Autism‐friendly eyecare: Developing recommendations for service providers based on the experiences of autistic adults

This publication is included in the Autistic Autism Scholarship Project. one author of this publication is identified as autistic in the project.

About the autistic author marker

Metadata sources used for this reference

OpenAlex Crossref OpenCitations
Learn more about the sources used

Parmar, K. R., Porter, C. S., Dickinson, C. M., Baimbridge, P., Pelham, J., & Gowen, E. (2022). Autism‐friendly eyecare: Developing recommendations for service providers based on the experiences of autistic adults. Ophthalmic and Physiological Optics, 42(4), 675-693. https://doi.org/10.1111/opo.12975

Publication date: 22 Mar 2022 Added to AutiHub: 7 Sep 2026 Type: Article Article language: English
Publisher source (DOI) OpenAlex source

This publication is integrated into AutiHub through:

Authors

Publication authors
6
Publication authors identified as autistic
1 / 6 (16.7%)
  1. Ketan R. Parmar
  2. Catherine S. Porter
  3. Christine M. Dickinson
  1. Peter Baimbridge *
  2. James Pelham
  3. Emma Gowen

Abstract

Abstract Purpose Autistic people face significant barriers when accessing healthcare services. Eye examinations present unique challenges. Accessibility of this healthcare sector for autistic people has not been investigated previously. The aim of this research was to investigate eye examination accessibility for autistic adults and produce recommendations for autism‐friendly eyecare. Methods Two qualitative studies were conducted. In Study 1, 18 autistic adults took part in focus groups to elicit their eye examination experiences. Transcripts of the recorded discussions were thematically analysed. Study 1 findings were used to design autism‐friendly eye examinations for autistic adults. These were conducted in Study 2. Twenty‐four autistic adults participated in these examinations, during which they were interviewed about their experience and how it might be improved by reasonable modifications. Audio recordings of the interviews were content analysed. Results Knowledge of what to expect, in advance of the eye examination, could greatly reduce anxiety. Participants liked the logical structure of the examination, and the interesting instrumentation used. However, the examination and practice environment did include sensory challenges, due to lights, sound and touch. Changes in practice layout, and interacting with multiple staff members, was anxiety provoking. Participants expressed a need for thorough explanations from the optometrist that outlined the significance of each test, and what the patient was expected to do. Conclusion A number of accessiblity barriers were identified. These suggested that UK eye examinations are not very accessible for autistic adults. Barriers began at the point of booking the appointment and continued through to the dispensing of spectacles. These caused anxiety and stress for this population, but could be reduced with easy‐to‐implement adaptations. Based on the findings, recommendations are presented here for the whole eyecare team which suggest how more autism‐friendly eye examinations can be provided.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

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 07:09.

Cited references
64
With a DOI
47
Without a DOI, from raw bibliography text
17
10 / 64 (15.6%) cited references include at least one author identified as autistic.
References with data to complete
6 / 64 (9.4%)
References with detected author names
58 / 64 (90.6%)
Without detected author names
6
Without a structured title
5
Without a stable identifier
15
References with raw author names still to review
4
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
240
From DOI or external metadata
240
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
4
106 / 240 (44.2%) names are linked to an author already present in AutiHub. 134 / 240 (55.8%) names are not yet linked.
Names linked to a person identified as autistic
22 / 240 (9.2%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 22 / 106 (20.8%). Distinct people identified as autistic: 8 / 181 (4.4%).
  1. Sharon A. Cermak , Leah I. Stein Duker , Marian E. Williams , Michael Dawson * , Christianne J. Lane , José C. Polido (2015). Sensory Adapted Dental Environments to Enhance Oral Care for Children with Autism Spectrum Disorders: A Randomized Controlled Pilot Study . Journal of Autism and Developmental Disorders, 45(9), 2876-2888. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-015-2450-5 OpenAlex: https://openalex.org/W1967639686
    Crossref OpenAlex OpenCitations
  2. Dido Green , Susie Chandler , Tony Charman , Emily Simonoff , Gillian Baird (2016). Brief Report: DSM-5 Sensory Behaviours in Children With and Without an Autism Spectrum Disorder . Journal of Autism and Developmental Disorders, 46(11), 3597-3606. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-016-2881-7 OpenAlex: https://openalex.org/W2492548518
    Crossref OpenAlex OpenCitations
  3. Vanessa Vogan , Johanna Lake , Ami Tint , Jonathan A. Weiss , Yona Lunsky (2017). Tracking health care service use and the experiences of adults with autism spectrum disorder without intellectual disability: A longitudinal study of service rates, barriers and satisfaction . Disability and Health Journal, 10(2), 264-270. Elsevier BV.
    Type: Article DOI: 10.1016/j.dhjo.2016.11.002 OpenAlex: https://openalex.org/W2551789181
    Crossref OpenAlex OpenCitations
  4. Virginia Braun , Victoria Clarke (2006). Using thematic analysis in psychology . Qualitative Research in Psychology, 3(2), 77-101. Informa UK Limited.
    Type: Article DOI: 10.1191/1478088706qp063oa OpenAlex: https://openalex.org/W1979290264
    Crossref OpenAlex OpenCitations
  5. David R. Simmons , Ashley Robertson , Lawrie S. McKay , Erin Toal , Phil McAleer , Frank E. Pollick (2009). Vision in autism spectrum disorders . Vision Research, 49(22), 2705-2739. Elsevier BV.
    Type: Article DOI: 10.1016/j.visres.2009.08.005 OpenAlex: https://openalex.org/W1982518229
    Crossref OpenAlex OpenCitations
  6. González Moreno, Andrés Santiago (2013). Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association.
    Type: Book DOI: 10.1176/appi.books.9780890425596 OpenAlex: https://openalex.org/W4247665917
    Crossref OpenAlex OpenCitations
  7. Belinda H A Crowe , Alison T Salt (2015). Autism: the management and support of children and young people on the autism spectrum (NICE Clinical Guideline 170) . Archives of disease in childhood - Education & practice edition, 100(1), 20-23. BMJ.
    Type: Article DOI: 10.1136/archdischild-2013-305468 OpenAlex: https://openalex.org/W1980983127
    Crossref OpenAlex OpenCitations
  8. World Health Organization (2021). International statistical classification of diseases . International statistical classification of diseases.
    Type: Other
    Crossref
  9. Steven K. Kapp * , Kristen Gillespie-Lynch , Lauren E. Sherman , Ted Hutman (2013). Deficit, difference, or both? Autism and neurodiversity. Developmental Psychology, 49(1), 59-71. American Psychological Association (APA).
    Type: Article DOI: 10.1037/a0028353 OpenAlex: https://openalex.org/W2124715426
    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
  11. (n.d.). BrughaT CooperS McManusS PurdonS SmithJ ScottF et al. Estimating the prevalence of autism spectrum conditions in adults: extending the 2007 adult psychiatric morbity survey;2012. [Accessed 14 March 2022]. http://www.wecommunities.org/MyNurChat/archive/LDdownloads/Est_Prev_Autism_Spec_Cond_in_Adults_Report.pdf
    Type: Other
    Crossref
  12. Rachel Anastasia Coulter , Annette Bade , Yin Tea , Gregory Fecho , Deborah Amster , Erin Jenewein et al. (2015). Eye Examination Testability in Children with Autism and in Typical Peers . Optometry and Vision Science, 92(1), 31-43. Wiley.
    Type: Article DOI: 10.1097/opx.0000000000000442 OpenAlex: https://openalex.org/W2058161650
    Crossref OpenAlex OpenCitations
  13. 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
  14. Jonathan A. Weiss , Barry Isaacs , Heidi Diepstra , Andrew S. Wilton , Hilary K. Brown , Caitlin McGarry et al. (2018). Health Concerns and Health Service Utilization in a Population Cohort of Young Adults with Autism Spectrum Disorder . Journal of Autism and Developmental Disorders, 48(1), 36-44. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-017-3292-0 OpenAlex: https://openalex.org/W2754086730
    Crossref OpenAlex OpenCitations
  15. Ewelina Rydzewska , Laura Anne Hughes-McCormack , Christopher Gillberg , Angela Henderson , Cecilia MacIntyre , Julie Rintoul et al. (2019). Age at identification, prevalence and general health of children with autism: observational study of a whole country population . BMJ Open, 9(7), e025904. BMJ.
    Type: Article DOI: 10.1136/bmjopen-2018-025904 OpenAlex: https://openalex.org/W2960560295
    Crossref OpenAlex OpenCitations
  16. Megan K. Tregnago , Nancy Cheak‐Zamora (2012). Systematic review of disparities in health care for individuals with autism spectrum disorders in the United States . Research in Autism Spectrum Disorders, 6(3), 1023-1031. Elsevier BV.
    Type: Article DOI: 10.1016/j.rasd.2012.01.005 OpenAlex: https://openalex.org/W2073477850
    Crossref OpenAlex OpenCitations
  17. Laura Hull , Will Mandy (2017). Protective Effect or Missed Diagnosis? Females with Autism Spectrum Disorder . Future Neurology, 12(3), 159-169. Informa UK Limited.
    Type: Article DOI: 10.2217/fnl-2017-0006 OpenAlex: https://openalex.org/W2745090619
    Crossref OpenAlex OpenCitations
  18. Ketan R. Parmar , Emma Gowen , Christine M. Dickinson , Catherine S. Porter (2020). Investigating optometric and orthoptic conditions in autistic adults: Pre-registration of methods and analysis plan . Zenodo (CERN European Organization for Nuclear Research). Zenodo.
    Type: Other DOI: 10.5281/zenodo.3775441 OpenAlex: https://openalex.org/W6969059604
    Crossref OpenAlex OpenCitations
  19. Eric P. Hazen , Jennifer L. Stornelli , Julia A. O’Rourke , Karmen Koesterer , Christopher J. McDougle (2014). Sensory Symptoms in Autism Spectrum Disorders . Harvard Review of Psychiatry, 22(2), 112-124. Ovid Technologies (Wolters Kluwer Health).
    Type: Article DOI: 10.1097/01.hrp.0000445143.08773.58 OpenAlex: https://openalex.org/W2089516943
    Crossref OpenAlex OpenCitations
  20. Amal M Hussein , Elizabeth Pellicano , Laura Crane (2019). Understanding and awareness of autism among Somali parents living in the United Kingdom . Autism, 23(6), 1408-1418. SAGE Publications.
    Type: Article DOI: 10.1177/1362361318813996 OpenAlex: https://openalex.org/W2903036379
    Crossref OpenAlex OpenCitations
  21. Brittany N. Hand , Amber M Angell , Lauren Harris , Laura Arnstein Carpenter (2020). Prevalence of physical and mental health conditions in Medicare-enrolled, autistic older adults . Autism, 24(3), 755-764. SAGE Publications.
    Type: Article DOI: 10.1177/1362361319890793 OpenAlex: https://openalex.org/W2990129335
    Crossref OpenAlex OpenCitations
  23. 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
  25. Lisa A. Croen , Ousseny Zerbo , Yinge Qian , Maria L Massolo , Steve Rich , Stephen Sidney et al. (2015). The health status of adults on the autism spectrum . Autism, 19(7), 814-823. SAGE Publications.
    Type: Article DOI: 10.1177/1362361315577517 OpenAlex: https://openalex.org/W2108322879
    Crossref OpenAlex OpenCitations
  26. Se-Jin Kim , Jeonggu Sim , Hyojin Kim (2020). Effects of the Communication and Professional Technical Skills of Optometrists on Customer Satisfaction . Journal of Korean Ophthalmic Optics Society, 25(3), 219-225. The Korean Opthalmic Optics Society.
    Type: Article DOI: 10.14479/jkoos.2020.25.3.219 OpenAlex: https://openalex.org/W3091881394
    Crossref OpenAlex OpenCitations
  27. Francisca J. A. van Steensel , Susan M. Bögels , Sean Perrin (2011). Anxiety Disorders in Children and Adolescents with Autistic Spectrum Disorders: A Meta-Analysis . Clinical Child and Family Psychology Review, 14(3), 302-317. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10567-011-0097-0 OpenAlex: https://openalex.org/W2138006810
    Crossref OpenAlex OpenCitations
  28. Mark Dusheiko , Hugh Gravelle (2018). Choosing and booking—and attending? Impact of an electronic booking system on outpatient referrals and non‐attendances . Health Economics, 27(2), 357-371. Wiley.
    Type: Article DOI: 10.1002/hec.3552 OpenAlex: https://openalex.org/W2273279986
    Crossref OpenAlex OpenCitations
  29. Lydia Luke , Isabel C.H. Clare , Howard Ring , Marcus Redley , Peter Watson (2012). Decision-making difficulties experienced by adults with autism spectrum conditions . Autism, 16(6), 612-621. SAGE Publications.
    Type: Article DOI: 10.1177/1362361311415876 OpenAlex: https://openalex.org/W2153940389
    Crossref OpenAlex OpenCitations
  30. Ewelina Rydzewska , Laura A. Hughes-McCormack , Christopher Gillberg , Angela Henderson , Cecilia MacIntyre , Julie Rintoul et al. (2019). General health of adults with autism spectrum disorders – A whole country population cross-sectional study . Research in Autism Spectrum Disorders, 60(April 2019), 59-66. Elsevier BV.
    Type: Article DOI: 10.1016/j.rasd.2019.01.004 OpenAlex: https://openalex.org/W2912237256
    Crossref OpenAlex OpenCitations
  31. Matthew Hollocks , Jian Wei Lerh , Iliana Magiati , Richard Meiser-Stedman , Traolach Brugha (2019). Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis . Psychological Medicine, 49(4), 559-572. Cambridge University Press (CUP).
    Type: Article DOI: 10.1017/s0033291718002283 OpenAlex: https://openalex.org/W2889987209
    Crossref OpenAlex OpenCitations
  32. Rini Vohra , Suresh Madhavan , Usha Sambamoorthi (2016). Emergency Department Use Among Adults with Autism Spectrum Disorders (ASD) . Journal of Autism and Developmental Disorders, 46(4), 1441-1454. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-015-2692-2 OpenAlex: https://openalex.org/W2233466805
    Crossref OpenAlex OpenCitations
  34. Sebastian Dern , Tanja Sappok (2016). Barriers to healthcare for people on the autism spectrum . Advances in Autism, 2(1), 2-11. Emerald.
    Type: Article DOI: 10.1108/aia-10-2015-0020 OpenAlex: https://openalex.org/W2295529484
    Crossref OpenAlex OpenCitations
  35. Ousseny Zerbo , Yinge Qian , Thomas Ray , Steve Sidney , Steve Rich , Maria L Massolo et al. (2019). Health Care Service Utilization and Cost Among Adults with Autism Spectrum Disorders in a U.S. Integrated Health Care System . Autism in Adulthood, 1(1), 27-36. SAGE Publications.
    Type: Article DOI: 10.1089/aut.2018.0004 OpenAlex: https://openalex.org/W2802980590
    Crossref OpenAlex OpenCitations
  36. Kirsti Malterud , Volkert Dirk Siersma , Ann Dorrit Guassora (2016). Sample Size in Qualitative Interview Studies . Qualitative Health Research, 26(13), 1753-1760. SAGE Publications.
    Type: Article DOI: 10.1177/1049732315617444 OpenAlex: https://openalex.org/W2305278139
    Crossref OpenAlex OpenCitations
  37. Beate Krieger , Barbara Piškur , Christina Schulze , Uta Jakobs , Anna Beurskens , Albine Moser (2018). Supporting and hindering environments for participation of adolescents diagnosed with autism spectrum disorder: A scoping review . PLOS ONE, 13(8), e0202071. Public Library of Science (PLoS).
    Type: Article DOI: 10.1371/journal.pone.0202071 OpenAlex: https://openalex.org/W2889155241
    Crossref OpenAlex OpenCitations
  38. Greg Guest , Emily Namey , Kevin McKenna (2017). How Many Focus Groups Are Enough? Building an Evidence Base for Nonprobability Sample Sizes . Field Methods, 29(1), 3-22. SAGE Publications.
    Type: Article DOI: 10.1177/1525822x16639015 OpenAlex: https://openalex.org/W2344333698
    Crossref OpenAlex OpenCitations
  39. Emma Gowen , Catherine S. Porter , Peter Baimbridge * , Kelvin Hanratty , James Pelham , Christine M. Dickinson (2017). Optometric and orthoptic findings in autism: a review and guidelines for working effectively with autistic adult patients during an optometric examination . Optometry Pract, 18(3), 145.
    Type: Article OpenAlex: https://openalex.org/W2767382037
    Crossref OpenAlex
  42. (n.d.). SeeAbility. Resources [internet]. SeeAbility;2019. [Accessed 14 March 2022]. https://www.seeability.org/resources?resource_specialism=52
    Type: Other
    Crossref
  44. (n.d.). National Autistic Society. A guide for eyecare professionals – working with autistic children. National Autistic Society;2020. [Accessed 14 March 2022]. https://www.autism.org.uk/advice‐and‐guidance/topics/physical‐health/going‐to‐the‐opticians/professionals
    Type: Other
    Crossref
  45. Virginia Braun , Victoria Clarke (2021). To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales . Qualitative Research in Sport, Exercise and Health, 13(2), 201-216. Informa UK Limited.
    Type: Article DOI: 10.1080/2159676x.2019.1704846 OpenAlex: https://openalex.org/W2996597775
    Crossref OpenAlex OpenCitations
  46. (n.d.). The College of Optometrists. Examining patients with autism. The College of Optometrists;2021. [Accessed 14 March 2022]. https://www.college‐optometrists.org/clinical‐guidance/guidance/knowledge ‐skills‐and‐performance/examining‐patients‐with‐autism
    Type: Other
    Crossref
  47. Philipp Mayring (2014). Qualitative content analysis: theoretical foundation, basic procedures and software solution .
    Type: Book OpenAlex: https://openalex.org/W2560150188
    Crossref OpenAlex
  48. Shenae Calleja , Fakir M. Amirul Islam , Jonathan Kingsley , Rachael McDonald (2020). Healthcare access for autistic adults . Medicine, 99(29), e20899. Ovid Technologies (Wolters Kluwer Health).
    Type: Article DOI: 10.1097/md.0000000000020899 OpenAlex: https://openalex.org/W3043350455
    Crossref OpenAlex OpenCitations
  49. Dawn Adams , Kate Young (2021). A systematic review of the perceived barriers and facilitators to accessing psychological treatment for mental health problems in individuals on the autism spectrum. Review Journal of Autism and Developmental Disorders, 8(4), 436-453. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s40489-020-00226-7 OpenAlex: https://openalex.org/W3094212365
    Crossref OpenAlex OpenCitations
  50. Youssra Saqr , Erika Braun , Kyle Porter , Debra Barnette , Christopher Hanks (2018). Addressing medical needs of adolescents and adults with autism spectrum disorders in a primary care setting . Autism, 22(1), 51-61. SAGE Publications.
    Type: Article DOI: 10.1177/1362361317709970 OpenAlex: https://openalex.org/W2740604847
    Crossref OpenAlex OpenCitations
  51. Rae Morris , Andrea Greenblatt , Michael Saini (2019). Healthcare Providers’ Experiences with Autism: A Scoping Review . Journal of Autism and Developmental Disorders, 49(6), 2374-2388. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-019-03912-6 OpenAlex: https://openalex.org/W2911241604
    Crossref OpenAlex OpenCitations
  52. Lemmi V (2017). The autism dividend . The autism dividend.
    Type: Other
    Crossref
  53. Durand MA (2014). Principles of social research . Principles of social research.
    Type: Other
    Crossref
  54. Maguire M (2017). Doing a thematic analysis: a practical, step‐by‐step guide for learning and teaching scholars. All Ireland . J Higher Educ, 9, 3351.
    Type: Other
    Crossref
  55. Mike Allen (2017). The SAGE Encyclopedia of Communication Research Methods . SAGE Publications, Inc.
    Type: Other DOI: 10.4135/9781483381411 OpenAlex: https://openalex.org/W4229766132
    Crossref OpenAlex OpenCitations
  56. Mauch D (2011). Report on state services to individuals with autism spectrum disorders (ASD) . Report on state services to individuals with autism spectrum disorders (ASD), 53.
    Type: Other
    Crossref
  57. Christou E (2016). A Spectrum of Obstacles: an enquiry into access to healthcare for autistic people . A Spectrum of Obstacles: an enquiry into access to healthcare for autistic people.
    Type: Other
    Crossref
  58. Sotirios Sarantakos (2013). Principles of social research . In Social Research (pp. 88-115). Macmillan Education UK.
    Type: Book chapter DOI: 10.1007/978-1-137-29247-6_4 OpenAlex: https://openalex.org/W4214723677
    OpenAlex
  59. (n.d.). NHS. Overview ‐ generalised anxiety disorder in adults. NHS;2018; [Accessed 14 March 2022]. https://www.nhs.uk/mental‐health/conditions/generalised‐anxiety‐disorder/overview/
    Type: Other
    Crossref
  60. (1950). INTERNATIONAL STATISTICAL CLASSIFICATION OF DISEASES . Medical Journal of Australia, 1(6), 193-194. AMPCo.
    Type: Article DOI: 10.5694/j.1326-5377.1950.tb80156.x OpenAlex: https://openalex.org/W4255135512
    OpenAlex
  61. Academic Autistic Spectrum Partnership in Research , Education (2021). AASPIRE Healthcare Toolkit . AASPIRE Healthcare Toolkit.
    Type: Other
    Crossref
  62. NHS England (2017). Accessible information standard – overview 2017/2018 . Accessible information standard – overview 2017/2018.
    Type: Other
    Crossref
  63. Mirsky LB (2018). Caring for patients with autism spectrum disorders . Decis Dent, 4, 47.
    Type: Other
    Crossref
  64. Kim C. (2014). Accessible health care for autistic adults . Accessible health care for autistic adults.
    Type: Other
    Crossref