteiro , António Santos Nunes , António Santos Nunes , António Santos Nunes (2020). Factor structure of the convergence insufficiency symptom survey questionnaire . PLOS ONE, 15(2), e0229511. Public Library of Science (PLoS).
    Type: Article DOI: 10.1371/journal.pone.0229511 OpenAlex: https://openalex.org/W3008603342
    Crossref OpenAlex OpenCitations
  40. L Garnham (2006). Effect of age on adult stereoacuity as measured by different types of stereotest . British Journal of Ophthalmology, 90(1), 91-95. BMJ.
    Type: Article DOI: 10.1136/bjo.2005.077719 OpenAlex: https://openalex.org/W2118603422
    Crossref OpenAlex OpenCitations
  41. P Desai , A Reidy , D C Minassian , G Vafidis , J Bolger (1996). Gains from cataract surgery: visual function and quality of life. British Journal of Ophthalmology, 80(10), 868-873. BMJ.
    Type: Article DOI: 10.1136/bjo.80.10.868 OpenAlex: https://openalex.org/W2124603659
    Crossref OpenAlex OpenCitations
  42. Eric Borsting , Michael W Rouse , Paul N Deland , Steve Hovett , Dan Kimura , Mark Park et al. (2003). Association of symptoms and convergence and accommodative insufficiency in school-age children . Optometry (St Louis, Mo), 74(1), 25.
    Type: Article OpenAlex: https://openalex.org/W2277806106
    Crossref OpenAlex
  43. Hassan Hashemi , Payam Nabovati , Mehdi Khabazkhoob , Hadi Ostadimoghaddam , Asgar Doostdar , Ehsan Shiralivand et al. (2017). The prevalence of convergence insufficiency in Iran: a population‐based study . Clinical and Experimental Optometry, 100(6), 704-709. Informa UK Limited.
    Type: Article DOI: 10.1111/cxo.12522 OpenAlex: https://openalex.org/W2591099139
    Crossref OpenAlex OpenCitations
  44. Bruce J.W. Evans , Peter M. Allen (2016). A systematic review of controlled trials on visual stress using Intuitive Overlays or the Intuitive Colorimeter . Journal of Optometry, 9(4), 205-218. Elsevier BV.
    Type: Article DOI: 10.1016/j.optom.2016.04.002 OpenAlex: https://openalex.org/W2474503369
    Crossref OpenAlex OpenCitations
  45. (2007). Pickwell's Binocular Vision Anomalies . Elsevier.
    Type: Book DOI: 10.1016/b978-0-7506-8897-0.x5001-x OpenAlex: https://openalex.org/W2758929207
    OpenAlex
  46. Ketan R. Parmar , Christine M. Dickinson , Bruce J.W. Evans (2019). Does an iPad fixation disparity test give equivalent results to the Mallett near fixation disparity test? Journal of Optometry, 12(4), 222-231. Elsevier BV.
    Type: Article DOI: 10.1016/j.optom.2019.03.002 OpenAlex: https://openalex.org/W2971443222
    Crossref OpenAlex OpenCitations
  47. (n.d.). Parmar K Gowen E Dickinson C et al. Investigating optometric and orthoptic conditions in autistic adults: pre-registration of methods and analysis plan. 2020.
    Type: Other
    Crossref
  48. Regina Sala , Lorene Amet , Natasa Blagojevic-Stokic , Paul Shattock , Paul Whiteley (2020). Bridging the Gap Between Physical Health and Autism Spectrum Disorder . Neuropsychiatric Disease and Treatment, Volume 16, 1605-1618. Informa UK Limited.
    Type: Article DOI: 10.2147/ndt.s251394 OpenAlex: https://openalex.org/W3038001243
    Crossref OpenAlex OpenCitations
  49. León A (2017). Lag of accommodation between 5 and 60 years of age . Optom Vis Perform, 5.
    Type: Other
    Crossref
  50. Howell-Duffy CJ (2013). Scientific evidence to support the art of prescribing spectacles. Bradford School of Optometry and Vision Science . Scientific evidence to support the art of prescribing spectacles. Bradford School of Optometry and Vision Science.
    Type: Other
    Crossref
  51. Evans BJ (2007). Pickwell’s binocular vision anomalies . Pickwell’s binocular vision anomalies.
    Type: Other
    Crossref